Starting in 2025, UC San Diego Health (UCSD) is making notable changes to how it accepts Medicare Advantage (Part C) Plans. While the shift is not as sweeping as what Scripps did, it signals the same shift in the San Diego Medicare market: major hospitals are limiting what plans they will accept and encouraging our community to select Supplement Plans. There are key differences that Medicare beneficiaries need to understand. Below is a breakdown of the new landscape and what you can do about it.

What Changes are Coming to Medicare Beneficiaries at UCSD Health in 2026?

All Medicare Supplement (Medigap) Plans are still accepted at UCSD Health

If you switch from a Medicare Advantage Plan to Original Medicare plus a Supplement (Medigap) Plan, UCSD will continue to accept those Supplement Plans. They already accepted Supplements prior to these changes.

A Small Number of Advantage Plans Will Allow Specialist Visits and UCSD Health Hospital Access

UCSD will only accept a narrower set of Medicare Advantage HMO and PPO plans. Some of these will require you to select a PCP outside of UCSD (for example, at Perlman Clinic or One Medical) in order to retain access.

In those cases, UCSD will still provide specialty care or hospital-level services if you follow the network rules (referrals, authorizations) and choose the right PCP arrangement.

UCSD Health Will Grandfather Some Existing Advantage Plan Members

For those who are already in certain Medicare Advantage Plans that include UCSD, that access may be preserved meaning you’re not forced out immediately if your plan was previously accepted. But this “grandfathered” status depends on your specific plan and when changes were made. For example, some SCAN plans are grandfathered in for next year like SCAN Alta and SCAN Classic. Other Advantage Plans like the ones from Humana are not grandfathered in.  Members on these plans will be forced to find a new network of primary care doctors or select a Supplement Plan to continue visiting UCSD.

That said, going forward you may have fewer plans available that keep UCSD in-network. This isn’t the first time UCSD Health has limited which Advantage Plans they will accept. UCSD Health did a similar move last Annual Open Enrollment.  This is further evidence that UCSD Health is gearing towards getting rid of all Advantage Plans in the near future.  Those grandfathered into a SCAN plan that is accepted for 2026 is not guaranteed access for UCSD Health in 2027.

What Does This Mean for UCSD Health Medicare Patients

• If your current Advantage Plan is no longer accepted, you might lose access to your favorite UCSD physicians or hospital services unless you switch plans or convert to Original Medicare and a Supplement.

• If you remain in an Advantage Plan that requires you to use an outside PCP (e.g. Perlman Clinic or One Medical) in order to access UCSD, that means more coordination and careful referrals.

• For those grandfathered in, you get a bit of breathing room this coming year but that protection might not last forever. UCSD can stop accepting these SCAN Select and SCAN Classic plans any coming year.

• Always check with UCSD and your plan to verify whether your specific contract is accepted. UCSD maintains a list of accepted plans and encourages calls to their Medicare plan helpline.

Use Medicare’s Annual Open Enrollment Windows wisely

During Medicare’s Annual Open Enrollment (Oct 15 – Dec 7) and the Advantage Open Enrollment (Jan 1 – March 31), you have multiple opportunities to switch plans.

• Consider moving to Original Medicare with a Supplement Plan
  This gives you broader flexibility with providers, including full access to UCSD and Scripps.

• Talk to a San Diego Medicare Team like HealthyMarks Medicare
  Changes like this can be confusing. A Medicare broker (like HealthyMarks) can help you understand which plans maintain UCSD access, whether the PCP requirement fits your lifestyle, and whether you should switch now or later.

Why Work with HealthyMarks Medicare?

At HealthyMarks, we specialize in guiding Medicare beneficiaries through transitions like these. We can help you:

• Compare Medicare Advantage Plans that still provide UCSD access

• Evaluate the costs and benefits of switching to a Supplement

• Understand your PCP, referral, and authorization responsibilities

• Make sure you’re covered without losing access to UCSD’s facilities and specialists

If you’d like assistance in navigating this, don’t hesitate to reach out to HealthyMarks. We’re here to help you preserve the care you need, with minimal disruption.