California Medicare Options - How to get Scripps now with Medicare

How to Get Scripps if you have Medicare

Many seniors got a nasty update from Scripps recently. They were fine on Advantage plans and seeing their favorite doctors but starting in 2024, that has ended.

Essentially, Scripps has decided to stop all relationships with Advantage plans.

They will only work with Traditional Medicare (Part A and B). We may be able to wrap a Medicare supplement and Part D around this.

Let's walk through the mechanics of it as it's a little tricky.

Of course, we're happy to help you with any questions and here's our reviews;

Here are the topics we'll cover:

• Scripps stops working with Advantage plans
• How to switch back to Medicare for Scripps
• Adding a Medicare supplement and Part D plan to stay with Scripps
• Quote Medicare supplements and Part D to keep Scripps

Let's get started.

Scripps stops working with Advantage plans

So...effective Jan 1st (recent Open Enrollment), Scripps will no longer work with Advantage plans.

Let's explain this in more detail.

There are two paths with Medicare:

• Traditional Medicare with or without a supplement and Part D (medication)
• Advantage plans

In the latter, Medicare literally turns over funding and control over to a private carrier to administer health care.

In the former, Medicare acts like an 80/20 plan with deductibles built in.

Learn all about the basics of Medicare here.

They are completely different systems. We compared Medicare Advantage plans and supplements here.

So...the people affected by Scripps notification are on Advantage plans by default. People with traditional Medicare are not impacted.

What are your options?

You either have to change providers (different from Scripps) or you have to go back to traditional Medicare and ideally wrap it in a supplement/Part D.

Technically, we could also look at a PPO Advantage plan and use the out-of-network benefits which are not as rich. You can quote these below.

It really comes down to whether you really want to stay with Scripps.

There's a cost consideration as Medicare supplements tend to be more expensive monthly but you may have less out of pocket when sick or hurt...especially if you have big health care costs.

Check out the trade-off between Advantage plans and Supplements.

You can quote other Advantage plans below to use with different providers (Sharp, UCSD, etc) and/or PPO plans that will allow you to continue with Scripps. You'll also have access to Medigap (supplement) quotes.

If you absolutely must stay with Scripps, let's investigate this now.

How to switch back to Medicare for Scripps

If you have an Advantage plan now, we have to release it and go back to traditional Medicare (Part A and B).

The timing on this is tricky.

You can release your Advantage plan during the first 3 months of the year if you're not happy. Potentially, you may be able to do so if you were in a course of treatment with a provider (Scripps) and the Advantage plan stopped working with the provider.

That's our best bet but the trickier part is the next step because we don't want Medicare by itself since there's a 20% coinsurance we have to pay with no cap!

Let's talk about the supplement.

Adding a Medicare supplement and Part D plan to stay with Scripps

If we're in good health, this is probably not an issue. Medicare supplements are medically underwritten (can be declined) once we get outside of special enrollment windows).

There are some special triggers we can look at though:

• New to Medicare (Part B)
• Recently lost group health coverage
• Tried Advantage plan first time within 12 months

The more promising one has to do with being in a course of treatment (with Scripps) which is involuntarily cut off (stops working with Advantage plan).

Ideally, we want to apply for the Medicare supplement/Part D and get a confirmation back before officially losing our Advantage plan.

We don't want a declination after canceling Advantage plan to find we have no coverage!

We can help with this process. Let's look at the rates first since that can be a deciding factor.

Quote Medicare supplements and Part D to keep Scripps

You can quote Medicare supplements here:

The supplements are standardized so a G plan is a G plan (see why the G plan is the most popular). Learn how to compare Medicare Supplement plans.

It then becomes a question of cost and rate stability.

We can help coordinate the whole process with the existing Advantage plan at help@calhealth.net or schedule a chat: https://calendly.com/dennis-jnw

As for Part D, a few quick tips.

You can quote Part D (for Medication) here.

Make sure to enter your prescriptions, dosages, and preferred pharmacy. Sort by "Total Estimated Cost" which takes into account both monthly premium and copays.

We can do this all for you at no cost to you. Just need date of birth, zip code, and current plan.

We'll see if this is the beginning of a trend with major health care providers and Advantage plans.

Scripps is a major player in the greater San Diego area and we were quite surprised by the move.

As were thousands of members.