LONG BEACH, CA, UNITED STATES, November 21, 2022 /EINPresswire.com/ — SCAN Health Plan, the award-winning Medicare Advantage insurer known for its expertise in keeping older adults healthy and independent, is expanding SCAN Connections (HMO SNP), California’s only Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP), into San Diego County, effective January 1, 2023. SCAN Connections is currently offered in Los Angeles, Riverside and San Bernardino Counties.
Nearly 20% of the nation’s older adults with low incomes and people with disabilities who receive health care coverage from both Medicare and Medicaid (also known as Dual Eligible) reside in the state of California. And in San Diego County, there are nearly 80,000 people who qualify as Dual Eligibles.
“Not only is SCAN Connections California’s first FIDE SNP since launching in 2008, but we continue to be the only FIDE SNP in the state,” said Dr. Sachin Jain, president and CEO of SCAN Group and SCAN Health Plan. “For more than 14 years we’ve been simplifying healthcare for our highest-needs members. We help navigate their benefits, coordinate their complex care needs and improve their health outcomes while keeping them home and out of nursing facilities.”
Jain noted that members enrolled in SCAN Connections have 15% lower acute utilization rates compared to high-need complex members who are not enrolled in a FIDE-SNP. And 99% of Connections members live in the community (meaning they’re not in facilities), compared to 88% of Medicare recipients nationwide.
As the name implies, a FIDE-SNP fully integrates both sets of benefits—Medi-Cal and Medicare—into one comprehensive health plan for easy and convenient access to care and coverage.
In addition to the robust benefits offered through SCAN’s Medicare Advantage plans, SCAN Connections member benefits include:
• $0 copays for all prescription drugs*
• $500 vision annually and $175 Over the Counter (OTC) per quarter
• No-cost access to virtual behavioral health services
• $50 per quarter food benefit cards**
• Dental coverage, transportation, and in-home caregiving services
State and Federal Changes Impact Duals in 2023
At the federal level, The Centers for Medicare and Medicaid Services (CMS) are sunsetting the Dual Eligible Special Needs Plan (D-SNP) look-alike plans that have approximately 120,000 dual-eligible members in California. These plans will sunset on 12/31/2022, leaving many older adults searching for coverage.
At the state level, the Cal MediConnect program, which currently covers 230,000 older adults, is changing at the end of this year. These members will be automatically moved to a different plan type. This “dual disruption” presents an opportunity for these older adults to choose a better option: a FIDE-SNP.
“These industry changes put SCAN in a prime position to provide our integrated care model to more dual-eligible older adults,” said Eve Gelb, SCAN’s senior vice president of duals. “Our successful results reflect our network of quality providers who are dedicated to serving this population. And every Connections member has access to a personal assistance team specially trained in the complexities of Medi-Cal and Medicare in order to help them navigate their robust benefits to full advantage.”
*$0 copay for prescription drugs provided as part of the Value-Based Insurance Design (VBID) program.
**Food benefits card offered as part of a special supplemental program for the chronically ill. Not all members qualify.
About SCAN Health Plan
SCAN Health Plan is one of the nation’s largest not-for-profit Medicare Advantage plans, serving more than 270,000 members across California, Nevada, Arizona, and in 2023, Texas. Since its founding in 1977, SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent. Independence at Home, a SCAN community service, provides vitally needed services and support to seniors and their caregivers regardless of plan membership. SCAN also offers educational programs, community funding and other community services throughout our service areas. To learn more, visit scanhealthplan.com or follow us on Twitter @scanhealthplan.
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