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My goal with this newsletter is to:
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1
Keep You Informed
I will be sharing current articles about the changes in Medicare.
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2
Answer Your Questions
I'm available to answer issues specific to you.
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3
Stay Connected
I want to make Medicare coverage as simple as possible.
(858) 935-9120
Referrals
- Mark S referred Carole S
- Leen G referred Claudio M
- Brad C referred Mark S
We try hard to recognize every referral but if we missed anyone, please let us know.
Just send us a quick email so that we can acknowledge you. We want all of you to know that it is our privilege to serve you.
The greatest compliment you pay us is the referral of your family and friends. Thank you!!!
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Hello Friends!! And Happy Fall!! I hope you are well 😊
In addition to my newsletter, I am also sharing useful and timely Medicare information on my social media sites. So, if you haven't already…
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Below are updates and reminders related to the medical groups and the corresponding plans available here in San Diego, CA.
If you live outside of San Diego and have questions about your plan and wonder if it is still the best option in your area, please visit my website, click on Contact and schedule a phone appointment with me for a review.
SCRIPPS CLINIC and SCRIPPS COASTAL
Scripps Clinic and Scripps Coastal are NOT accepting ANY Medicare Advantage HMO plans. However, they will accept Medicare Advantage PPO plans or Medicare Supplement plans
It is IMPORTANT to understand that with a PPO plan you will have IN-Network doctors and services with lower copays and a lower Maximum Out of Pocket. The OUT-of-Network doctors and services will have higher copays and a considerably higher Maximum Out of Pocket.
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The copays MAY be a fixed dollar amount, so you will know what you owe. But for many of the Out-of-Network services, your portion will be a PERCENTAGE of the cost of the service. For example, if you see your Scripps doctor (which will be OUT-of- Network on ALL PPO plans in 2025), and he/she refers you to get an MRI or have an Outpatient Surgery, your copay is 40%. But the question is ... 40% of what?? The doctor is not going to be able to tell you what the full cost of the MRI or Outpatient Surgery is, and most likely will not refer you to an IN-Network medical group to have it done at the lower copay. Also, your OUT-of-Network Maximum Out of-Pocket is probably going to be in the $8,900 - $10,000 range. If you have to have access to Scripps Clinic or Coastal doctors and have a Medicare Advantage PPO, you are going to need keep track of IN and OUTof-Network doctors, facilities, services and copayments.
SHARP COMMUNITY, SHARP REES STEALY and PALOMAR HEALTH
If you are seeing Sharp Rees Stealy, Sharp Community or Palomar Health doctors, and currently have the UnitedHealthcare Sharp Walgreens plan, which is changing its name to the UnitedHealthcare Sharp Value RX plan, this plan will remain relatively the same for most copays. What will be changing are some of the additional benefits:
- The vision allowance for frames is being reduced to $300 every TWO years.
- The $1,500 comprehensive dental coverage is going away. Instead, you will have preventative dental coverage (2 exams, x-rays and cleanings per year at $0 copay). You have the option to add an additional HMO dental rider to this plan for $54/month.
- There will be a $175 Part D deductible, where there was no deductible before.
- The transportation benefit is going away.
The only reason I would suggest you make a move from this plan is if you really relied on the transportation benefit.
UCSD MEDICAL GROUP
If you currently are using UCSD doctors, you probably have either the SCAN Alta plan or the Humana UCSD plan. Both are great plans, however, if you are new to Medicare or trying to switch from another medical group to UCSD Medical Group, we cannot enroll you in the SCAN Alta plan, as UCSD has put a hold on taking any new patients with the SCAN plan.
However, we can enroll you in the Humana UCSD plan, and that will get you to see UCSD doctors and use UCSD facilities/hospitals. If you already have the Humana UCSD plan or SCAN Alta plan, you do not need to do anything.
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