SAN RAFAEL -- Long Beach-based SCAN Health Plan, a not-for-profit Medicare Advantage carrier, announced it will expand into Marin County, where it will partner with Marin General Hospital and the Meritage Medical Network.
Starting Jan. 1, 2014, SCAN -- short for Senior Care Action Network -- will offer three different Medicare Advantage plans for Marin County seniors. It already operates in San Francisco, Contra Costa, Santa Clara and San Joaquin counties along with eight counties in Southern California and Arizona.
“For more than 35 years, SCAN has been committed to providing services that enhance seniors’ ability to manage their health and to continue to control where and how they live,” Karen Sugano, SCAN’s general manager in Northern California, said in a statement. “As a result, we believe we bring a unique mission and an unmatched perspective to the more than 50,000 Medicare-eligible individuals in Marin County.”
Out of those 50,000 Medicare-eligible residents, Kaiser Permanente controls a significant market share, with roughly 17,000 members. Ms. Sugano said the primary motivation of expanding into Marin was to offer an alternative in California's oldest county.
"It's a neighboring county for us," Ms. Sugano said. "It seemed like a prime market with a need for a Medicare Advantage plan. Even with Kaiser's presence, she said, "it still left a very significant number of Medicare-eligible beneficiaries without an alternative."
Ms. Sugano said additional counties will be eyed for further expansion in Northern California."Every year we do take a look at additional counties," she said.
The Medicare health plan, the second largest not-for-profit Medicare Advantage plan in California, serves some 136,000 members in the state and about 13,000 in Arizona, according to Ms. Sugano. It entered the Northern California Market in 2010.
The provider network in Marin County will consist exclusively of 235-bed Marin General, along with its affiliates Prima Medical Foundation and Marin Healthcare District Centers, and Meritage Medical Network. SCAN members will have access to 50 primary care physicians and some 275 specialists through the network.
“Meritage Medical Network is very excited to bring enhanced benefits and services to Medicare beneficiaries in Marin County through the introduction of SCAN Health Plan”, Joel Criste, CEO of Meritage Medical Network, said in a statement. “Both Meritage and SCAN are committed to providing comprehensive, compassionate care and services to improve the health of seniors our community”.
SCAN said it will offer three health plans in Marin County -- the SCAN Classic (HMO), along with two "special needs" plans for those eligible and who have chronic conditions such as diabetes or cardiovascular disease. Annual enrollment for Medicare plans begins Oct. 15 and ends Dec. 7.
The health plan has 25 employees in its Northern California operation, which is based in San Bruno. All told, SCAN employees some 1,000 in Southern California and Arizona. In Marin County, SCAN will deploy sales and broker representatives.
Last year, the health plan agreed to the largest-ever settlement with the state Department of Health Care Services, totaling $327 million, for over payments from Medi-Cal, according to California Watch, a part of Berkeley-based The Center for Investigative Reporting.