New HMO Option for Area Seniors

Long Beach-based SCAN Health Plan is entering the Ventura County market, offering services in limited areas for seniors looking to supplement Medicare coverage, officials said.

More than 50,000 seniors in Camarillo, Fillmore, Oxnard, Santa Paula and Ventura will now be able to choose between two Medicare Advantage HMOs, potentially finding savings, said Katharine Raley, an insurance counselor for the county’s Area Agency on Aging.

“This is a good opportunity for Medicare beneficiaries,” she said.

However, Raley cautioned people to compare services carefully before switching coverage.

SCAN provides coverage for brand-name drugs, unlike Secure Horizons, the other health maintenance organization, she said.

But SCAN has a limited number of doctors in its network, and people switching from Secure Horizons may have to find new doctors, she said.

“It all depends on what type of health plan you need and what is most convenient for you,” she said.

SCAN’s plan, available since Monday, costs $30 a month; Secure Horizons charges a $55 monthly premium.

SCAN has contracts with two physician groups in western Ventura County: Buenaventura Medical and Valley Care. Combined, they provide more than 60 primary care physicians, said Sherry Stanislaw, SCAN vice president of marketing.

Hospitals affiliated with the plan are Community Memorial in Ventura, St. John’s Regional Medical Center in Oxnard and St. John’s Pleasant Valley in Camarillo.

Formed in 1977 as a nonprofit health plan serving seniors, SCAN provides coverage for nearly 70,000 Medicare beneficiaries in Los Angeles, Orange, Riverside and San Bernardino counties.

Stanislaw said the company has been looking at Ventura County for a couple of years, and hopes to expand services to Simi Valley and Moorpark in the near future. The company tentatively plans to add Thousand Oaks to its coverage area in 2006, Stanislaw said.

Those eastern Ventura County cities already have two HMO plans for seniors -- Universal Care and Kaiser -- Raley said. But more choice is beneficial for seniors, many of whom live on fixed incomes, she said.

The federal Centers for Medicare & Medicaid Services has processed more than 141 applications for new Medicare Advantage HMOs this year, officials said.

Federal officials say the proliferation of plans, spurred by Medicare reform legislation in 2003, will provide lower-cost coverage options for millions of older Americans.

Options in Ventura County have declined in recent years. In 2003, Blue Cross of California and Kaiser Permanente pulled out of western Ventura County. Company officials said there were not enough customers to justify coverage, especially with low reimbursements and rising medical costs.