Anthem, SCAN To Cease MA Plan Coverage for 140,000 Beneficiaries

More than 140,000 elderly California residents will have to find new Medicare Advantage plans, according to industry and government officials, Payers & Providers reports.

Anthem Blue Cross of California and SCAN Health Plan are terminating coverage under certain plans because of government mandates and business reasons.

Changes for Anthem Policyholders

Anthem has decided to shut down its MA Freedom Blue plan, which offered coverage through a PPO. The move affects about 110,500 beneficiaries.

Darrel Ng, a spokesperson for Anthem, said the "decision to discontinue the plan was made after evaluating the changes to the benefits, the pricing and the regulatory approval needed to make this plan financially viable in 2012 and beyond."

Ng added that beneficiaries can enroll in other Anthem MA plans and that their enrollment period has been extended to Feb. 28, 2012.

Changes for SCAN Policyholders

SCAN must drop about 30,000 policyholders from its Healthy at Home plan because of a change in Medicare regulations.

The plan covered individuals who have chronic conditions. As a non-exclusive plan, it could enroll people who did not have special needs as long as the total number did not exceed certain percentages.

However, the Medicare Improvements for Patients and Providers Act of 2008 barred non-exclusive plans beginning in January 2012.

Sherry Stanislaw, a SCAN spokesperson, said that affected policyholders could enroll in another SCAN plan, another MA plan or choose fee-for-service coverage.

Affected beneficiaries also have until the end of February to select another plan (Payers & Providers, 10/20).