St. Joseph Health offers new health care plan for Sonoma County seniors

Sonoma County seniors now have a new health insurance option, a Medicare Advantage plan that has partnered with St. Joseph Health hospitals and affiliated medical providers.

The Senior Care Action Network, or SCAN, health plan is part of St. Joseph’s effort to compete with Kaiser’s longtime HMO and Sutter Health’s proposed health plan currently under state review.

The move comes two years after St. Joseph helped bring the commercial HMO Western Health Advantage to Sonoma County.

“We’re trying to cover the spectrum of all of our community members who are seeking price-competitive managed care health models,” said Todd Salnas, president of St. Joseph Health in Sonoma County.

A Medicare Advantage plan is a Medicare health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits.

Karen Sugano, SCAN’s general manager for Northern California, said the nonprofit HMO was started more than 35 years ago in the Long Beach area by a group of senior activists who were frustrated by the lack of access to services and support that could keep them healthy and independent.

The goal was to create a comprehensive, all-inclusive benefit plan that offered more benefits than traditional Medicare, including Part D drug coverage.

The nonprofit SCAN is available in California and Arizona. This year, the plan will be available in Marin, San Francisco, Sonoma County, San Joaquin and Napa counties.

“We’ve had a big splash in Sonoma,” Sugano said, adding that its members, who began enrolling in the fall, now number in the “thousands.”?Sugano said one of SCAN’s missions is to keep seniors out of institutions and inside their homes.

“We help provide services that help keep them there,” she said.

That includes managing a team of nurses, health care providers and physicians through the Meritage Medical Network, which also partners with St. Joseph Health.

“We case-manage the members that are sick,” she said.

SCAN offers three benefit plans:

Classic, which includes comprehensive preventive and hospital care, as well as prescription drug coverage.

Balance, for Medicare patients who are diagnosed with diabetes.

Heart First, for Medicare patients diagnosed with cardiovascular disorder or chronic or congestive heart failure.

Salnas said the health plan is “priced competitively” to compete with Kaiser and allows local seniors to access health care providers who partner with St. Joseph Health, such as Annadel Medical Group.

Sutter Health, which announced late in 2014 that it this year would be marketing its own HMO plan, Sutter Plus, does not offer a Medicare Advantage plan.

Salnas said SCAN’s mission closely matched that of St. Joseph, to “care for the more complex patient population.” He said SCAN hews close to the spirit of its origins, with strong programs in place to manage care for its aging members.

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.