Sophie Exdell manages San Diego’s Health Insurance Counseling & Advocacy Program (HICAP), which helps beneficiaries make sense of the often-confusing changes that sometimes occur in Medicare.

She has monitored the changes underway in the Medicare Advantage program in which members of SCAN health plans are losing access to UC San Diego primary care doctors, a change that is forcing about 4,000 across the region to find new physicians. It is important, Exdell notes, for beneficiaries to know their rights in a situation such as this.

There are three facts to keep in mind as those who are directly affected try to decide whether they should change their coverage.

First, it pays to understand the assignment. Those with UCSD primary doctors will be assigned a new doctor in a medical group that is contracted with SCAN. All plan members should realize that they do not have to stick with the doctor that has been assigned. They can choose anyone in SCAN’s online or printed doctor directory.

Second, all should understand that the open enrollment period for all Medicare Advantage plans runs from Jan. 1 through March 31, 2026. So, there is no need to stick with SCAN. There are many advantage plans offered in San Diego County, and enrollees can just pick another. “During this period, until March 31, anyone who has a Medicare Advantage plan can change to any other type of coverage,” Exdell said.

Third, losing your primary care doctor entitles you to buy a “guaranteed issue” Medigap plan.

“In a situation like this, it’s in people’s best interests to know all of their options and, at this point, original Medicare with a Medigap is definitely a possibility due to guaranteed issue,” Exdell said.

Remember, there is an “original” version of Medicare out there that lets you see whatever doctor you wish. But that privilege comes with a major risk: you are on the hook for 20% of your medical bills, and that obligation has no limit. So a big bill can cause bankruptcy. People manage this risk by purchasing supplemental Medigap policies, but they can be denied coverage if they have a pre-existing condition.

Restoration of the guaranteed issue benefit blocks denials for those with existing medical problems. But, understand that Medigap plans can cost hundreds per month, and you’re also likely to need a supplemental “Part D” drug plan if you decide to rejoin original Medicare.

Email info-hicap@elaca.org to request HICAP’s comprehensive fact sheet on SCAN-UCSD changes.