More Medicare Advantage organizations are developing customized plans for patients with special needs, including for those who may need palliative care or are nearing the end of life.
SCAN Health Plan recently launched a new special needs plan designed to serve older adults who have multiple chronic conditions, as well as an additional plan oriented around women’s specific health needs. A program to address the needs of the LGBTQ+ community launched earlier this year and has since expanded.
These actions reflect a broader trend among insurance plans that are increasingly creating customized benefits designed for specific populations, according to Dr. Sachin Jain, CEO of SCAN Group, the health plan’s parent company.
“Women, for example, oftentimes have different kinds of health care experiences than men, and we’re trying to acknowledge those things,” Jain told Hospice News. “A broader trend to pay attention to is the fact that there’s a growing number of plans that are focused on customizing to different populations.”
AARP research shows that nearly two-thirds of women age 50 or older have been discriminated against or have had their health issues downplayed or dismissed. Gender disparities also exist when it comes to end-of-life and palliative care, a 2023 study in the Journal of Palliative Care found.
“Some of these differences arise from deeply rooted gender norms and roles that society has traditionally deemed acceptable despite their embedded inequities, creating disparities between women and men in terms of place of death, amount and type of support offered, likelihood of accepting palliative care, or experiences of symptoms such as fatigue, and caregiver burnout,” researchers indicated.
The new women’s health plan, branded as SCAN Inspired, is launching California’s Orange County and Los Angeles County in partnership with Cedars-Sinai Medical Center. Members of the plan have access to women’s health advocates, wellness programs and zero-cost estrogen therapy.
The multi-condition special needs plan is available in 13 counties in California, Arizona, Nevada and Texas. Patients enrolled in the plan will have no copays for medications and will be able to access transportation and in-home caregiving benefits, as well as virtual behavioral health services.
Meanwhile, SCAN Affirm, a plan offered in partnership with the Included LGBTQ+ Health HMO, is expanding to a total of five California counties, up from two. The program launched earlier this year. Several of SCAN’s existing special needs plans will also expand to new markets next year.
As of 2024, SCAN will reduce members’ costs for 13 medications to between $0 and $11 for a month’s supply. The move preempts new policies by the Biden Administration that do not take effect until 2026. Among the 13 drugs are common treatments for stroke prevention, diabetes and heart failure that have no generic alternatives.
“At SCAN, listening to the needs of older adults and meeting those needs through our Medicare Advantage benefits is always our priority,” Karen Schulte, president of Medicare for SCAN Health Plan, said in a statement. “This year, with the cost of living and the cost of health care continuing to rise, we’re offering benefits that make health and well-being affordable and accessible.”