Consumer / Employer, Payers

SCAN creates MA plan for LGBTQ+ seniors through partnership with Included Health

The health plan offered through SCAN includes care navigation services from Included Health, in which members can receive assistance in finding peer groups, support groups and community resources. Members can also receive virtual behavioral healthcare through Included Health.

About 2.4 million people aged 65 years and older in the U.S. identify as lesbian, gay, bisexual, transgender and queer (LGBTQ+), according to a report by the American Psychological Association. By 2030, that number will likely be even higher.

Yet, the LGBTQ+ community experiences unique health challenges, including discrimination against their sexual orientation and gender identity, the same report said. They’re also more likely to suffer physical and mental health conditions. 

Through a new partnership, SCAN Health Plan and Included Health are trying to change that by offering a Medicare Advantage plan called SCAN Affirm, which is specifically geared toward LGBTQ+ older adults. SCAN serves people in California, Arizona, Nevada and Texas, but Affirm is currently only available for members in California’s Los Angeles and Riverside counties, according to a news release. In the announcement last week, the insurer billed itself as the “first-ever” Medicare Advantage plan for the LGBTQ+ community. 

“What we are trying to do through this product is really create … a dignified health journey so that we can navigate them to a provider, to a medical group, to a system that acknowledges their lifestyle, their sexuality choice and gives them equal access to healthcare [compared] to anybody else,” said Jill Selby, senior vice president of product development and market expansion at SCAN, in an interview.

The health plan offered through SCAN will include care navigation services from Included Health, in which members can receive assistance in finding peer groups, support groups and community resources. The navigators also help with family dynamics, such as challenges like members’ children not understanding their lifestyle, Selby said. 

San Francisco-based Included Health will provide virtual behavioral healthcare as well. Seeking mental health services can be a challenge for the LGBTQ+ community as there is a lack of providers who understand their situation. But clinicians through Included Health are specifically trained to speak with LGBTQ+ members, according to Selby.

“There’s a series of licensed professionals, anyone from a psychiatrist down to a licensed social worker, and all of them are either LGBTQ community members themselves or they are highly affirming, clinically competent in the space,” Selby said. “So when they’re speaking to somebody, they’re either speaking to a peer in the community, or they’re speaking to someone who has spent time really understanding it.”

Members will also have lower co-pays on specialty tier drugs, such as HIV treatments and gender-affirming hormone treatment. Additionally, members have access to companion care services and reimbursement for legal services.

Selby said SCAN believes it is the first insurer to offer a Medicare Advantage plan specifically for LGBTQ+ members, although it is difficult to know for sure.

“It is not anything other than an average, ordinary Medicare Advantage plan, meaning it’s not a special needs plan where you can go in and filter the CMS data, like a diabetic plan,” she said. “I can tell you how many diabetic plans there are across the nation because they fall into subcategories … So it’s a little hard to tell, but I’ve worked in the industry for many, many years and to my knowledge, I have not seen anything like this.”

While she believes SCAN is the first, Selby added that she hopes the industry follows and creates more health plans for the LGBTQ+ community.

“They say copy-catting is the best form of flattery,” she said. “I expect that there will be other products like this in the 2024 benefit year.”

And with the open enrollment period for Medicare beginning only a few days ago, SCAN is already seeing people sign up for the Affirm plan. As of Monday, six people were enrolled, Selby said.

“These are people who went to the Medicare site to sign themselves up,” she said. “So they weren’t influenced by a face-to-face sales individual … To have six people 48 hours into the selling cycle go to the Medicare site and sign up for this product gives me confidence that this is a need.”

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