OVer the past couple of weeks I’v had a similar conversation with a number of San Diego long term HIV survivors. The majority of People Living with HIV (PLWH) in San Diego are over 50 and and an increasing number are over 60. This has many of these folks, either on disability or as they age, receiving medical care through the Medicare programs. Many have chosen Medicare part C, or a Medicare Advantage Plan. Part of the reason for this is cost, as these programs tend to keep out of pocket costs low, and many aging PLWH are on limited income. Another factor is that many are HMO plans which eliminate the hassle of dealing with in/out of network issues, high deductibles and co-pays. A lot of these folks reside in or near the Hillcrest hub of the LGBTQ+ community, and so the proximity to Scripps was a major deciding factor in choosing to get their care there, and the care is good. Kaiser also provides good HIV care, but has no facilities that are easy to get to from Hillcrest if you rely on public transportation. UCSD or a small number of private practice physicians are available as well, but can they readily absorb all of the people now leaving Scripps? The alternatives that Scripps is offering are reportedly more costly to patients than their previous plans, with all of the complexity of standard Medicare supplemental and the challenge in getting medication coverage for pre-existing conditions.
I am disappointed in Scripps for essentially abandoning this and other communities of aging San Diegans and hope to see them help to place their former patients and ensure continuity of care.