SCAN and Optum SDPMG Part Ways January 1: What San Diego Members Need to Know

If you have a SCAN Medicare Advantage plan and your doctor is with Optum Care Network–SDPMG, you may have received a letter from SCAN this week. Starting January 1, 2027, SCAN and Optum SDPMG will no longer work together in San Diego. The two sides were unable to reach a contract agreement.

This change can feel confusing, especially with Annual Enrollment starting October 15. The good news is that you have options, and you have time to use them. Here's what's happening and how to decide what's right for you.

What's changing

Optum Care Network–SDPMG will leave SCAN's San Diego provider network effective December 31, 2026. SCAN has also closed SDPMG doctors to new SCAN enrollments, effective immediately.

If the name SDPMG doesn't sound familiar, you may know this group by its former name, Scripps Physicians Medical Group. It's a large network of independent primary care doctors and specialists with small offices across San Diego County, from North County to the South Bay.

Who is (and isn't) affected

You're affected if: you're enrolled in a SCAN Medicare Advantage plan and your primary care doctor is assigned to Optum Care Network–SDPMG. Your SCAN member ID card or member portal shows your medical group.

San Ysidro Health patients, check your medical group. Many San Ysidro Health patients with Medicare Advantage are assigned to Optum SDPMG. If you're on a SCAN plan and get your care at San Ysidro Health, look at your member ID card or call SCAN Member Services to confirm which medical group you're in. If it's Optum SDPMG, this change affects you.

You're not affected if: your SCAN medical group is Optum Care North County SD or Optum Care North County SD Encinitas. Both North County groups remain in SCAN's network.

This isn't about Scripps hospitals or Scripps Health's own medical groups. This change involves the Optum SDPMG medical group's contract with SCAN. If you aren't sure which group your doctor belongs to, call your doctor's office and ask.

What happens if you do nothing

If you stay on your SCAN plan, SCAN will automatically move you to a different medical group for 2027. SCAN says it will keep your current primary care doctor if that doctor is also available in the new group. If your doctor isn't, you'll be assigned a new one.

You can change your assigned doctor at any time through the "Manage Care" tab in your SCAN member portal, or by calling SCAN Member Services at (800) 559-3500 (TTY: 711).

Your two main paths

Path 1: Stay with SCAN and accept a new medical group. This can make sense if you like your SCAN plan's benefits, costs, and drug coverage more than you're attached to your current doctors. Before you decide, check that the new group includes the specialists you see and works with the hospitals you'd want to use.

Path 2: Keep your Optum SDPMG doctors by switching plans. If keeping your doctor matters most, you can switch to a different Medicare Advantage plan that works with Optum SDPMG for 2027. Carriers whose plans have worked with this group include UnitedHealthcare, Alignment Health Plan, Humana, Anthem Blue Cross, Blue Shield of California, and certain Aetna plans. Networks can change from year to year, though, so confirm your doctor is in-network on the specific 2027 plan before you enroll. A plan from the same carrier isn't automatically the right one.

SCAN is also offering its SCAN Costco Medicare Advantage plan as an alternative for affected members. That plan uses a different set of San Diego medical groups, so it only fits if your doctors are in one of those groups.

Key dates

• Week of October 12, 2026: SCAN begins mailing letters to affected members.
• October 15 – December 7, 2026: Annual Enrollment Period. This is your main window to switch plans for January 1.
• December 31, 2026: Optum SDPMG's last day in SCAN's network.
• January 1 – March 31, 2027: Medicare Advantage Open Enrollment Period. If you're in a Medicare Advantage plan, you can make one switch during this window. It's a backup if you miss AEP or change your mind.

Before you decide, check these four things

1. Your doctors. Call the office and ask, "Will you be in-network with [plan name] in 2027?" Don't rely only on online directories.
2. Your specialists. In an HMO, your medical group largely determines which specialists you can see.
3. Your hospitals. If being able to use Scripps Memorial or Scripps Mercy matters to you, confirm that the plan and medical group you choose work with them.
4. Your prescriptions. A new plan means a new drug list, so check every medication.

How I can help

This is exactly what I do every day. I'm an independent, licensed Medicare broker in San Diego County, and I work with UnitedHealthcare, Alignment, Humana, Anthem, Blue Shield, Aetna, SCAN, and other carriers. That means I can compare your options side by side without pushing you toward one company. My help costs you nothing.

If you got a letter from SCAN, or you're not sure whether this affects you, call me at (619) 947-2325 and we'll check your doctors, specialists, and prescriptions together before AEP closes on December 7.

Related reading: Sharp Health Plan's Medicare Advantage changes for 2027 · How Medicare HMOs and medical groups work in San Diego · San Diego hospitals and Medicare: which plans work where

Watson Insurance is an independent licensed insurance agency and is not affiliated with or endorsed by Sharp HealthCare, Sharp Health Plan, the federal Medicare program, or any government agency. Information is based on public reporting as of October 2026 and may change. Confirm details with your plan's official notice.

We do not offer every plan available in your area. Currently we represent 8 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.