As Medicare Advantage continues to gain popularity among seniors, three Southern California companies are pioneering new types of plans that target cultural and ethnic communities with special offerings and native-language practitioners.
, based in Huntington Beach, and , based in nearby Orange, both have plans aimed at Asian Americans, with extra benefits including coverage for Eastern medicines and treatments such as cupping and tui na massage. Alignment also has an offering targeting Latinos, while Long Beach-based has a product aimed at the LGBTQ+ community. All of them have launched since 2020.
While many Medicare Advantage providers target various communities with their advertising, this trio of companies appear to be among the first in the nation to create plans with provider networks and benefits designed for specific cultural cohorts. Medicare Advantage is typically cheaper than traditional Medicare but generally requires patients to use in-network providers.
鈥淭his fits me better,鈥� said Clever Care member Tam Pham, 78, a Vietnamese American from Westminster, California. Speaking to 黑料吃瓜网 News via an interpreter, she said she appreciates the dental care and herbal supplement benefits included in her plan, and especially the access to a Vietnamese-speaking doctor.
鈥淚 can always get help when I call, without an interpreter,鈥� she said.
Proponents of these new culturally targeted plans say they can offer not only trusted providers who understand their patients鈥� unique context and speak their language, but also special products and services designed for their needs. Asian Americans may want coverage for traditional Eastern treatments, while LGBTQ+ patients might be especially concerned with HIV prevention or management, for example.
Health policy researchers note that Medicare Advantage tends to be lucrative for insurers but can be a mixed bag for patients, who often have a limited choice of providers 鈥� and that targeted plans would not necessarily solve that problem. Some also worry that the approach could end up being a new vector for discrimination.
鈥淚t鈥檚 strange to think about commodifying and profiting off people鈥檚 racial and ethnic identities,鈥� said Naomi Zewde, an assistant professor at the UCLA Fielding School of Public Health. 鈥淲e should do so with care and proceed carefully, so as not to be exploitive.鈥�
Still, there鈥檚 plenty of evidence that patients can benefit from care that is targeted to their race, ethnicity, or sexual orientation.
A November 2020 study of almost 118,000 patient surveys, published in JAMA Network Open, underscored the need for a connection between physician and patient, finding that patients with the same racial or ethnic background as their physicians to rate the latter highly. A 2022 survey of 11,500 people around the world by the pharmaceutical company Sanofi showed a legacy of distrust in health care systems among marginalized groups, such as ethnic minorities, LGBTQ+ people, and people with disabilities.
Clever Care, founded by Korean American health care executive Myong Lee, aimed from the start to create Medicare Advantage plans for underserved Asian communities, said Peter Winston, the senior vice president and general manager of community and provider development at the company. 鈥淲hen we started enrollments, we realized there is no one 鈥楢sian,鈥� but there is Korean, Chinese, Vietnamese, Filipino, and Japanese,鈥� Winston added.
The company has separate customer service lines by language and gives members flexibility on how and where to spend their allowances for benefits like fitness programs.
Winston said the plan began with 500 members in January 2021 and is now up to 14,000 (still very small compared with mainstream plans). Herbal supplement benefit dollars vary by plan, but more than 200 products traditionally used by Asian clients are on offer, with coverage of up to several hundred dollars per quarter.
Sachin Jain, a physician and the CEO of SCAN Group, said its LGBTQ+ plan serves 600 members.
鈥淭his is a group of people who, for much of their lives, lived in the shadows,鈥� Jain added. 鈥淭here is an opportunity for us as a company to help affirm them, to provide them with a special set of benefits that address unmet needs.鈥�
SCAN has run into bias issues itself, with some of its employees posting hate speech and one longtime provider refusing to participate in the plan, Jain recounted.
Alignment Health offers a plan targeting Asian Americans in six California counties, with benefits such as traditional wellness services, a grocery allowance for Asian stores, nonemergency medical transportation, and even pet care in the event a member has a hospital procedure or emergency and needs to be away from home.
Alignment also has an offering aimed at Latinos, dubbed el 脷nico, in parts of Arizona, Nevada, Texas, Florida, and California. The California product, an HMO co-branded with Rite Aid, is available in six counties, while in Florida and Nevada, it鈥檚 a so-called special needs plan for Medicare beneficiaries who also qualify for Medicaid. All offer a Spanish-speaking provider network.
Todd Macaluso, the chief growth officer for Alignment, declined to share specific numbers but said California membership in Harmony 鈥� its plan tailored to Asian Americans 鈥� and el 脷nico together has grown 80% year over year since 2021.
Alignment鈥檚 marketing efforts, which include visiting places where prospective members may shop or socialize, are about more than just signing up customers, Macaluso said.
鈥淏eing present there means we can see what works, what鈥檚 needed, and build it out. The Medicare-eligible population in Fresno looks very different from one in Ventura.鈥�
鈥淛ust having materials in the same language is important, as is identifying the caller and routing them properly,鈥� Macaluso added.
Blacks, Latinos, and Asians overall are significantly more likely than white beneficiaries to choose Medicare Advantage plans, according to conducted for Better Medicare Alliance, a nonprofit funded by health insurers. (Latino people can be of any race or combination of races.) But it鈥檚 not clear to what extent that will translate into the growth of targeted networks: Big insurers鈥� Medicare Advantage marketing efforts often target specific racial or ethnic cohorts, but the plans don鈥檛 usually include any special features for those groups.
Utibe Essien, an assistant professor of medicine at UCLA, noted the historical underserving of the Black community, and that the shortage of Black physicians could make it hard to build a targeted offering for that population. Similarly, many parts of the country don鈥檛 have a high enough concentration of specific groups to support a dedicated network.
Still, all three companies are optimistic about expansion among groups that haven鈥檛 always been treated well by the health care system. 鈥淚f you treat them with respect, and bring care to them the way they expect it, they will come,鈥� Winston said.
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