Home > Scan Medicare Health Plan Review Help

Scan Medicare Health Plan Review Help

SCAN Health Plan Medicare Advantage: States, Plans & Costs Compared

SCAN Medicare Health Plan Types HMO, and PPO Coverage Options Free Agent Broker Enrollment Help Arizona, California, Nevada, New Mexico, Washington, and Texas

Key Takeaways

SCAN Health Plan stands out in the Medicare Advantage market with impressive quality ratings and cost advantages, but its network limitations may affect your access to care.

• 87% of SCAN plans cost $0 monthly premium with all plans earning 4+ star quality ratings, making it one of the most affordable high-quality options available.
• SCAN operates HMO-only plans across 6 states (Arizona, California, Nevada, New Mexico, Texas, Washington), requiring network providers and specialist referrals.
• Average out-of-pocket maximum is just $1,563 compared to industry standards, with $0 copays for most generic medications and comprehensive supplemental benefits included.
• Network issues drive 30% of member departures versus 17% industry average, indicating potential access challenges despite strong financial benefits.
• Part B premium givebacks reach up to $185 monthly, the highest among major competitors, plus extensive extras like dental, vision, transportation, and fitness benefits.

SCAN excels for cost-conscious Medicare beneficiaries who prioritize quality ratings and comprehensive benefits over network flexibility. However, if you need broader provider access or PPO-style freedom, larger national carriers may better serve your healthcare needs.

Compare Plans free agent broker help SCAN Health Plan is expanding, while many insurers are pulling back from Medicare markets.

SCAN Health Plan is expanding, while many insurers are pulling back from Medicare markets. This nonprofit Medicare Advantage provider has served members since 1977 and stands out with impressive numbers: 87% of plans carry a $0 monthly premium, and every plan earns a quality rating of 4 out of 5 stars or better. SCAN operates exclusively as an HMO in six states and covers nearly 440,000 beneficiaries. We’ll walk you through SCAN’s plan options and costs, plus how it compares to competitors, so you can determine if SCAN Medicare Advantage fits your healthcare needs in 2026.

What is SCAN Health Plan Medicare Advantage

SCAN stands for Senior Care Action Network, an acronym that reflects the organization’s founding mission. Twelve determined seniors in Long Beach, California, came together in 1977 to address inadequate healthcare services for older adults. These activists pushed the city to establish the Long Beach Geriatric Health Care System, a nonprofit entity focused on keeping seniors healthy and independent [1]. What began as a local community effort grew into one of the nation’s largest nonprofit Medicare Advantage programs, serving more than 425,000 members [2].

SCAN’s Nonprofit Structure Since 1977

SCAN has maintained its nonprofit status since its inception in 1977 [2]. This structure means the organization invests in benefits and services rather than distributing profits to shareholders [2]. SCAN, a mission-driven organization, focuses on addressing major healthcare challenges for older adults. These challenges include chronic illness, access to care, homelessness, and inequities [3]. The nonprofit model allows SCAN to weather revenue declines differently from for-profit insurers, though difficult decisions about benefits or programs may still be necessary under financial pressure [4].

Medicare Advantage plans, also called Medicare Part C, serve as all-in-one alternatives to Original Medicare [2]. Private, Medicare-approved insurance companies offer these plans that combine hospital coverage (Part A) and medical coverage (Part B) into a single plan [2]. Most Medicare Advantage plans include prescription drug coverage (Part D), thereby simplifying benefit management [2]. Many plans offer extra benefits not available through Original Medicare. These include dental, vision, hearing, fitness programs, transportation, and over-the-counter allowances designed to support everyday health needs [2].

Medicare Advantage HMO-Only Plan Approach

SCAN offers HMO (Health Maintenance Organization) plans exclusively [5]. This approach offers less flexibility for seeking medical care than PPO or other plan types [5]. HMO plans require members to use network providers and need referrals for specialist visits. SCAN’s provider networks are specific to each county, with supplemental benefits such as over-the-counter medications, transportation, and dental coverage tailored to the unique needs of each service area [2].

Coverage Areas: 6 States Overview

SCAN operates in six states: Arizona, California, Nevada, New Mexico, Texas, and Washington [6]. The organization serves Medicare beneficiaries in 33 counties throughout these states [3]. California remains SCAN’s home base, where the organization was founded in Long Beach and now helps beneficiaries statewide [2]. SCAN recorded the largest membership increase in its history in 2026, with enrollment growing by more than 127,000 individuals and total membership reaching nearly 440,000 members [3].

SCAN Medicare Advantage Plans Available by State

SCAN operates in 33 counties as of January 1, 2026, with several new markets added to the footprint [3]. The expansion reaches about 9 million Medicare-eligible individuals [3].

California Medicare Advantage Plans

California represents SCAN’s largest market, with coverage spanning 19 counties [3]. The 2026 expansion added six new California counties:

Sacramento
Placer
Yolo
San Joaquin
Kings
Tulare [3][7]

SCAN continues to serve markets such as Los Angeles, Riverside, Orange, San Bernardino, San Diego, Ventura, Alameda, San Mateo, San Francisco, Stanislaus, Fresno, Madera, and Santa Clara [3]. The coverage extends from coastal regions like Ventura to technology centers in Santa Clara and from urban areas to rural communities in Kings and Tulare counties [8].

Arizona Medicare Advantage Coverage

SCAN Health Plan operates in three Arizona counties: Maricopa, Pima, and Pinal [3]. Maricopa County encompasses the Phoenix metropolitan area and includes cities such as Tempe and Goodyear [8]. Pima County covers southern Arizona, with Tucson, Oro Valley, and Green Valley as primary service areas [8]. Benefits vary by county. Some Maricopa plans offer $0 copays for primary care and specialists, up to $3,000 in annual dental coverage, and up to $300 per year in eyewear coverage [8]. Pima County has similar benefit structures, though specific amounts depend on the selected plan [8].

Compare Enroll in Nevada and New Mexico Options

SCAN Health Plan (Nevada) provides coverage in Clark and Nye counties [3]. Clark County includes the Las Vegas metropolitan area, while Nye County extends coverage to more rural communities in Nevada [3].
New Mexico has SCAN Health Plan operating in Bernalillo and Sandoval counties [3]. Bernalillo County has Albuquerque, New Mexico’s largest city, while Sandoval County covers communities north of the metropolitan area [3].

Compare a Join Texas Medicare Plan and Washington State Availability

SCAN Health Plan (Texas) serves four counties: Bexar, Harris, Fort Bend, and Montgomery [3]. The 2026 expansion added Fort Bend and Montgomery counties to the existing Bexar and Harris county coverage [3]. Bexar County has San Antonio, while Harris County covers Houston and the surrounding areas.

Washington represents a new state for SCAN in 2026 [3]. SCAN Health Plan (Washington) operates in Pierce, Spokane, and Thurston counties, all of which are marked as new markets [3]. Pierce County has Tacoma, Spokane County serves the eastern Washington region, and Thurston County covers the state capital area. This expansion into Washington bucked industry trends, as many insurers exited Medicare markets rather than expanded [3].

SCAN currently serves over 310,000 members in all six states [3][7].

SCAN Health Plan Types and Coverage Options

SCAN Medicare Advantage operates through four distinct plan categories. Each one addresses specific healthcare needs and eligibility requirements. All SCAN plans have prescription drug coverage as an integrated benefit [5].

Standard HMO Plans

Standard HMO plans combine Medicare Parts A and B coverage into a single comprehensive package. These plans have Part D prescription drug coverage and eliminate the need for separate medication insurance [5]. Members must use network providers and require referrals for specialist visits. This creates more structured care pathways compared to other Medicare options.

Chronic Condition Special Needs Plans (C-SNP)

C-SNPs target people living with severe or disabling chronic conditions. These conditions have a major impact on daily life and carry a high risk of hospitalization [9]. Medicare approves 15 specific chronic conditions for C-SNP eligibility. The list has diabetes mellitus, chronic heart failure, cardiovascular disorders, HIV/AIDS, and end-stage renal disease requiring dialysis. It also covers dementia, stroke, cancer (excluding pre-cancer conditions), and chronic lung disorders like asthma and emphysema [9].

SCAN offers three C-SNP products tailored to different member needs. SCAN Balance HMO serves people with type 1 or type 2 diabetes and certain heart conditions. It features $0 insulin copays [9]. SCAN Strive HMO serves members with chronic health conditions who have both Medicare and full Medicaid coverage. The plan offers low or no costs for most benefits [9]. SCAN VillageHealth HMO-POS specializes in end-stage renal disease and kidney transplant patients. It provides point-of-service flexibility to see doctors outside the network and assigns a VillageHealth nurse for care management [9].

All C-SNPs provide care coordination through personalized care plans developed after enrollment. Care managers help members navigate the healthcare system, track health metrics, and schedule preventive exams. They also coordinate support services [9]. The Returning Home benefit assists members after hospital stays. It provides in-home support, meal delivery, medication education, and care navigator coordination [9].

Dual-Eligible Special Needs Plans (D-SNP)

SCAN Connections is California’s only Fully Integrated Dual-Eligible Special Needs Plan. The plan combines Medicare and Medi-Cal benefits into one detailed package [8]. Members enrolled in SCAN Connections demonstrate 15% lower acute care utilization rates than high-need complex members not enrolled in a FIDE-SNP [8]. 99% of Connections members live in the community rather than in facilities. This compares to 88% of Medicare recipients nationwide [8].

The plan provides $0 copays for all prescription drugs, $500 vision coverage each year, and $175 over-the-counter allowance per quarter. Members also receive $50 quarterly food benefit cards [8][8]. They get dedicated assistance teams trained in the complexities of Medi-Cal and Medicare [8].

LGBTQ+ and Culturally Sensitive Plans

SCAN developed specialized plans that address unique community needs. SCAN Affirm launched in Los Angeles and Riverside counties. It became the first Medicare Advantage plan in the U.S. designed for LGBTQ+ seniors [10]. Research shows that 3 million LGBTQ+ adults currently exceed age 50. Projections reach 7 million by 2030 [10][5].

SCAN Affirm has lower copays for HIV treatments and gender-affirming hormone therapy. The plan offers companion care services to address social isolation and reimbursement for legal services related to living wills and power of attorney documents [10][5]. SCAN Allied serves Asian Americans with $0 copays for unlimited acupuncture visits and allowances for use at Asian markets [10]. SCAN Inspired provides women with health coaches and networks that feature doctors specializing in heart, breast, and pelvic Health [10].

SCAN Medicare Advantage Costs Breakdown

To understand SCAN Medicare Advantage costs, you need to look beyond monthly premiums and see the complete financial picture. Most SCAN Health Plan members pay nothing monthly, but several cost components shape your annual healthcare spending.

Monthly Premium: 87% Have $0 Cost

87% of SCAN Health Plan Medicare Advantage plans carry a $0 monthly premium [3]. Plans that charge a premium average $29.62 per month, weighted by enrollment [3]. Keep in mind that all members must continue to pay their Medicare Part B premium, regardless of the plan they choose [3]. The Part B premium represents a separate cost paid to Medicare, not to SCAN.

SCAN keeps most HMO plans at zero premium cost in 2026. This has Classic and Prime HMO options [7]. Venture Plans charge between $20 and $75 monthly, but offset this with Part B premium reductions that can exceed the plan cost [7]. Special Needs Plans maintain $0 premiums while delivering focused benefits for dual-eligible members and those with chronic conditions [7].

Maximum Out-of-Pocket Limits: $1,563 Average

SCAN Health Plan Medicare Advantage plans set an average maximum out-of-pocket spending cap of $1,563, weighted by enrollment [3]. This figure falls nowhere near typical industry averages. SCAN Classic establishes a 2026 maximum out-of-pocket limit of $9,149 for in-network services [5]. Classic and Prime HMO plans in Los Angeles range from $2,400 to $2,499 MOOP [7].

All covered services cost $0 for the remainder of the calendar year once you reach your plan’s MOOP [3]. Your monthly premiums do not count toward this protection limit.

Prescription Drug Coverage Tiers and Copays

Every SCAN plan has prescription drug coverage [3]. All SCAN Health Plan Medicare Advantage plans offer $0 copays for Tier 1 preferred generics [3]. 99% of plans provide $0 cost for Tier 2 generic medications [3].

Members pay an average of $42.67 for Tier 3 preferred brand drugs with a $200 retail price [3]. SCAN Classic charges $42 copays for preferred brands and 35% coinsurance for non-preferred drugs [5]. Specialty tier medications require 30% coinsurance [5]. The annual Part D deductible stands at $250 [5].

Members never pay more than $2,100 in out-of-pocket drug costs each year [11]. All covered prescriptions are free for the rest of the year once this threshold is reached [11].

Part B Premium Giveback Options

Select SCAN plans return up to $185 monthly toward your Part B premium [7]. The giveback amount appears as an increase in your Social Security check or as a credit on your Part B premium statement [12]. You do not receive a separate check [12].

The Social Security Administration processes givebacks, which may take three to four months to appear [12]. Your first payment has retroactive credits for waiting months [12]. You must pay your own Medicare Part B premium to qualify [12]. Members receiving Medicaid or government assistance that covers Part B do not qualify for this benefit [12].

Supplemental Benefits Included with SCAN Plans

Most SCAN plans package supplemental benefits at no extra premium and extend coverage well beyond the limits of Original Medicare [9]. These extras address daily health needs through provider partnerships.

Dental Coverage Options

SCAN partners with Delta Dental and DentaQuest to deliver dental benefits. Provider assignment depends on your county and plan [13]. Delta Dental serves California and Washington residents through the DeltaCare USA network. Some plans offer an optional PPO upgrade for an additional monthly premium [14]. DentaQuest provides coverage in Arizona, California, New Mexico, Nevada, and Texas [15].

All SCAN plans cover preventive dental services that Original Medicare requires, such as pre-transplant exams [16]. Many plans expand this to cover cleanings, fillings, extractions, dentures, root canals, and gum disease treatment [9]. Your SCAN member ID card lists your dental provider’s customer service number on the back, so you don’t need a separate dental card [13].

Vision Benefits and Eyewear Allowance

SCAN delivers routine vision care through EyeMed Vision Care for most plans [17]. Members receive yearly routine eye exams plus an eyewear allowance for frames and lenses or contact lenses [17]. The EyeMed Select network has major retailers and independent providers nationwide [8]. You choose either eyeglasses or contacts each benefit period. The period renews every 12 or 24 months, depending on your plan [18].

FlexEssentials OTC Allowance

All FlexEssentials benefits cover over-the-counter items such as allergy relief, first-aid supplies, and cold medication through CVS [13]. Members shop in-store, online at cvs.com/benefits, by phone, or through the OTCHS app [8]. SCAN MyChoice members can use their FlexEssentials card for dental and vision copays and for at-home fitness equipment [19]. Select plans, such as SCAN Connections and SCAN Strive, allow for utility bills [19].

Free Transportation to Appointments

All SCAN plans have transportation benefits through SafeRide Health [20]. Members schedule rides to medical appointments, pharmacies, and other health-related destinations by calling at least 24 business hours ahead [21]. Wheelchair transportation requires 48 business hours’ notice [20]. SafeRide assigns either Uber/Lyft drivers for standard trips or contracted medical transport companies for members needing special assistance [20].

Fitness Membership Programs

The One Pass fitness benefit provides access to 25,000+ gyms nationwide, including premium locations, at no extra cost [10]. Members also access thousands of on-demand and live-streaming classes covering yoga, fall prevention, Pilates, and strength conditioning [10]. Grouper connects members to social activities, such as walking groups and pickleball, in their communities [10].

SCAN Health Plan Quality Ratings and Performance

Quality measurements for SCAN Medicare Advantage plans reveal mixed performance across various evaluation systems. The Centers for Medicare & Medicaid Services assigns star ratings each year to measure plan quality and customer satisfaction. Scores range from 1 to 5 stars.

CMS Star Ratings: 4.01 Average

SCAN Health Plan Medicare Advantage plans earned an average quality rating of 4.01 stars out of 5 from CMS for 2026, weighted by enrollment [5]. The average weighted star rating stands at 4.02 for companies of all sizes [5]. All SCAN Health Plan members in rated plans have a plan with a 2026 CMS rating of 4 stars or higher [5][3].

State-specific performance shows variation. Arizona earned a 4.5-star rating for 2026, representing a full-star improvement year over year [7]. Nevada’s rating increased to 4.0 stars for 2026 [7]. SCAN maintained a 4.0-star rating in California for 2026, marking the 13th consecutive year at 4 stars or higher [3][7]. SCAN’s Fully Integrated Dual Eligible Special Needs Plan contract in California received a 4.0-star rating for 2026 [7].

Member Experience Scores

SCAN Medicare Advantage plans score below average on measures of member experience [5]. Problems getting covered care affected 16% of departing members. The all-company average stands at 11% [5]. Prescription drug benefit issues troubled 7% versus a 3% industry average [5]. Information access problems reached 11%, just above the all-company figure of 9% [5].

Why Members Leave SCAN Plans

Members leaving SCAN Health Plan most often cited problems with doctor and hospital networks, at 30%. The all-company average stands at 17% [5]. Financial issues affected only 6% of departing members, far below the 17% industry average [5].

JD Power Rankings in California

SCAN Health Plan ranked second among eight major providers in California, with a score of 672 points in 2025 [22][23]. Kaiser Permanente led with 675 points [22]. SCAN ranked first for overall customer satisfaction in California, according to the JD Power 2023 U.S. Medicare Advantage study [24].

SCAN vs Major Competitors Cost and Coverage Comparison

Choosing between SCAN Health Plan and national carriers requires you to examine specific cost and coverage differences that directly affect your healthcare expenses and access to care.

SCAN vs UnitedHealthcare Medicare Advantage

UnitedHealthcare is larger than SCAN, but competition is tightening within SCAN’s six-state footprint. SCAN Health Plan Medicare Advantage plans have a $0 monthly premium about 84% of the time, compared with 65% of UnitedHealthcare plans [6]. Among these zero-premium options, 100% of SCAN plans include drug benefits, compared with 77% of UnitedHealthcare offerings [6].

UnitedHealthcare received an overall rating of 3.9 stars, while SCAN Health earned 4.1 stars [6]. The lowest MOOP with UnitedHealthcare sits at $800, among the industry’s best. It reaches the federal limit of $9,250 [25]. Unlike SCAN’s HMO-only approach, UnitedHealthcare offers HMO, HMO-POS, and PPO plans [25]. Part B givebacks reach up to $185 per month with SCAN, versus $120 with UnitedHealthcare [11].

SCAN vs Humana Plans

Humana operates in 46 states, whereas SCAN has a six-state presence. SCAN maintains 4.0 stars in California while Humana averages 3.5 stars [26]. SCAN’s Part B gives back extends to $185 monthly compared to Humana’s $164 maximum ^[26]. Humana offers both HMO and PPO plans, providing network flexibility that SCAN cannot match ^[26].

SCAN vs Devoted Health

Devoted Health operates in 29 states with both PPO and HMO options ^[6]. Both companies score closely on overall ratings, with SCAN at 4.1 and Devoted at 4.0 ^[6]. Customer satisfaction tilts heavily toward SCAN at 4.9 stars versus Devoted’s 2.8 ^[6]. Devoted’s maximum out-of-pocket costs climb to $9,250 annually. SCAN caps at $6,700 ^[6]. About 92% of Devoted plans feature $0 premiums ^[6].

Network Coverage and Doctor Availability Problems

Problems with doctor and hospital networks drove 30% of members away from SCAN, well above the 17% industry average ^[6]. Agent Broker James O’Neal has been helping people with Medicare, Health, Life, Dental, Vision, and Cancer/Critical Illness Insurance for over 38 years. Call (877) 808-2900 or visit us online at www.ONealInsuranceGroup.com.

Comparison Table
SCAN Health Plan vs Major Competitors: 2026 Comparison

SCAN Health Plan vs Major Competitors Humana, Devoted Health, UnitedHealthcare Comparison

Key Takeaways:

Low Premiums: SCAN tops the list with 87% of plans at $0 premium, and all include drug coverage
Network Flexibility: UnitedHealthcare and Humana offer PPO options, while SCAN provides HMO-only plans
Quality Ratings: SCAN scores highest at 4.1 stars overall
Part B Giveback: SCAN offers the highest maximum at $185/month
Customer Satisfaction: SCAN substantially outperforms Devoted with 4.9 stars compared to 2.8 stars
Low MOOP: UnitedHealthcare offers the lowest minimum at $800. SCAN’s average of $1,563 remains competitive

Conclusion

SCAN Health Plan delivers strong value for this reason: consistently achieving quality ratings of 4 stars or higher, with 87% of plans offering $0 premiums and comprehensive supplemental benefits. The HMO-only structure means less flexibility. Network problems cause 30% of departures compared to the 17% industry average.

SCAN works best if you prioritize low costs and quality ratings over network flexibility. Competitors like UnitedHealthcare might suit you better if you value PPO freedom or need broader provider access.

Agent Broker James O’Neal has been helping people for over 38 years with Medicare, Health, Life, Dental, Vision, and Cancer/Critical Illness Insurance. Call (877) 808-2900 or visit us online at www.ONealInsuranceGroup.com. Please like us, follow, and share on Facebook and YouTube.

FAQs

Q1. Is SCAN Health Plan a good Medicare Advantage option? SCAN Health Plan consistently earns strong quality ratings, with every rated plan achieving 4 stars or better out of 5. Nearly 87% of their plans have $0 monthly premiums and include prescription drug coverage. They also offer lower average maximum out-of-pocket costs compared to many competitors, making them a solid choice for cost-conscious beneficiaries who prioritize quality.

Q2. What states does SCAN Health Plan cover in 2026? SCAN Health Plan operates in six states: Arizona, California, Nevada, New Mexico, Texas, and Washington. They serve members across 33 counties in these states, with California being their largest market, covering 19 counties. In 2026, SCAN expanded into Washington for the first time and added several new counties in California and Texas.

Q3. How much do SCAN Medicare Advantage plans cost monthly? About 87% of SCAN Health Plan Medicare Advantage plans have a $0 monthly premium. For plans that do charge a premium, the average cost is $29.62 per month. However, all members must continue paying their Medicare Part B premiums separately. The average maximum out-of-pocket limit across SCAN plans is $1,563, which is competitive compared to industry standards.

Q4. What extra benefits come with SCAN Medicare Advantage plans? SCAN plans include supplemental benefits beyond Original Medicare, such as dental coverage through Delta Dental or DentaQuest; routine vision care with eyewear allowances through EyeMed; over-the-counter medication allowances via CVS; free transportation to medical appointments through SafeRide Health; and fitness memberships that provide access to over 25,000 gyms nationwide, plus virtual classes.

Q5. How does SCAN compare to UnitedHealthcare for Medicare Advantage? SCAN has a higher overall star rating (4.1 stars) than UnitedHealthcare (3.9 stars) and offers a higher percentage of $ 0-premium plans (87% vs. 65%). SCAN also provides a larger Part B premium giveback of up to $185 per month, compared with UnitedHealthcare’s $120 maximum. However, UnitedHealthcare offers more plan flexibility with HMO, PPO, and regional PPO options, whereas SCAN offers only HMO plans.

References

Call Now for a Quote!

We're Available Monday - Friday, from 9AM - 5PM

Get A Quote

Customer Reviews

5 stars!

Shell B

Excellent customer service and very friendly and helpful 😃

Pamela H

They made selecting the right healthcare plan a smooth process.

Donald W