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SCAN Connections at Home (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SCAN Connections at Home (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SCAN Connections at Home (HMO D-SNP) in 2026, please refer to our full plan details page.
SCAN Connections at Home (HMO D-SNP) is a HMO D-SNP plan offered by SCAN Group available for enrollment in 2025 to people living in Los Angeles, Inland Empire, and San Diego Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that SCAN Connections at Home (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
SCAN Connections at Home (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about SCAN Connections at Home (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For SCAN Connections at Home (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $375.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The SCAN Connections at Home (HMO D-SNP) prescription drug plan features an annual drug deductible of $375.00. During the initial coverage phase, Tier 1 preferred generic drugs have no copay at preferred retail pharmacies and preferred mail-order services, while standard pharmacies and standard mail-order services carry a $1.00 copay. For higher-tier medications, you will pay a 25% coinsurance for Tier 2 standard generics and Tier 4 non-preferred drugs, and a 29% coinsurance for Tier 3 preferred brand drugs. If you qualify for the low-income subsidy, your Part D premium and costs may be reduced to nothing. Furthermore, once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D drugs.
Additional Benefits
The SCAN Connections at Home (HMO D-SNP) plan offers comprehensive medical coverage, with many key services featuring no copay and a 20% coinsurance. This cost-sharing structure applies to outpatient care, emergency services, primary care, diagnostic tests, and durable medical equipment. Additionally, home health services are available with no copay and no coinsurance, while inpatient hospital stays follow Original Medicare-defined copays and coinsurance. For specialized care, members benefit from routine dental, vision exams with a $500 eyewear allowance, and hearing aid coverage featuring copays between $699 and $999. The plan also provides extra value through a $155 monthly over-the-counter allowance, unlimited acupuncture, and post-hospitalization meals. Most preventive services, including annual physicals and fitness programs, are fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital acute and psychiatric services are partially covered by SCAN Connections at Home (HMO D-SNP), with cost sharing following Original Medicare-defined copays and coinsurance. Prior authorization and doctor referrals are required for these benefits, and additional days, non-Medicare-covered stays, and acute upgrades are not covered.
Outpatient Services See details
SCAN Connections at Home (HMO D-SNP) covers outpatient services, including outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with a 20% coinsurance and no copay. These covered outpatient services require prior authorization and a doctor referral.
Partial Hospitalization See details
Partial hospitalization is covered by the SCAN Connections at Home (HMO D-SNP) plan with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by SCAN Connections at Home (HMO D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation services are partially covered, and transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by SCAN Connections at Home (HMO D-SNP), including urgently needed and worldwide emergency care. These services feature no copay and a 20% coinsurance, which counts toward the plan-level deductible.
Primary Care See details
SCAN Connections at Home (HMO D-SNP) partially covers primary care benefits, offering most services, such as physician visits, therapy, and telehealth, with a 20% coinsurance and no copay. Podiatry services are not covered under this plan, and most covered services require prior authorization and a doctor referral.
Preventive Services See details
Preventive services are partially covered by SCAN Connections at Home (HMO D-SNP), with no copay and no coinsurance for annual physicals, safety assessments, and fitness benefits. A 20% coinsurance and no copay apply to kidney disease education, glaucoma screenings, diabetes training, digital rectal exams, and EKGs. Uncovered services include medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, smoking cessation, disease management, telemonitoring, and counseling.
Hearing Services See details
Hearing services are partially covered by SCAN Connections at Home (HMO D-SNP), with routine hearing exams requiring a 20% coinsurance and no copay, and covered prescription hearing aids requiring a copay of $699 to $999 and no coinsurance. However, OTC hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by SCAN Connections at Home (HMO D-SNP), as upgrades are not covered. Covered benefits, including one routine eye exam per year and eyewear up to a $500 annual limit, require a 20% coinsurance and no copay or deductible.
Dental Services See details
Dental services are partially covered by SCAN Connections at Home (HMO D-SNP), offering Medicare-covered dental benefits with a 20% coinsurance and no copay. While preventive and comprehensive services like exams, cleanings, and implants are covered, orthodontics is not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by SCAN Connections at Home (HMO D-SNP) with prior authorization, featuring no copay and no coinsurance to 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs under this benefit require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
SCAN Connections at Home (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Medical Equipment See details
SCAN Connections at Home (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with prior authorization. These benefits are offered with no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
SCAN Connections at Home (HMO D-SNP) partially covers diagnostic and radiological services, as lab services are not covered. Covered benefits—including diagnostic procedures, radiological services, and outpatient X-rays—require prior authorization and a doctor referral, and feature no copay and a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by SCAN Connections at Home (HMO D-SNP) with no copay and no coinsurance. Access to these benefits requires prior authorization and a doctor referral.
Cardiac Rehabilitation Services See details
SCAN Connections at Home (HMO D-SNP) offers Cardiac Rehabilitation Services where some services are covered, but in practice, sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
SCAN Connections at Home (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services, which require prior authorization and a doctor referral but no prior three-day hospital stay. The plan charges Medicare-defined cost-sharing for copays and coinsurance, and additional days beyond Medicare-covered SNF stays are not covered.
Other Services See details
Other Services are partially covered by SCAN Connections at Home (HMO D-SNP), which excludes Dual Eligible SNPs with Highly Integrated Services. Covered benefits include unlimited acupuncture and post-hospitalization meal benefits with prior authorization, as well as a $155 monthly allowance for over-the-counter items.
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