A non-government entity
SCAN Classic (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SCAN Classic (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SCAN Classic (HMO) in 2026, please refer to our full plan details page.
SCAN Classic (HMO) is a HMO plan offered by SCAN Group available for enrollment in 2025 to people living in Clark and Nye Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that SCAN Classic (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about SCAN Classic (HMO).
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 Classic (HMO), 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $900.00 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:
Sign up for SCAN Classic (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The SCAN Classic (HMO) prescription drug plan features a $0 drug deductible, meaning your coverage begins immediately. For Tier 1 preferred generics and Tier 2 generics, there is no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose a standard pharmacy or standard mail-order service, copays range from $5 to $10 for Tier 1 and $9 to $18 for Tier 2 depending on the supply duration. For Tier 3 preferred brand drugs, copays start at $42 at preferred pharmacies and $47 at standard pharmacies for a one-month supply. Tier 4 non-preferred drugs require a 35% coinsurance across all pharmacy types and supply lengths. Specialty drugs in Tier 5 carry a 33% coinsurance for a one-month supply at both preferred and standard pharmacies or mail-order services.
Additional Benefits
The SCAN Classic (HMO) plan offers robust healthcare coverage with many essential medical services available with no copay and no coinsurance. Members can access inpatient hospital stays, primary care and specialist visits, preventive care, and routine dental, vision, and hearing exams at no cost. Home health services, cardiac rehabilitation, and diagnostic services are also covered with no copay or coinsurance. For other medical needs, the plan provides predictable cost-sharing, including a $90 copay for emergency room visits and a $125 copay for ambulance services. You also receive valuable extra benefits like a $300 annual eyewear allowance, a $100 quarterly over-the-counter allowance, and up to 54 free one-way transportation trips to plan-approved locations with no copay. These clear copays and robust extra benefits provide comprehensive support for your daily health and wellness needs.
Inpatient Hospital See details
SCAN Classic (HMO) covers inpatient acute hospital stays with no copay, no coinsurance, and unlimited days, though upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric care is also covered with no coinsurance, requiring a $200 copay for days 1 through 7 and no copay for days 8 through 90.
Outpatient Services See details
SCAN Classic (HMO) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. Outpatient substance abuse individual and group sessions are covered with a $20 copay and no coinsurance.
Partial Hospitalization See details
SCAN Classic (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services, and a referral may also be necessary.
Ambulance and Transportation Services See details
SCAN Classic (HMO) covers ground and air ambulance services with a $125 copay and no coinsurance. Transportation services are partially covered, offering up to 54 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
SCAN Classic (HMO) covers emergency services with a $90 copay and no coinsurance, with the copay waived if you are immediately admitted to the hospital. Urgently needed services are covered with no copay and no coinsurance, while worldwide emergency services feature a $90 copay for emergency care, a $125 copay for emergency transportation, and no coinsurance.
Primary Care See details
SCAN Classic (HMO) covers primary care, specialist visits, therapy services, and telehealth with no copay and no coinsurance. Mental health, psychiatric, and opioid treatment services are covered with no coinsurance and copays ranging up to $20, while routine chiropractic care is partially covered with a $15 copay (no coinsurance) and podiatry is not covered.
Preventive Services See details
Preventive services are offered by SCAN Classic (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. While additional benefits like health education and fitness programs are covered, several services such as in-home safety assessments, alternative therapies, and weight management programs are not covered.
Hearing Services See details
SCAN Classic (HMO) hearing services are partially covered, offering routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $550 to $850, but OTC hearing aids and 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 Classic (HMO) with no copay, no coinsurance, and no deductible for covered services, which include one routine eye exam and up to $300 annually for eyewear like contacts or eyeglasses. Prior authorization and referrals are required for these benefits, while other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by SCAN Classic (HMO) with no copay and no coinsurance for covered preventive and comprehensive treatments, subject to a $3,000 annual maximum. While many services like cleanings, exams, and implants are covered, other diagnostic dental services, other preventive dental services, and orthodontics are not covered.
Home Infusion bundled Services See details
SCAN Classic (HMO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by SCAN Classic (HMO) with no copay and a 20% coinsurance, subject to prior authorization and referral requirements.
Medical Equipment See details
SCAN Classic (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and coinsurance ranging from no coinsurance up to 20%, subject to prior authorization. Diabetic equipment is partially covered because diabetic supplies are not covered, though diabetic therapeutic shoes and inserts are covered with a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
SCAN Classic (HMO) covers diagnostic and radiological services with no copay and no coinsurance, though prior authorization and referrals are required. While some services are covered, diagnostic procedures/tests, lab services, diagnostic and therapeutic radiological services, and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered by SCAN Classic (HMO) with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by SCAN Classic (HMO) with no copay and no coinsurance, requiring prior authorization and a referral. Although some services are covered, specific sub-services such as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
SCAN Classic (HMO) covers skilled nursing facility services with no coinsurance, though prior authorization and a referral are required. There is no copay for days 1 through 20, followed by a $125 copay for days 21 through 100, with no prior three-day hospital stay required.
Other Services See details
Other Services covered by the SCAN Classic (HMO) include acupuncture for a $15 copay and no coinsurance for up to 30 treatments per year, and a quarterly $100 over-the-counter item allowance with no copay and no coinsurance. A limited-duration meal benefit is also covered with no copay and no coinsurance following hospitalizations or for chronic illnesses, while other miscellaneous services and dual eligible SNP services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 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.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved