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SCAN Compass (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SCAN Compass (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SCAN Compass (HMO) in 2025, please refer to our full plan details page.
SCAN Compass (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 3.5 out of 5 stars in 2025.
It's important to know that SCAN Compass (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 Compass (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 Compass (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 $1200.00 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 Compass (HMO) plan has an enhanced alternative drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a $0 copay for preferred generic drugs at a preferred pharmacy or through mail order, and $9 copay at a standard pharmacy or standard mail order. For standard generic drugs, the copay is $42 at a preferred pharmacy or through mail order, and $47 at a standard pharmacy or standard mail order. For preferred brand drugs, you pay 50% coinsurance, and for non-preferred drugs you pay 33% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The SCAN Compass (HMO) plan offers a variety of benefits to help cover your healthcare needs. For inpatient hospital stays, you'll pay a copay depending on the length of your stay, and for outpatient services, copays vary. The plan also covers ambulance services for a copay, as well as emergency services. This plan includes coverage for primary care, preventive services, vision, and dental. Hearing services include routine exams and hearing aids, while vision services include routine eye exams and eyewear. Dental services cover a range of services, with some limitations on the number of visits and x-rays per year.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, there is a $50 copay for days 1-3, and no copay for days 4-90; there is no coinsurance. For Inpatient Hospital Psychiatric, there is a $200 copay for days 1-7, and no copay for days 8-90; there is no coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, are covered. Outpatient Hospital Services have a copay between $0 and $100, while individual and group outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
SCAN Compass (HMO) covers partial hospitalization with a $55 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by SCAN Compass (HMO), with a $121 copay for both ground and air ambulance services. Transportation services to a plan-approved health-related location are covered for up to 54 one-way trips per year, using rideshare services, bus/subway, or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the SCAN Compass (HMO) plan. Emergency Services have a $90 copay and no coinsurance, while Worldwide Emergency Coverage also has a $90 copay and no coinsurance, and Worldwide Emergency Transportation has a $121 copay and no coinsurance.
Primary Care See details
The SCAN Compass (HMO) plan covers primary care physician services, chiropractic services (with a $15 copay for routine care), occupational therapy services, physician specialist services, mental health specialty services (with a $30 copay for individual and group sessions), psychiatric services (with a $30 copay for individual and group sessions), physical therapy and speech-language pathology services (no copay or coinsurance), additional telehealth benefits, and opioid treatment program services (with a $30 copay). Podiatry services are not covered.
Preventive Services See details
The SCAN Compass (HMO) plan covers a variety of preventive services, including Medicare-covered services, annual physical exams, health education, personal emergency response systems, fitness benefits, remote access technologies, and support for caregivers. Some services are not covered, including in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices, and counseling services.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams are covered once per year, and the fitting/evaluation for hearing aids has no limit. Prescription Hearing Aids (all types) are covered with a copay between $550 and $850 for 2 visits per year. Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The SCAN Compass (HMO) plan covers vision services including routine eye exams with no copay, and eyewear with a combined maximum benefit of $300 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered, but upgrades are not covered.
Dental Services See details
The SCAN Compass (HMO) plan covers a range of dental services, including oral exams, dental x-rays, other diagnostic dental services, and cleaning, with limitations on the number of visits and x-rays per year. Fluoride treatment, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. The plan also provides coverage for restorative services, adjunctive general services, endodontics, periodontics, and oral and maxillofacial surgery. Orthodontic services have a maximum benefit of $2,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the SCAN Compass (HMO) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0% to 20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0% to 20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the SCAN Compass (HMO) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, and medical supplies, is covered by SCAN Compass (HMO). Durable Medical Equipment has a coinsurance between 0% and 20%, and no copay, while durable medical equipment for use outside of the home is not covered. Prosthetic devices have a coinsurance between 0% and 20% with no copay, and medical supplies have a coinsurance between 0% and 20% with no copay. Diabetic equipment is covered, but diabetic supplies are not covered. Diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by SCAN Compass (HMO), but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered under the SCAN Compass (HMO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by SCAN Compass (HMO) with prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $125 per day; additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The SCAN Compass (HMO) plan covers acupuncture with a $15 copay per visit, up to 30 treatments per year, and over-the-counter items, with a maximum benefit of $65 every three months. The plan also covers a meal benefit, and some other services are not covered.
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