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SCAN Strive (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SCAN Strive (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SCAN Strive (HMO C-SNP) in 2026, please refer to our full plan details page.
SCAN Strive (HMO C-SNP) is a HMO C-SNP plan offered by SCAN Group available for enrollment in 2025 to people living in Clark County. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that SCAN Strive (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
SCAN Strive (HMO C-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 Strive (HMO C-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 Strive (HMO C-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 $615.00 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 $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:
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Drug Coverage
The SCAN Strive (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications, whether filled for a one, two, or three-month supply at preferred or standard pharmacies and mail-order services. This plan structure provides excellent cost savings on everyday generic medications. For higher-tier medications, costs are structured as coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance at preferred pharmacies and mail-order services, or 25% coinsurance at standard pharmacies and mail-order options. Tier 4 non-preferred drugs carry a 30% coinsurance across all pharmacy options, while Tier 5 specialty drugs require a 25% coinsurance for a one-month supply.
Additional Benefits
The SCAN Strive (HMO C-SNP) plan offers comprehensive coverage with no copays and no coinsurance for many essential services, including inpatient acute hospital stays, primary and specialist doctor visits, and outpatient hospital care. For emergency and urgent needs, members pay no copay for urgent care and a $90 copay for emergency room visits, which is waived if admitted. Skilled nursing facility stays feature no copay for the first 20 days, followed by a $125 daily copay for days 21 through 100. This plan also provides valuable supplemental benefits, such as dental coverage up to a $4,000 annual limit and vision care featuring no copay, no deductible, and a $300 annual allowance for eyewear. Additionally, members can access up to 48 one-way transportation trips per year and receive a $105 monthly allowance for over-the-counter items with no copays. While hearing exams are covered with no copay, please note that hearing aids and cardiac rehabilitation services are not covered under this plan.
Inpatient Hospital See details
SCAN Strive (HMO C-SNP) covers inpatient acute hospital stays with no copay and no coinsurance for unlimited days, while upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric hospital stays are also covered with no coinsurance, requiring a $200 daily copay for days 1 through 7 and no copay for days 8 through 90.
Outpatient Services See details
SCAN Strive (HMO C-SNP) covers outpatient hospital, ambulatory surgical center, and outpatient blood services with no copay and no coinsurance, subject to prior authorization and referral requirements. For outpatient substance abuse services, some services are covered with no copay or coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by SCAN Strive (HMO C-SNP) with no copay and no coinsurance. Prior authorization and referrals are required to receive these services.
Ambulance and Transportation Services See details
SCAN Strive (HMO C-SNP) covers ground and air ambulance services with a $125 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
SCAN Strive (HMO C-SNP) covers emergency services with a $90 copay and no coinsurance, which is waived if you are admitted to the hospital. Urgently needed services are covered with no copay or coinsurance, while worldwide emergency services require a $90 copay and worldwide emergency transportation has a $125 copay, both with no coinsurance.
Primary Care See details
SCAN Strive (HMO C-SNP) covers primary care, specialist, therapy, and telehealth services with no copay and no coinsurance. While some chiropractic, mental health, and psychiatric services are covered, routine and other chiropractic care, individual and group mental health sessions, and individual and group psychiatric sessions are not covered, and podiatry is not covered.
Preventive Services See details
SCAN Strive (HMO C-SNP) offers partially covered preventive services with no copays and no coinsurance for covered care, including annual physical exams, kidney disease education, and select additional benefits like memory fitness and personal emergency response systems. However, several additional preventive services are not covered, such as in-home safety assessments, weight management programs, medical nutrition therapy, and alternative therapies.
Hearing Services See details
SCAN Strive (HMO C-SNP) offers partial coverage for hearing exams with no copay and no coinsurance, though routine hearing exams and fitting evaluations are not covered. Both prescription and OTC hearing aids are not covered under this plan.
Vision Services See details
SCAN Strive (HMO C-SNP) features partially covered vision services with no copay, no coinsurance, and no deductible, which includes one routine eye exam and up to $300 per year for eyeglasses or contact lenses. Other eye exam services and eyewear upgrades are not covered under this plan, and referrals and prior authorizations are required.
Dental Services See details
SCAN Strive (HMO C-SNP) offers partially covered dental services with no copay and no coinsurance for covered preventive and comprehensive treatments, up to a $4,000 annual limit. Other diagnostic dental services, other preventive dental services, and orthodontics are not covered.
Home Infusion bundled Services See details
SCAN Strive (HMO C-SNP) 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 require no copay and range from no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
SCAN Strive (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by SCAN Strive (HMO C-SNP) with no copay and coinsurance ranging from 0% (no coinsurance) to 20% depending on the item. The benefit is partially covered because diabetic therapeutic shoes and inserts are covered with no copay and 20% coinsurance, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
SCAN Strive (HMO C-SNP) 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 radiological services, therapeutic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by SCAN Strive (HMO C-SNP) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
SCAN Strive (HMO C-SNP) does not cover Cardiac Rehabilitation Services, as all associated sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
SCAN Strive (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and a referral but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $125 daily copay for days 21 through 100, though additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by SCAN Strive (HMO C-SNP), which offers over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. Eligible members receive up to $105 per month for OTC items, and prior-authorized meals are covered at no cost following a hospital stay or for chronic illnesses.
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