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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 2025, 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 3.5 out of 5 stars in 2025.
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 $21.30. 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 $590.00 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 $9350.00 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) plan has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay either a coinsurance or no copay depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have no copay, while standard generic drugs have a 24-25% coinsurance. Preferred brand drugs have a 45% coinsurance.
Additional Benefits
The SCAN Strive (HMO C-SNP) plan offers a variety of benefits, including coverage for inpatient and outpatient services, with some services requiring prior authorization and a doctor's referral. Many services, such as outpatient services, ambulance, and vision services, have a 20% coinsurance. The plan also covers preventive services, hearing services, and dental services, with varying levels of coverage and cost-sharing. Additionally, the plan offers home infusion services with a $35 copay for certain drugs, and covers medical equipment with a coinsurance between 0% and 20%. Other services include a monthly allowance for over-the-counter items, and Dialysis Services, Home Health Services, and Skilled Nursing Facility (SNF) services with 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered and require prior authorization and a doctor's referral. Additional days for Inpatient Hospital-Acute and Psychiatric, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, are covered with a 20% coinsurance. Outpatient Substance Abuse Services are partially covered, with Individual and Group Sessions for Outpatient Substance Abuse not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the SCAN Strive (HMO C-SNP) plan, but requires prior authorization and a doctor's referral. The plan does not list any cost information, so it is not possible to determine the copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered, with a limit of 48 one-way trips per year, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the SCAN Strive (HMO C-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, and there is no copay. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a 20% coinsurance, and no copay.
Primary Care See details
The SCAN Strive (HMO C-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a 20% coinsurance, and routine care is not covered. Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits also have a 20% coinsurance. Podiatry Services are not covered, and individual and group sessions for Mental Health Specialty Services and Psychiatric Services are not covered.
Preventive Services See details
The SCAN Strive (HMO C-SNP) plan covers preventive services, including annual physical exams, health education, personal emergency response systems, in-home support services, support for caregivers of enrollees, fitness benefits, remote access technologies, and other preventive services. Kidney disease education services are covered with 20% coinsurance. 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 related to chemotherapy, 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 modifications, and counseling services.
Hearing Services See details
Hearing Services are partially covered under the SCAN Strive (HMO C-SNP) plan. Hearing Exams require prior authorization and a doctor's referral with a coinsurance of at most 20%, while Routine Hearing Exams, Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids (all types, inner ear, outer ear, and over the ear), and OTC Hearing Aids are not covered.
Vision Services See details
Under the SCAN Strive (HMO C-SNP) plan, vision services include eye exams and eyewear, with a 20% coinsurance for eye exams and contact lenses. Eyewear has a combined maximum benefit of $300 every year, and upgrades are not covered.
Dental Services See details
Dental services are covered, with 20% coinsurance for Medicare dental services. Oral exams are covered for 2 visits per year, and dental X-rays are covered for 1 per year. Fluoride treatment, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. Orthodontic services have a maximum plan benefit of $3,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and coinsurance between 0% and 20%, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the SCAN Strive (HMO C-SNP) plan. A doctor referral and prior authorization are required, and you will pay 20% coinsurance.
Medical Equipment See details
The SCAN Strive (HMO C-SNP) plan covers Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, as well as Prosthetics/Medical Supplies with no copay and a coinsurance for Medicare-covered items. Diabetic Equipment is covered, but Diabetic Supplies are not covered, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the SCAN Strive (HMO C-SNP) plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the SCAN Strive (HMO C-SNP) plan with no copay and no coinsurance, but require authorization and referral. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the SCAN Strive (HMO C-SNP) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered stays are not covered. Prior authorization and a doctor's referral are required.
Other Services See details
Other services offered by SCAN Strive (HMO C-SNP) include a monthly allowance of $80 for over-the-counter items, and meal benefits that require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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