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SCAN Embrace (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SCAN Embrace (HMO-POS I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SCAN Embrace (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
SCAN Embrace (HMO-POS I-SNP) is a HMO-POS I-SNP plan offered by SCAN Group available for enrollment in 2025 to people living in Maricopa and Pima Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that SCAN Embrace (HMO-POS I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
SCAN Embrace (HMO-POS I-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 Embrace (HMO-POS I-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 Embrace (HMO-POS I-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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $1500.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $1500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Embrace (HMO-POS I-SNP) plan has a $0 deductible for prescription drugs. For those who qualify for the low-income subsidy, there is no copay. During the initial coverage phase, you will pay varying copays or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay, while standard generic drugs have a $42 or $43 copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for Part D covered drugs.
Additional Benefits
The SCAN Embrace (HMO-POS I-SNP) plan offers comprehensive coverage with a focus on inpatient and outpatient services. Inpatient hospital stays have a $150 copay for days 1-5, and no copay for days 6-90, while outpatient services have copays ranging from $0 to $100 depending on the service. The plan also includes coverage for emergency services, ambulance services, and a range of primary care and preventive services. Additional benefits include dental, vision, and hearing services with varying copays and annual limits, as well as coverage for home health and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, there is a $150 copay for days 1-5, and no copay for days 6-90, while Inpatient Hospital Psychiatric has the same cost-sharing.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, and ambulatory surgical center services, with copays ranging from $0 to $100 depending on the service. Outpatient substance abuse services are partially covered, with individual and group sessions not covered. Outpatient blood services are covered, with three pints of blood deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered by the SCAN Embrace (HMO-POS I-SNP) plan. There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the SCAN Embrace (HMO-POS I-SNP) plan. Ground and air ambulance services have a $200 copay, and there is no coinsurance. Transportation services to a plan-approved health-related location are covered for up to 56 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the SCAN Embrace (HMO-POS I-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $120 copay, Worldwide Urgent Coverage has a $120 copay, and Worldwide Emergency Transportation has a $200 copay; all services have no coinsurance.
Primary Care See details
The SCAN Embrace (HMO-POS I-SNP) plan covers primary care physician services, occupational therapy services, physician specialist services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services, mental health specialty services, and routine chiropractic care are partially covered; routine chiropractic care, individual sessions, and group sessions for mental health specialty services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered preventive services, annual physical exams, and additional preventive services, though some services like in-home safety assessments, personal emergency response systems, and others are not covered. The plan also covers health education, fitness benefits, and other preventive services like glaucoma screening and diabetes self-management training.
Hearing Services See details
The SCAN Embrace (HMO-POS I-SNP) plan covers hearing exams, including routine hearing exams once per year, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered, with a copay between $450 and $750, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The SCAN Embrace (HMO-POS I-SNP) plan covers vision services including routine eye exams with one visit per year, and eyewear with a combined maximum benefit of $375 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered, with a limit of one per year. Upgrades are not covered.
Dental Services See details
The SCAN Embrace (HMO-POS I-SNP) plan covers a wide range of dental services, including oral exams and dental x-rays with a limit of 2 visits per year, other diagnostic dental services with a copay between $0 and $5, prophylaxis (cleaning) with a limit of 2 visits per year, other preventive dental services with a copay between $0 and $80, restorative services with a copay between $8 and $395, adjunctive general services with a copay between $0 and $125, endodontics with a copay between $5 and $395, periodontics with a copay between $0 and $380, removable prosthodontics with a copay between $13 and $395, fixed prosthodontics with a copay between $25 and $395, and oral and maxillofacial surgery with a copay between $0 and $140; however, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered. The plan has a maximum benefit of $2,000 per year for dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the SCAN Embrace (HMO-POS I-SNP) plan. This plan covers dialysis services.
Medical Equipment See details
Medical Equipment is covered by the SCAN Embrace (HMO-POS I-SNP) plan, with Durable Medical Equipment (DME) subject to 0% to 20% coinsurance and Prosthetic Devices subject to 0% to 20% coinsurance; however, Durable Medical Equipment for use outside the home and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
The SCAN Embrace (HMO-POS I-SNP) plan offers Diagnostic and Radiological Services, but Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services are not covered. Diagnostic Radiological Services have a maximum copay of $125, and Therapeutic Radiological Services have a maximum copay of $60.
Home Health Services See details
Home Health Services are covered by the SCAN Embrace (HMO-POS I-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization and a referral.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are 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, but additional days beyond Medicare-covered SNF and non-Medicare-covered stays for SNF are not covered. Prior authorization is required.
Other Services See details
The SCAN Embrace (HMO-POS I-SNP) plan covers Over-the-Counter (OTC) items with a maximum benefit of $200.00 every three months, and also covers Nicotine Replacement Therapy (NRT) and Naloxone as a Part C OTC benefit. Acupuncture, Meal Benefit, 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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