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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 Maricopa and Pima County. This plan received an overall rating of 4.5 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 $2000.00 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) Medicare plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. For those who qualify for the low-income subsidy or Extra Help, the Part D premium can be reduced to nothing. Once the deductible is met, you will benefit from no copay on Tier 1 Preferred Generic drugs across all standard, preferred, and mail-order pharmacy options. For other drug tiers in the initial coverage phase, you will pay a coinsurance of 24% to 25% for Tier 2 Standard Generics, 30% for Tier 3 Preferred Brands, and 25% for Tier 4 Non-Preferred Drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for covered Medicare Part D drugs. This plan structure provides clear cost-sharing tiers to help you easily manage your prescription expenses.
Additional Benefits
The SCAN Strive (HMO C-SNP) plan offers comprehensive medical coverage designed to keep your out-of-pocket costs manageable. For inpatient acute hospital stays, you will pay a $75 daily copay for days one through five, with no copay for days six through 90. Emergency room visits require a $90 copay, which is waived if you are admitted, while urgently needed care is available with no copay. Beyond medical care, the plan provides robust dental and vision benefits, including a $4,000 annual maximum for dental services and a $300 yearly eyewear allowance with no copay. Members also benefit from helpful extras like up to 48 one-way trips to plan-approved health locations and a $130 monthly allowance for over-the-counter items.
Inpatient Hospital See details
SCAN Strive (HMO C-SNP) partially covers inpatient hospital services with no coinsurance, but does not cover upgrades, non-Medicare-covered stays, or additional psychiatric days. Acute stays require a $75 daily copay for days 1 to 5 and no copay for days 6 to 90, while psychiatric stays require a $200 daily copay for days 1 to 7 and no copay for days 8 to 90.
Outpatient Services See details
Outpatient services are covered by SCAN Strive (HMO C-SNP), including outpatient hospital, observation, ambulatory surgical center, and blood services, though outpatient substance abuse services are not covered. Covered services require prior authorization and a doctor referral, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
SCAN Strive (HMO C-SNP) covers partial hospitalization benefits, which require prior authorization and a doctor referral.
Ambulance and Transportation Services See details
SCAN Strive (HMO C-SNP) covers ground and air ambulance services with a $250 copay and no coinsurance, though prior authorization is required. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations, while 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 coverage has a $90 copay and worldwide emergency transportation has a $250 copay, both with no coinsurance.
Primary Care See details
SCAN Strive (HMO C-SNP) covers primary care, specialist, and telehealth services, with physical, occupational, and speech therapies requiring a $10 copay and no coinsurance. Chiropractic services are partially covered, excluding routine chiropractic care, while podiatry, mental health specialty, and psychiatric services are not covered.
Preventive Services See details
SCAN Strive (HMO C-SNP) covers preventive services with no copay and no coinsurance for Medicare-covered zero-dollar services, annual physical exams, and kidney disease education. Additional preventive services are partially covered, excluding medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, smoking cessation, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered under the SCAN Strive (HMO C-SNP) plan with no deductible, but routine hearing exams, fitting and evaluation for hearing aids, prescription hearing aids, and over-the-counter hearing aids are not covered.
Vision Services See details
SCAN Strive (HMO C-SNP) offers partially covered vision services, including one routine eye exam per year with no copay and no coinsurance. Eyewear is covered up to a $300 annual limit with no copay, though contact lenses require a 20% coinsurance and upgrades are not covered.
Dental Services See details
Dental services are partially covered by SCAN Strive (HMO C-SNP), featuring preventive care such as exams and cleanings alongside comprehensive services up to a $4,000 annual maximum. Prior authorization is required for most comprehensive procedures, and orthodontics is not covered.
Home Infusion bundled Services See details
SCAN Strive (HMO C-SNP) covers home infusion bundled services with prior authorization, offering chemotherapy, radiation, and other Part B drugs with no copay and no coinsurance up to 20% coinsurance. Covered Part B insulin drugs require a $35 copay and no coinsurance up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by SCAN Strive (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a doctor referral are required to receive these services.
Medical Equipment See details
Medical equipment is partially covered by SCAN Strive (HMO C-SNP) with no copays, except for diabetic supplies which are not covered. Covered durable medical equipment incurs a 0% to 20% coinsurance, while prosthetics, medical supplies, and diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by SCAN Strive (HMO C-SNP), as diagnostic procedures, lab services, and outpatient X-ray services are not covered. Covered diagnostic services require no copay or coinsurance, while diagnostic radiological services have a $0 to $50 copay with no coinsurance, and therapeutic radiological services require both a copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered by SCAN Strive (HMO C-SNP), requiring prior authorization and a doctor referral for members to receive care.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the SCAN Strive (HMO C-SNP) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by SCAN Strive (HMO C-SNP) with no copay for days 1 to 20 and a $150 daily copay for days 21 to 100, with no coinsurance. Prior authorization and a doctor referral are required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
SCAN Strive (HMO C-SNP) partially covers Other Services, providing a $130 monthly allowance for over-the-counter items and a meal benefit for qualifying medical conditions with prior authorization. Acupuncture and dual-eligible SNP highly integrated services are not covered under this plan.
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