A non-government entity
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 Maricopa and Pima 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 $29.90. 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:
Sign up for SCAN Strive (HMO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The SCAN Strive (HMO C-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay a coinsurance or no copay depending on the drug tier and pharmacy. For preferred generic drugs, there is no copay. For standard generic drugs, you pay 24-25% coinsurance, and for preferred brand drugs, you pay 45% coinsurance.
Additional Benefits
The SCAN Strive (HMO C-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, emergency services, and primary care, with some services requiring prior authorization. Many services, such as outpatient services, ambulance, vision, and dental, require a coinsurance of 20%. The plan also provides additional benefits, like coverage for OTC items with a monthly allowance, and home health services with no copay or 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 referral. Additional days for Inpatient Hospital-Acute, Non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute are not covered, nor are additional days or non-Medicare covered stays for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services, offered by SCAN Strive (HMO C-SNP), include coverage for Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, each with a 20% coinsurance. Outpatient Substance Abuse Services are partially covered, with individual and group sessions 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 referral. The plan does not specify any cost sharing for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the SCAN Strive (HMO C-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and there is no copay. Transportation Services to a plan-approved health-related location are covered for up to 48 one-way trips per year, using rideshare services, bus/subway, and medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. For all emergency services, you will pay a 20% coinsurance, with a maximum per visit amount of $110 for Emergency Services and $45 for Urgently Needed Services.
Primary Care See details
The SCAN Strive (HMO C-SNP) plan's primary care benefits cover primary care physician services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services are covered with 20% coinsurance, and routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered preventive services with no copay and annual physical exams. Kidney Disease Education Services are covered with 20% coinsurance, and other preventive services like Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas are covered. However, services like Medical Nutrition Therapy, and Counseling Services are not covered.
Hearing Services See details
Hearing services are partially covered by the SCAN Strive (HMO C-SNP) plan. Hearing exams are covered with a coinsurance of at most 20%, but routine hearing exams and fitting/evaluation for hearing aids are not covered; prescription hearing aids and OTC hearing aids are also not covered.
Vision Services See details
The SCAN Strive (HMO C-SNP) plan covers vision services, including eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are limited to one per year. Eyewear, including contact lenses, eyeglasses, and eyeglass lenses and frames are covered with a 20% coinsurance, with a combined maximum benefit of $300 per year, while upgrades are not covered.
Dental Services See details
The SCAN Strive (HMO C-SNP) plan covers Medicare Dental Services with a 20% coinsurance, Oral Exams (2 visits per year), Dental X-Rays (1 per year), Other Diagnostic Dental Services, and Prophylaxis (Cleaning) (2 visits per year). Orthodontic Services are covered up to a maximum of $3,000 per year, and the plan also covers Restorative Services, Adjunctive General Services, Endodontics, Periodontics, and Oral and Maxillofacial Surgery. Fluoride Treatment, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the SCAN Strive (HMO C-SNP) plan. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the SCAN Strive (HMO C-SNP) plan and require prior authorization and a doctor's referral. You will pay a 20% coinsurance for this service.
Medical Equipment See details
Medical equipment benefits are covered by SCAN Strive (HMO C-SNP), with Durable Medical Equipment (DME) having a coinsurance between 0% and 20% and no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit has a coinsurance, and Prosthetic Devices have a 20% coinsurance with no copay, while Medical Supplies have a 20% coinsurance. Diabetic Equipment is covered, with Diabetic Supplies not covered, and Diabetic Therapeutic Shoes/Inserts having a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by 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 prior authorization and a referral. However, 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's referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but require prior authorization and a doctor referral. The plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays.
Other Services See details
The "Other Services" benefit for SCAN Strive (HMO C-SNP) covers over-the-counter (OTC) items with a maximum benefit of $90.00 every month, and also covers a meal benefit, but requires 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved