A non-government entity
SCAN MyChoice (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for SCAN MyChoice (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on SCAN MyChoice (HMO) in 2025, please refer to our full plan details page.
SCAN MyChoice (HMO) is a HMO plan offered by SCAN Group available for enrollment in 2025 to people living in Maricopa, Pima, and Pinal Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that SCAN MyChoice (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about SCAN MyChoice (HMO).
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 MyChoice (HMO), 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 Maximum Out-Of-Pocket cost of $2800.00 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 MyChoice (HMO)
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 MyChoice (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay no copay for preferred generic drugs. For standard generic drugs, you'll pay a $42 or $43 copay depending on the pharmacy. For preferred and non-preferred drugs, you will pay coinsurance. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The SCAN MyChoice (HMO) plan offers comprehensive coverage including inpatient and outpatient hospital services, with varying copays depending on the service. Emergency, ambulance, and hearing services are also covered, with copays for some services and no copays for others. Vision and dental benefits are included, with coinsurance for certain services like eyewear and a $2,000 annual maximum for orthodontics. Additional benefits include coverage for preventive services, home health, and skilled nursing facilities, each with its own cost structure. The plan also covers a range of other services such as acupuncture and over-the-counter items, with some services requiring prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits for SCAN MyChoice (HMO) include coverage for Inpatient Hospital-Acute with a $75 copay for days 1-5, and no copay for days 6-90, as well as Inpatient Hospital Psychiatric with a $200 copay for days 1-7, and no copay for days 8-90. Additional days and upgrades for Inpatient Hospital-Acute are covered, while non-Medicare-covered stays are not covered. Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered with prior authorization and a doctor referral. Individual and group sessions for outpatient substance abuse have a copay between $20.00 and $20.00.
Partial Hospitalization See details
Partial Hospitalization is covered by SCAN MyChoice (HMO) with a $20 copay, but requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
The SCAN MyChoice (HMO) plan covers ambulance services, including ground and air ambulance services, each with a $250 copay and no coinsurance, but transportation services are not covered. Prior authorization is required for all ambulance services.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by SCAN MyChoice (HMO). Emergency Services and Worldwide Emergency Coverage have a $90 copay with no coinsurance, while Worldwide Emergency Transportation has a $250 copay with no coinsurance. Worldwide Urgent Coverage has no copay and no coinsurance.
Primary Care See details
The SCAN MyChoice (HMO) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Routine chiropractic care has a $10 copay for up to 20 visits per year. Individual and group sessions for mental health and psychiatric services have a copay between $0 and $20. Physical therapy and speech-language pathology services have a copay between $0 and $10. Opioid treatment program services have a $20 copay. Podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, including annual physical exams and additional services not usually covered by Medicare plans. Health Education, Personal Emergency Response System (PERS), In-Home Support Services, Support for Caregivers of Enrollees, Fitness Benefit, and Remote Access Technologies are covered, while In-Home Safety Assessment, Medical Nutrition Therapy (MNT), 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 Benefit, 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 are not covered.
Hearing Services See details
Hearing Services are covered by SCAN MyChoice (HMO), including hearing exams, routine hearing exams, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) have a copay between $550 and $850, and you are eligible for 2 visits every year.
Vision Services See details
The SCAN MyChoice (HMO) plan covers vision services, including eye exams and eyewear. Eyewear has a 20% coinsurance for contact lenses and a combined maximum plan benefit of $300.
Dental Services See details
The SCAN MyChoice (HMO) plan covers dental services, including oral exams (2 visits per year), dental x-rays (1 per year), other diagnostic dental services, and prophylaxis (cleaning) (2 visits per year); however, fluoride treatment is not covered. Orthodontic services are covered up to a maximum of $2,000 per year. Restorative services, adjunctive general services, endodontics, periodontics, and oral and maxillofacial surgery are also covered. However, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the SCAN MyChoice (HMO) plan. Medicare Part B Insulin Drugs have a $35 copay with 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the SCAN MyChoice (HMO) plan, but require prior authorization and a doctor's referral. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, Prosthetics/Medical Supplies with a coinsurance, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance; however, Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. There is no copay for any of these services.
Diagnostic and Radiological Services See details
The SCAN MyChoice (HMO) plan covers diagnostic and radiological services, but does not cover diagnostic procedures/tests, lab services, or outpatient X-Ray services. Diagnostic Radiological Services have a copay of up to $200, and Therapeutic Radiological Services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by SCAN MyChoice (HMO), with no copay or coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, or Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services. A doctor referral and prior authorization are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by SCAN MyChoice (HMO) with prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $150.
Other Services See details
The SCAN MyChoice (HMO) plan covers acupuncture with a $10 copay, up to 20 treatments per year and also covers over-the-counter (OTC) items with a maximum benefit of $80 every three months. Additionally, the plan covers meal benefits, and provides other services, but does not cover 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), and several other services.
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