SCAN Classic (HMO)

SCAN Classic (HMO) is a HMO plan offered by SCAN Group available for enrollment in 2025 to people living in Ventura County. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that SCAN Classic (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 Classic (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.

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:

Drug Coverage

The SCAN Classic (HMO) Medicare prescription drug plan features an Enhanced Alternative benefit structure with a $250 annual drug deductible. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs filled at preferred pharmacies or through preferred mail order. For Tier 2 standard generics, you will pay a $42 copay at preferred locations or a $47 copay at standard pharmacies. For brand-name and non-preferred medications, the plan charges a 35% coinsurance for Tier 3 preferred brands and a 30% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. Additionally, qualifying low-income subsidy recipients can see their drug premiums reduced to $0.

Additional Benefits

The SCAN Classic (HMO) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay for preventive care and primary care visits that range from no copay to $10. Inpatient hospital stays require a $300 daily copay for the first 5 days and no copay thereafter, while emergency room visits carry a $90 copay that is waived if you are admitted. Outpatient services, partial hospitalization, and skilled nursing facility stays are also covered, generally requiring no coinsurance and low-to-moderate copayments. For supplemental care, the plan includes dental, vision, and hearing benefits, highlighted by a $250 annual eyewear allowance and a $10 copay for routine hearing exams. Members also benefit from up to 32 one-way transportation trips per year, a $120 over-the-counter allowance every three months, and acupuncture coverage. While most services feature no coinsurance, specialized services like dialysis and diagnostic radiology require a 20% coinsurance.