SCAN Classic (HMO)

SCAN Classic (HMO) is a HMO plan offered by SCAN Group available for enrollment in 2025 to people living in Santa Clara and Stanislaus Counties. 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) prescription drug plan features an annual drug deductible of $250.00 before coverage begins. Once this deductible is met, you will pay no copay for Tier 1 preferred generic drugs at preferred retail pharmacies or through preferred mail order, while standard generics carry a $42.00 copay. For higher-tier medications, you will pay a 35% coinsurance for preferred brands and a 30% coinsurance for non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the Low-Income Subsidy (Extra Help) can benefit from a reduced Part D premium of $0.00. This plan provides structured, predictable cost-sharing to help you manage your healthcare budget.

Additional Benefits

The SCAN Classic (HMO) plan offers comprehensive medical coverage featuring no copay for preventive services, annual physicals, and urgently needed care. Members benefit from low out-of-pocket costs, including a $5 copay for routine chiropractic care, a $10 copay for mental health sessions, and outpatient hospital services ranging from no copay up to $100. Emergency room visits require a $90 copay, which is waived upon hospital admission, while ground and air ambulance services carry a $95 copay. For supplemental care, the plan provides robust dental coverage up to a $3,000 annual limit and a $250 annual allowance for eyewear alongside routine vision exams. Additional perks include a $170 quarterly allowance for over-the-counter items, up to 40 one-way transportation trips to approved health locations, and meal benefits with no copay. Specialized care like skilled nursing facilities features no copay for the first 20 days, while prescription hearing aids are covered with copays ranging from $550 to $850.