SCAN Classic (HMO)

SCAN Classic (HMO) is a HMO plan offered by SCAN Group available for enrollment in 2025 to people living in Alameda and San Mateo 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) medicare plan features an Enhanced Alternative drug benefit with a $250 prescription drug deductible. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies or through preferred mail order, while standard pharmacies and standard mail order charge a $10 copay. For Tier 2 standard generic drugs, you will pay a $42 copay at preferred locations and preferred mail, or a $47 copay at standard locations and standard mail. Tier 3 preferred brand drugs require a 35% coinsurance, and Tier 4 non-preferred drugs require a 30% coinsurance across all pharmacy types. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, if you qualify for full Extra Help, your Part D premium is reduced to $0.

Additional Benefits

The SCAN Classic (HMO) plan offers robust medical coverage with predictable costs, featuring no copays for urgent care and a $90 copay for emergency services. For hospital stays, members pay a $100 daily copay for days 1 through 5 of acute inpatient care and a $125 copay for outpatient hospital services, both with no coinsurance. Additionally, skilled nursing facility stays require no copay for the first 20 days, followed by a $75 daily copay for days 21 through 100. Routine vision and hearing exams are available with no copay, alongside a $200 annual eyewear allowance and up to $3,000 in annual dental coverage. The plan also includes valuable extras like an $85 quarterly over-the-counter allowance, up to 28 one-way transportation trips to approved locations, and acupuncture benefits. While many services require prior authorization, most preventive care, primary care visits, and medical equipment have no copays or low coinsurance rates.