SCAN Alta (HMO)

SCAN Alta (HMO) is a HMO plan offered by Scan Health Plan available for the 2026 plan year to people living in San Diego County. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that SCAN Alta (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 Alta (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 Alta (HMO) Medicare Advantage plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $250. Once this deductible is met, you enter the initial coverage phase where you pay copays or coinsurance until your total drug costs reach $2,100. If you qualify for Extra Help, your Part D premium may be reduced to $0. Under this plan, Tier 1 preferred generic drugs have no copay when filled at preferred retail or mail-order pharmacies, while standard pharmacies charge a $15 copay. Tier 2 standard generics require a $42 copay at preferred pharmacies, whereas Tier 3 preferred brands and Tier 4 non-preferred drugs require 35% and 30% coinsurance respectively. After your yearly out-of-pocket drug costs reach $2,100, you enter catastrophic coverage and pay nothing for covered Part D prescriptions.

Additional Benefits

The SCAN Alta (HMO) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no coinsurance for inpatient hospital stays and no copay for most acute care days. Outpatient hospital visits, emergency care, and primary care services generally feature low copays ranging from no copay up to $90, with no coinsurance. Additionally, skilled nursing facility care is highly affordable, requiring no copay for the first 20 days of care. For daily wellness, the plan provides valuable supplemental benefits including dental care with no coinsurance, a $325 annual vision allowance, and hearing aid coverage with copays between $550 and $850. Members also benefit from up to 40 one-way transportation trips per year to approved locations and a $175 over-the-counter allowance every three months. Furthermore, Medicare-covered preventive care and urgent care are available with no copay and no coinsurance, while home health services are also fully covered.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.