SCAN Classic (HMO)

SCAN Classic (HMO) is a HMO plan offered by SCAN Group available for enrollment in 2025 to people living in Fresno, Madera, Kings and Tulare 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 offers an Enhanced Alternative drug benefit with a $250.00 prescription drug deductible. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs when using a preferred retail pharmacy or preferred mail order. For Tier 2 standard generics, you will pay a $42.00 copay at preferred locations and a $47.00 copay at standard locations. Tier 3 preferred brand drugs require a 35% coinsurance, while Tier 4 non-preferred drugs carry a 30% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescriptions. Additionally, if you qualify for the low-income subsidy, your Part D premium can be reduced to $0.00.

Additional Benefits

The SCAN Classic (HMO) plan provides comprehensive medical coverage with no coinsurance for many core services, including inpatient hospital stays that feature no copay for days one through three and days eight through ninety. Outpatient hospital services range from no copay up to an eighty-five dollar copay, while emergency room visits require a ninety dollar copay that is waived upon admission. Urgent care and preventive services, including annual physicals and fitness benefits, are fully covered with no copay or coinsurance. For specialized and supplemental care, the plan offers up to a three thousand dollar annual maximum for dental services, a two hundred dollar yearly eyewear allowance with no deductible, and prescription hearing aid coverage with a four hundred fifty to seven hundred fifty dollar copay. Members also benefit from a one hundred ten dollar quarterly over-the-counter allowance and qualifying meal benefits with no copay. Additionally, routine chiropractic and acupuncture services are available with a five dollar copay, while ambulance services require a seventy-five dollar copay.