SCAN Classic (HMO)
SCAN Health Plan · HMO · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Most you pay in a year for covered care in network
- $4,200
- Higher than most plans here
- Drug deductible
- $370
- Higher than most plans here
- Medicare star rating
- No rating yet
In plain English
Compared with the 45 other plans in San Diego County that the same person could join.
What stands out
- No monthly premium
- $120 for the emergency room, lower than most plans here
Watch out for
- Up to $4,200 a year for covered care, higher than most plans here
- $1,625 for a 5-day hospital stay, higher than most plans here
- $35 for specialist visits, higher than most plans here
- $10 for primary care visits, tied for highest here
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$20$0 in premiums + $20 for careHigher than most plans here2 checkups and 2 lab tests.
- A busier year$210$0 in premiums + $210 for careHigher than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$2,565$0 in premiums + $2,565 for care6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$10Tied for highest here
- Specialist visit$35Higher than most plans hereReferral neededPlan approval may be needed
- Urgent care$30Higher than most plans here
- Emergency room$120Lower than most plans hereNot charged if you stay in the hospital
- Hospital stay$325 a day for days 1 to 7, then $0 for days 8 to 90Higher than most plans hereReferral neededPlan approval may be needed
- Lab tests$0Referral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$75 to $250Depends on the serviceReferral neededPlan approval may be needed
- Outpatient hospital care$150 to $350Depends on the service
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$50Higher than most plans hereReferral neededPlan approval may be needed
- Ground ambulance$240Plan approval may be needed
- Skilled nursing facility$0 for days 1 to 20, then $140 a day for days 21 to 100Referral neededPlan approval may be needed
From the costs the plan filed with Medicare for 2027. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 45 other plans in San Diego County that the same person could join. Read the plan’s 2027 booklet (PDF)
What medicines cost
| Drug tier | Preferred pharmacy | Other network pharmacy |
|---|---|---|
| 1Preferred Generic | $0 | $9 |
| 2Generic | $5 | $15 |
| 3Preferred BrandAfter the deductible | $42 | $47 |
| 4Non-Preferred DrugAfter the deductible | 30% of the price | 30% of the price |
| 5Specialty TierAfter the deductible | 29% of the price | 29% of the price |
For a 1-month supply. The $370 drug deductible applies only to the tiers marked. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2027, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams: $0. Some bigger dental work included, more with an optional add-on you can buy.
- Vision Not included
- Hearing IncludedRoutine hearing test covered. Hearing aids covered.
- Over-the-counter items Not included
- Fitness Not included
- Rides to care Not included
What changed from 2026
- Most you pay in a year2026$3,4002027$4,200
- Drug deductible2026$2502027$370
- Emergency room2026$902027$120
- Hospital stay2026$275 a day for days 1 to 7, then $0 for days 8 to 902027$325 a day for days 1 to 7, then $0 for days 8 to 90
- Outpatient surgery center2026$35 to $2502027$75 to $250
- Outpatient hospital care2026$35 to $3002027$150 to $350
- Vision2026Routine eye exam covered. Glasses or contacts covered. Eyewear: plan pays up to $300 every two years2027Not covered
- Over-the-counter items2026Up to $50 every three months for things like vitamins, pain relief and bandages2027Not covered
- Fitness2026Includes gym or fitness classes2027Not covered
- Rides to care202640 one-way rides to medical visits a year2027Not covered
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take SCAN Classic (HMO), plan number H5425-005, for 2027?”