SCAN Health Plan Medicare Advantage 2024 Review

SCAN Health Plan Medicare Advantage plans are available in five states and get lower-than-average star ratings from CMS.
Kate Ashford, CSA®
By Kate Ashford, CSA® 
Updated
Edited by Holly Carey

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SCAN Health Plan Medicare Advantage - Chapter

SCAN Health Plan

3.49

CMS Star Rating

SCAN Health Plan offers Medicare Advantage plans in five states. Although plans rank well in California, overall star ratings from CMS are below average.

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States available

5 states


Members in high-rated plans

Low (49% or less)


Member experience

2.48 (Below average)


States available

5 states


Members in high-rated plans

Low (49% or less)


Member experience

2.48 (Below average)


Pros

  • Many of SCAN's Medicare Advantage plans have a $0 premium, and average max out-of-pocket costs are lower than other providers.
  • SCAN Health Plan gets top marks for customer satisfaction in California.
  • SCAN offers plans targeted at women and LGBTQ+ older adults.

Cons

  • Below-average star ratings from CMS.
  • Below-average member experience ratings.
  • Available in only 5 states.

SCAN Health Plan sells Medicare Advantage plans in five states, and the company offers plans that are tailored to specific populations, such as women and LGBTQ+ older adults. Although SCAN plans rank well in California, according to J.D. Power's latest study, overall ratings from the Centers for Medicare & Medicaid Services (CMS) are below the industry average.

Here’s what you should know about SCAN Health Plan Medicare Advantage.

SCAN Health Plan Medicare Advantage pros and cons

SCAN Health Plan’s offerings have advantages and disadvantages.

Pros

  • Low-cost plans: Many of SCAN Health Plan’s Medicare Advantage plans have a $0 premium, and the average maximum out-of-pocket cost is much lower than other major providers. 

  • Drug coverage: All SCAN Health Plan Medicare Advantage plans include prescription drug coverage.

  • Tailored plans: SCAN offers the SCAN Affirm plan in partnership with LGBTQ+ Health, designed to address the unique needs of LGBTQ+ older adults. And in 2024, SCAN is introducing the SCAN Inspired HMO plan, which is geared toward women.

  • Top marks in California: In California, SCAN Health Plan lands at the top of the list for Medicare Advantage providers in terms of customer service, according to J.D. Power’s latest Medicare Advantage study. 

Cons

  • Limited availability: SCAN Health Plan offers Medicare Advantage plans in just five states: Arizona, California, Nevada, New Mexico and Texas. 

  • Only HMOs: SCAN Health Plan offers only HMO and HMO-POS plans, which generally provide the least flexibility when seeking medical care.

  • Specialized plans are limited: SCAN’s plans for women and LGBTQ+ older adults are available in only a few counties in California so far. 

  • Mediocre customer ratings overall: On average, member experience ratings for all SCAN Medicare Advantage plans, including customer service and getting needed care, fall below the average for major providers. 

SCAN Health Plan Medicare star ratings

Average star rating, weighted by enrollment: 3.49

The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Based on the most recent year of data and weighted by enrollment, SCAN Health Plan’s 2024 Medicare Advantage plans get an average rating of 3.49 stars

Centers for Medicare & Medicaid Services. 2024 Star Ratings Data Tables (Oct 13 2023). Accessed Nov 30, 2023.
.

For comparison, the average star rating for plans from all providers is 4.04

Centers for Medicare & Medicaid Services. 10.13.23 Fact Sheet - 2024 Medicare Advantage and Part D Ratings (PDF). Accessed Nov 30, 2023.
.

You can find a plan’s rating with the Medicare plan finding tool.

What does SCAN Health Plan Medicare Advantage cost?

Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.

Premiums

One of the costs to consider is the plan’s premium. In 2024, eight out of 10 SCAN Health Plan Medicare Advantage plans that aren’t special needs plans (SNPs) have a $0 premium

Centers for Medicare & Medicaid Services. CY2024_Landscape_Files_Final_20231005 (ZIP). Accessed Nov 30, 2023.
.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $164.90 per month in 2023 ($174.70 in 2024)

Centers for Medicare & Medicaid Services. Costs. Accessed Nov 30, 2023.
, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay more.)

Copays, coinsurance and deductibles

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

Here are examples of SCAN Health Plan Medicare Advantage costs for three plans in a mid-range city:

SCAN Health Plan Medicare Advantage plan

Pricing

SCAN Classic (HMO)

Monthly premium: $0.

Out-of-pocket max: $2,800.

Copays:

  • Primary care: $0.

  • Specialist: $0.

  • Tier 1 prescription drugs: $0.

SCAN MyChoice (HMO)

Monthly premium: $0.

Out-of-pocket max: $2,800.

Copays:

  • Primary care: $0.

  • Specialist: $0.

  • Tier 1 prescription drugs: $0.

SCAN Balance (HMO C-SNP)

Monthly premium: $0.

Out-of-pocket max: $2,800.

Copays:

  • Primary care: $0.

  • Specialist: $0.

  • Tier 1 prescription drugs: $0.

Selected plans are available in ZIP code 94536.

To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only SCAN Health Plan plans or compare across carriers. You can also shop directly from SCAN Health Plan’s website by entering your ZIP code.

Available Medicare Advantage plans

There are a few kinds of SCAN Health Plan Medicare Advantage plans, and they vary in terms of structure, costs and benefits. SCAN Health Plan offers Medicare Advantage prescription drug plans (MAPDs).

Plan offerings include the following types:

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

HMO point of service (POS) plans are HMO plans that allow members to get some out-of-network services, but they’ll pay more for those services.

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. SCAN Health Plan offers three types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members living with certain chronic conditions, such as diabetes, congestive heart failure and cardiovascular disease.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

  • Institutional SNP: For people living in a SCAN Health Plan network nursing home or assisted living community, or another plan-approved spot.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included one here:

J.D. Power Ranking

In its 2023 U.S. Medicare Advantage Study — the ninth it's done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints

. The study was fielded in the five biggest Medicare markets: California, Florida, New York, Pennsylvania and Texas. On these measures, SCAN Health Plan ranked first out of all major providers in California (one of the two states from the study in which SCAN has plans).

SCAN Health Plan Medicare Advantage service area

SCAN Health Plan offers Medicare Advantage plans in five states: Arizona, California, Nevada, New Mexico and Texas. SCAN Health Plan covers more than 280,000 Medicare Advantage beneficiaries.

About SCAN Health Plan

Scan Health Plan is part of the SCAN Group, which began as the Senior Care Action Network — a not-for-profit that was founded in 1977 with the mission of keeping seniors healthy and independent. SCAN Health Plan offers Medicare Advantage plans. The SCAN Group has entered into an agreement to merge with CareOregon and become HealthRight Group.

SCAN Health Plan customer service

Here’s how SCAN Health Plan members can contact customer service:

  • Call a SCAN member services advocate at 800-559-3500 (TTY: 711). From Oct. 1 to March 31, services are open seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, services are open Monday to Friday, 8 a.m. to 8 p.m.

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

Still deciding on the right carrier? Compare Medicare Advantage plans

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