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SCAN Health Plan Medicare Advantage 2024-2025: Pros, Cons, Costs
SCAN Health Plan Medicare Advantage plans are available in five states and get above-average star ratings from CMS.
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Kate Ashford, CSA® Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 20 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
The bottom line: SCAN Health Plan Medicare Advantage is highly rated and offers plans tailored to specific communities of people, such as women and LGBTQ+ older adults, but plans are available in only 22 counties across five states.
Jump to: Full Review
SCAN Health Plan
4.48
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
SCAN Health Plan Medicare Advantage pros and cons
Pros
High star ratings: SCAN Health Plan gets above-average star ratings from the Centers for Medicare & Medicaid Services (CMS) for 2025.
Low-cost plans: Most SCAN Health Plan 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 plans targeted toward the needs of LGBTQ+ older adults as well as women. In 2025, SCAN is introducing the SCAN Allied HMO, designed for the needs of Asian American older adults.
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, LGBTQ+ and Asian American older adults are available in only a few counties in California.
Mediocre customer ratings: 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.
Compare against other providers
UnitedHealthcare
3.93
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
M-F 8am-10pm EST, Sa-Su 9am-9pm EST
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
NerdWallet’s Medicare content, including articles, reviews and recommendations, is produced by a team of writers and editors who specialize in Medicare. Their work has appeared in The Associated Press, Washington Post, Nasdaq, MSN, MarketWatch, Yahoo! Finance and other national and regional media outlets. They have been cited in publications including Healthline, and appeared on NerdWallet's "Smart Money" podcast.
SCAN Health Plan Medicare Advantage star ratings
Average star rating, weighted by enrollment: 4.48
SCAN Health Plan Medicare Advantage plans are rated above the industry average, receiving an average rating of 4.48 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.95.
CMS 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.
. You'll also be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024 ($185 in 2025).
(Most people pay this standard amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.)
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.
Deductible: None.
Out-of-pocket max: $1,500.
Copays:
Primary care: $0.
Specialist: $0.
Emergency care: $90.
Inpatient hospital: $100.*
Dental allowance: No limit, many comprehensive services aren't covered.
SCAN MyChoice (HMO)
Monthly premium: $0.
Deductible: None.
Out-of-pocket max: $1,500.
Copays:
Primary care: $0.
Specialist: $0.
Emergency care: $90.
Inpatient hospital: $100.*
Dental allowance: $2,000.
SCAN Balance (HMO C-SNP)
Monthly premium: $0.
Deductible: None.
Out-of-pocket max: $1,500.
Copays:
Primary care: $0.
Specialist: $0.
Emergency care: $90.
Inpatient hospital: $100.*
Dental allowance: $2,000.
Selected plans are available in ZIP code 94536.
*Inpatient hospital copay is per day for days 1-5.
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.
Available Medicare Advantage plans
SCAN Health Plan offers Medicare Advantage prescription drug plans.
Plan offerings include the following types:
HMO plans
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-POS plans
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.
SNPs
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
J.D. Power Ranking
In its 2024 U.S. Medicare Advantage Study — the 10th 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 10 biggest state Medicare markets. On these measures, SCAN Health Plan ranked third out of all major providers in California (the only state in which SCAN had enough market share to be considered).
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 nearly 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.
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.
Frequently asked questions
Is SCAN a PPO or HMO?
SCAN Health Plan offers only HMO and HMO-POS plans, which usually require you to get care from medical providers in the plan’s network. They may also require a referral from your primary doctor if you want to see a specialist.
What is the difference between Medicare and SCAN Medicare Advantage?
Original Medicare is federal government-provided health insurance for people 65 and older and younger people with certain conditions or disabilities. SCAN Health Plan Medicare Advantage is a bundled alternative to Original Medicare, provided by a private insurer, that offers the same coverage as Original Medicare and includes prescription drug coverage.
Is SCAN a PPO or HMO?
SCAN Health Plan offers only HMO and HMO-POS plans, which usually require you to get care from medical providers in the plan’s network. They may also require a referral from your primary doctor if you want to see a specialist.
What is the difference between Medicare and SCAN Medicare Advantage?
Original Medicare is federal government-provided health insurance for people 65 and older and younger people with certain conditions or disabilities. SCAN Health Plan Medicare Advantage is a bundled alternative to Original Medicare, provided by a private insurer, that offers the same coverage as Original Medicare and includes prescription drug coverage.
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.
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).
SCAN Health Plan
4.48
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
SCAN Health Plan Medicare Advantage has above-average star ratings and unique plan offerings, but plans are available in only five states.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.
States available
5 states
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (85% to 100%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.61 (Below average)
IS THIS PROVIDER AVAILABLE IN MY STATE?
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
Pros
Above-average star ratings from CMS.
Plans targeted at women, LGBTQ+ and Asian American older adults.
92% of plans are $0-premium.
Maximum out-of-pocket cost is lower than big providers.
Cons
Available in only 5 states.
Offers HMO plans only.
Below-average member experience ratings.
Specialized plans offered in only a few California counties.
States available
5 states
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (85% to 100%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.61 (Below average)
IS THIS PROVIDER AVAILABLE IN MY STATE?
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
PROS & CONS
Pros
Above-average star ratings from CMS.
Plans targeted at women, LGBTQ+ and Asian American older adults.
92% of plans are $0-premium.
Maximum out-of-pocket cost is lower than big providers.
Cons
Available in only 5 states.
Offers HMO plans only.
Below-average member experience ratings.
Specialized plans offered in only a few California counties.