MAPD
2027 plan HMO
SCAN Costco Medicare Advantage (HMO)
Plan information effective January 1, 2027.
Plan costs & ratings
Monthly premium$0.00
Medical premium$0.00
Drug premium$0.00
Annual premium$0.00
Medical deductible$0
Drug deductible$450
Max OOP in network$699
Max OOP out of network$0
Initial coverage limit$2,400
Catastrophic limit$2,400
Availability
Available in 2 California countiesFresno County, CA, Kings County, CA
Available Cities
This plan is available in 10+ cities in California.
Benefits
Primary care
In Network
In-Network: $0 copay per visit
Inpatient hospital
In Network
In-Network: $0 copay per day for days 1-2, $50 copay per day for days 3-7, $0 copay per day for days 8-90.
Skilled nursing
In Network
In-Network: $0 copay per day for days 1-20, $221 copay per day for days 21-100.
Emergency care
In Network
In-Network: $90 copay per visit
Urgently needed care
In Network
In-Network: $0 copay for Medicare-covered urgently-needed-care visits.
Ambulance
In Network
In-Network: $75 copay per trip
Plan Overview
CarrierSCAN Health Plan
OrganizationSCAN HEALTH PLAN
Plan typeMAPD
PlanHMO
Drug coverageIncluded
Enrollment hours8 am to 8 pm
Provider searchOpen provider directory
Carrier websiteOpen website
Plan identifiers
Plan IDH5425-136-000
Plan number136
ContractH5425
Segment0
DRX ID18892MJCSQ
Carrier ID15
Formulary ID27384
Formulary versionV11 Last Updated 09-01-2026
Carrier contact
Carrier phone8336089576
Enrollment phone8336089576
Enrollment TTY711
Carrier hours8 am to 8 pm
Network & documents
Preferred pharmacy networkYes
Preferred retail pharmacyYes
Preferred mail pharmacyYes
Mail drug benefitsYes
Provider searchYes