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$370
Max OOP in network$900
Max OOP out of network$0
Initial coverage limit$2,400
Catastrophic limit$2,400
Availability
Available in San Diego County, CASan Diego County, CA
Available Cities
This plan is available in 31+ cities in California.
Borrego Springs
San Diego County
Campo
San Diego County
Cardiff By The S
San Diego County
Carlsbad
San Diego County
Chula Vista
San Diego County
Coronado
San Diego County
Del Mar
San Diego County
Descanso
San Diego County
El Cajon
San Diego County
Encinitas
San Diego County
Escondido
San Diego County
Fallbrook
San Diego County
Imperial Beach
San Diego County
Jamul
San Diego County
La Jolla
San Diego County
La Mesa
San Diego County
Lakeside
San Diego County
Lemon Grove
San Diego County
National City
San Diego County
Oceanside
San Diego County
Poway
San Diego County
Ramona
San Diego County
Rancho Santa Fe
San Diego County
San Diego
San Diego County
San Marcos
San Diego County
San Ysidro
San Diego County
Santee
San Diego County
Solana Beach
San Diego County
Spring Valley
San Diego County
Valley Center
San Diego County
Vista
San Diego County
Benefits
Primary care
In Network
In-Network: $0 copay per visit
Inpatient hospital
In Network
In-Network: $0 copay per day for days 1-3, $50 copay per day for days 4-7, $0 copay per day for days 8-90.
Skilled nursing
In Network
In-Network: $0 copay per day for days 1-20, $50 copay per day for days 21-100.
Emergency care
In Network
In-Network: $120 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 IDH5425-145-000
Plan number145
ContractH5425
Segment0
DRX ID1KNJRCWPN3
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