SCAN Health Plan is one of the most recognized Medicare Advantage (MA) plans in the United States, providing high-quality healthcare coverage tailored to seniors and people with special healthcare needs. If you’re considering enrolling in SCAN or are just curious about its offerings, this comprehensive guide will break down all you need to know. From SCAN’s unique benefits, such as the Fide Medicare and Hide Medicare plans, to their various Medicare Advantage options, we’ll cover it all.
What is SCAN Health Plan?
Founded in 1977, SCAN Health Plan is a not-for-profit Medicare Advantage organization offering healthcare coverage to Medicare beneficiaries. SCAN primarily operates in Long Beach California, Arizona, Nevada, New Mexico, and Texas. The organization focuses on delivering quality care for seniors, particularly those with complex medical needs, and offering a robust network of primary care doctors, specialists, hospitals, and other healthcare providers.
What is Fide Medicare and Hide Medicare?
Fide Medicare and Hide Medicare are two specialized programs under the Medicare Advantage umbrella designed to serve specific populations:
- Fide Medicare is focused on full integration of dual-eligible beneficiaries, meaning those who qualify for both Medicare and Medicaid. This allows SCAN to manage both sets of benefits more efficiently, providing a seamless healthcare experience for these individuals.
- Hide Medicare is designed for individuals who primarily qualify for Medicare but may have some partial benefits from Medicaid. Like Fide Medicare, this program coordinates the two types of insurance to optimize the patient’s healthcare experience.
Both of these programs are available as part of SCAN’s Special Needs Plans (SNPs), which cater to individuals with specific healthcare requirements, such as those with chronic conditions or those who are dually eligible for Medicare and Medicaid.
Special Needs Plans (SNPs) Offered by SCAN
SCAN Health Plan offers various Special Needs Plans (SNPs) for people who need specialized care. These plans ensure that those with unique medical needs receive the right care at an affordable price. There are two main types of SNPs available through SCAN:
- Chronic Condition Special Needs Plans (C-SNPs): Designed for individuals with chronic health conditions such as diabetes, heart disease, or chronic lung disorders. These plans provide additional benefits and specialized care to manage these conditions effectively.
- Dual-Eligible Special Needs Plans (D-SNPs): These plans are specifically for individuals who qualify for both Medicare and Medicaid. D-SNPs help coordinate Medicare and Medicaid benefits, ensuring comprehensive coverage and lower out-of-pocket costs for enrollees.
SCAN Health Plan’s Coverage and Benefits
SCAN offers a range of Medicare Advantage plans that go beyond basic Medicare coverage. These include benefits such as dental, vision, hearing, and fitness memberships. Below are some key benefits offered by SCAN:
1. Scan Health Fitness Benefit through One Pass
Most SCAN Medicare Advantage plans include access to One Pass, a fitness program that provides free or discounted access to fitness facilities. SCAN members can select from a wide range of local gyms or take advantage of virtual fitness programs, offering flexibility whether you prefer working out at home or in a facility.
- SCAN Health One Pass Membership: This benefit includes both in-person and virtual fitness classes, giving you access to hundreds of workout programs from the comfort of your home or at partner fitness centers.
2. Scan Health Diabetic Supplies
For individuals with diabetes, SCAN offers comprehensive coverage for diabetic supplies, including lancets, test strips, and monitors. These items are essential for managing diabetes and are included at low or no cost in most SCAN plans.
3. Scan Health Durable Medical Equipment (DME)
SCAN Health Plan also covers Durable Medical Equipment (DME), such as wheelchairs, walkers, and oxygen equipment, which are necessary for individuals who require long-term medical assistance.
4. Scan Health Food and OTC Card
SCAN provides a Food Card and an OTC Card to eligible members. These cards offer a quarterly allowance to purchase nutritious food and over-the-counter health products at participating retailers. Members can use these cards at popular stores such as CVS, Walgreens, Walmart, and more.
- OTC Catalog: SCAN’s OTC catalog lists all the eligible items that you can purchase using your OTC card, including cold medicine, first aid supplies, vitamins, and other essential health items.
5. Scan Health Telehealth Services
In today’s fast-paced world, accessing healthcare through Telehealth is becoming more popular. SCAN offers telehealth services to allow members to consult with doctors remotely, ensuring you get the care you need without leaving home.
6. Scan Health Urgent Care and Skilled Nursing Facilities
SCAN covers Urgent Care Services for members who need immediate but non-emergency medical attention. The plan also includes coverage for stays at Skilled Nursing Facilities, providing rehabilitation services and care after surgeries or illnesses.
7. Scan Health Inpatient Hospital Care
For those requiring hospitalization, SCAN provides comprehensive coverage for Inpatient Hospital Care, ensuring members receive high-quality care without worrying about excessive costs.
8. Scan Health Maximum Out-of-Pocket (MOOP) Limit
All SCAN Medicare Advantage plans come with a maximum out-of-pocket (MOOP) limit. This cap ensures that after reaching a certain amount in out-of-pocket costs, SCAN will cover all additional Medicare-covered services for the rest of the year.
SCAN Health Network of Healthcare Providers
SCAN prides itself on offering access to a wide network of primary care doctors, specialists, hospitals, and other healthcare providers. This means members can choose from a large variety of professionals within SCAN’s network, ensuring they receive high-quality care tailored to their needs.
The Low-Income Subsidy (LIS) and Medicaid Support
The Low-Income Subsidy (LIS), also known as Extra Help, is a federal program that helps Medicare beneficiaries with limited income pay for prescription drugs. It reduces monthly premiums, annual deductibles, and co-payments for medications under Medicare prescription drug coverage.
- What is LICS?: LICS stands for Low-Income Cost Sharing, and it refers to the extra help available for individuals who qualify for the Low-Income Subsidy program. Those who qualify for LIS automatically receive LICS, which helps reduce their out-of-pocket costs for prescription drugs.
In addition to LIS, SCAN Health Plan offers enhanced coverage for members eligible for Medicaid, ensuring low-income individuals receive the necessary care and support.
SCAN HEALTH Medicare Advantage Plans
SCAN HEALTH Medicare Advantage plans provide a wide range of benefits, from prescription drug coverage to fitness memberships, dental, vision, and even transportation services. These plans are available in California, Arizona, Nevada, New Mexico, and Texas, and they offer unique benefits tailored to each state’s healthcare landscape.
How to Access SCAN’s Services
1. SCAN HEALTH Provider Portal
Healthcare providers who work with SCAN can access a special provider portal where they can manage patient information, submit claims, and communicate with SCAN’s health management team.
2. SCAN Health Plan Phone Number
If you have any questions or need help enrolling in a plan, you can call SCAN Health Plan’s customer service team at 1-877-814-7226. The SCAN team is available to help with everything from plan details to finding providers and managing your benefits.
SCAN HEALTH Coverage for 2025 and Beyond
As SCAN Health Plan continues to grow and evolve, members can expect even more comprehensive coverage and improved benefits in 2025. With a strong focus on member satisfaction and quality care, SCAN is committed to meeting the healthcare needs of seniors and individuals with special healthcare needs.
Conclusion: Why Choose SCAN Health Plan?
SCAN Health Plan offers a wide array of benefits and coverage options tailored to seniors, individuals with special healthcare needs, and dual-eligible beneficiaries. Whether you need a D-SNP plan, diabetic supplies, access to One Pass fitness benefits, or support through Telehealth, SCAN has a Medicare Advantage plan designed to meet your healthcare needs.
With coverage across California, Arizona, Nevada, New Mexico, and Texas, SCAN Health Plan stands out for its focus on providing affordable, quality healthcare to Medicare beneficiaries.
For more information or to enroll in SCAN Health Plan, you can visit their website or call 1-877-814-7226 to speak with a representative.
To access or submit a SCAN Health Plan authorization form, follow these steps:
1. Visit SCAN Health Plan’s Website
Go to the official SCAN Health Plan website to find the most up-to-date authorization forms for different services, including medical procedures, referrals, and durable medical equipment (DME).
- Website: www.scanhealthplan.com
2. Navigate to the Forms Section
Most health plans have a dedicated section for forms. Look for the “Forms” or “Documents” section, typically found under the Member Resources or Provider tabs.
3. Locate Authorization Forms
In the forms section, you should find the authorization forms needed for various services. These may include:
- Medical service authorizations
- Durable medical equipment (DME) authorization
- Specialist referrals
4. Download and Complete the Form
Download the form you need and fill out all the required details. Authorization forms typically require the following information:
- Member information (name, member ID, etc.)
- Service provider details
- Medical service or procedure details
- Physician or specialist information
5. Submit the Form
Once completed, submit the form through the appropriate channels:
- Fax: Most SCAN forms will include a fax number where the authorization form can be sent.
- Mail: You may also mail the form to the address provided on the form.
- Provider Portal: Healthcare providers can submit authorization requests through the SCAN Provider Portal.
Contact SCAN for Assistance
If you have trouble finding or completing the authorization form, you can contact SCAN Health Plan at their customer service number for assistance: 1-877-814-7226.
For providers, they can access the Provider Portal for authorization submissions and tracking.
