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Medicare Advantage with drug coverage · HMO · Plan ID H5425-155

SCAN Baekse (HMO)

Offered by SCAN Health Plan (SCAN Group) · available in 2 counties in CA

Monthly premium$0health + drug coverage
Yearly out-of-pocket max$499in network
Drug deductible$200Enhanced Alternative
Star Rating★★★★ 4 out of 52027 CMS rating

Extra benefits listed in the CMS file

DentalPreventive and comprehensive dental, up to $1,375 a year for comprehensive
Visionroutine eye exam; eyewear
Hearingroutine hearing exam; hearing aids, plan pays up to $600 per year
Over-the-counter items$375 per quarter allowance
FitnessFitness benefit (gym membership or program)
TransportationRides to health-related locations
Personal emergency response systemMedical alert device or service

Allowances and limits come from the plan's filing with CMS and are simplified here. Some benefits are only for members with certain chronic conditions. The plan's Evidence of Coverage is the final word.

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