SCAN Plans: A Closer Look at Star Ratings and Performance
The Medicare Star Rating is a critical metric for evaluating Medicare Advantage plans. It’s a system used to compare the quality of health plans on a scale of up to 5 stars. In this regard, SCAN Health Plan stands tall with a 4.5-star rating from the Centers for Medicare and Medicaid Services for the top 3 plans, maintaining this high rating for six consecutive years.
This 4.5-star rating is particularly commendable, given that CMS has raised its quality standards, making it a challenging year for attaining high star ratings. However, SCAN Health Plan’s focus on consistent improvement has enabled it to sustain its high performance in the star rating system.
Enrollment Essentials for SCAN Medicare Advantage Plans
Enrolling in a SCAN Health Plan is made convenient through their online enrollment system. Individuals can receive a comprehensive quote for SCAN Medicare Advantage plans by running an initial quote, inputting medication and doctor information in a subsequent email, and then obtaining a detailed comparison quote for the area.
However, it’s important to note that plan availability with SCAN Medicare Advantage may differ by county. Individuals can utilize the online Plan Search Tool or contact SCAN directly to check if a specific plan is offered in their locality.
Member Services Advocacy: Your Support System with SCAN
At SCAN, a team of dedicated Member Services Advocates acts as the primary point of contact for member inquiries about potential benefits, eligibility, referrals, and claims. They are committed to ensuring member satisfaction by delivering superior customer service and maintaining professionalism in all interactions.
Advocates are responsible for:
- Following up with members to address queries
- Demonstrating a high level of accuracy and efficiency in resolving issues and complaints
- Coordinating with providers and other departments as necessary
- Participating in skill development activities to continuously improve their service
They are trained to perform these tasks and are committed to providing excellent customer service.
Navigating the Network: Doctors and Hospitals Within SCAN Plans
SCAN Health Plan offers a network of primary care doctors, specialists, hospitals, and other healthcare providers specifically for their members. Members are required to receive all routine care from in-network plan providers except for emergency or urgent care situations or out-of-area renal dialysis.
It’s important to note that if members obtain routine care from out-of-network providers, neither Medicare nor SCAN will cover the costs. Also, it’s important to keep in mind that the SCAN Health Plan provider network may change at any time, and members will receive notice when necessary.
SCAN’s Expansion: Growth and New Horizons in Health Care
SCAN is not just a name in California’s healthcare scene; it’s a growing entity. SCAN Group and CareOregon have combined to form HealthRight Group, a new nonprofit healthcare organization that enhances care for traditionally underserved populations. This merger is expected to strengthen further SCAN’s commitment to providing high-quality healthcare services.
In addition, SCAN Health Plan is expanding its footprint into Texas, including Harris and Bexar Counties and Nevada’s Nye County, with an expected increase in the customer base to nearly seven million across four states. This is a significant leap towards providing more people with access to SCAN’s high-quality services.
The Financial Side: Understanding Costs and Savings with SCAN
Financial aspects are a significant consideration when choosing a health plan. SCAN Medicare Advantage plans are designed to help seniors manage healthcare expenses by offering comprehensive coverage with cost-effective potential benefits. The average maximum out-of-pocket cost for SCAN plans is typically lower than other major providers, which can help alleviate financial strain for members.
Certain SCAN plans feature potential benefits such as give-back benefits and Part B premium reductions, enhancing the affordability of healthcare coverage. For instance, SCAN Prime exemplifies SCAN’s approach to reducing costs with a low monthly premium, low copayments for most routine services, and a capped maximum out-of-pocket cost.
Comparing SCAN Against Other Providers in California
In the competitive Medicare Advantage market in California, SCAN directly rivals major insurers such as:
- UnitedHealth (AARP)
- Kaiser
- Anthem
- Blue Shield
- Health Net
- Humana
- Aetna
However, each provider has its unique features and potential benefits. For instance, UnitedHealth (AARP) maintains a more extensive provider network compared to SCAN, which may be preferred by those seeking a broader healthcare provider choice.
On the other hand, Kaiser Permanente operates with a strong HMO model, offering care within their closed network, whereas SCAN allows access to a wider network of independent providers. While both SCAN and UnitedHealth (AARP) offer low premium plans with high star ratings, SCAN focuses more on Special Needs Plans (SNPs) for those with dual eligibility or chronic illnesses.
It’s also worth noting that local hospital networks and medical groups are significant factors when comparing SCAN and Kaiser. They impact the accessibility and choices available in one’s healthcare plan. Therefore, individuals looking to choose between SCAN and UnitedHealth (AARP) Medicare Advantage plans can leverage online quoting systems to make comparative assessments, including considerations for specific doctors and medications.
Summary
In summary, SCAN Health Plan offers comprehensive Medicare Advantage plans with a wide range of potential benefits catering to various healthcare needs. Their high member satisfaction rates, cost-effective premiums, comprehensive prescription drug coverage, and a host of potential extra benefits make them a reliable choice for Medicare beneficiaries in California.
