SCAN Classic (HMO)
New Mexico Medicare Advantage Plan (2025 Plan)
by SCAN Health Plan New Mexico
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Insurance Carrier
SCAN Health Plan New Mexico
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
SCAN Classic (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in New Mexico and offered by the health insurance company SCAN Health Plan New Mexico. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Primary doctor visit
$0 copay
Specialist visit
$20 copay per visit
ER visit
$90 copay per visit (always covered)
SCAN Classic (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $2,800 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for SCAN Classic (HMO) are defined below.
Yes
Part D Prescription Drug Coverage
SCAN Classic (HMO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. SCAN Classic (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. SCAN Classic (HMO) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Health Portion of Premium
Health Plan Max Out-of-Pocket
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Tests, labs, & imaging
Diagnostic tests & procedures
Diagnostic radiology services (like MRI)
Emergency care
$90 copay per visit (always covered)
Urgent care
$10 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
$150 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage
Skilled nursing facility
Skilled nursing facility
$0 per day for days 1 through 20
$75 per day for days 21 through 100
Preventive services
Ambulance
Therapy services
Occupational therapy visit
Physical therapy & speech & language therapy visit
Mental health services
Outpatient group therapy with a psychiatrist
Outpatient individual therapy with a psychiatrist
Outpatient group therapy visit
Outpatient individual therapy visit
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
Prosthetics (like braces, artificial limbs)
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Catastrophic coverage phase |
---|
Preferred Generic | $0.00 copay | $0 copay |
Generic | $0.00 copay | $0 copay |
Preferred Brand | $43.00 copay | $0 copay |
Non-Preferred Drug | 50% coinsurance | $0 copay |
Specialty Tier | 33% coinsurance | $0 copay |
Part B Drugs
Hearing
Preventive Dental
Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
Maxillofacial prosthetics
Oral and maxillofacial surgery
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay
Vision
Eyeglasses (frames & lenses)
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