SCAN Classic WA (HMO)
Washington Medicare Advantage Plan (2026 Plan)
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
SCAN Classic WA (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Washington and offered by the health insurance company SCAN Health Plan. 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
$35 copay
SCAN Classic WA (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 $6,700 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 WA (HMO) are defined below.
Yes
Part D Prescription Drug Coverage
SCAN Classic WA (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 WA (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. SCAN Classic WA (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
Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $35 copay
Out-of-network: $35 copay
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $10 copay
Out-of-network: $10 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $0-$200 copay
Out-of-network: $0-$200 copay
Outpatient x-rays
In-network: $10 copay
Out-of-network: $10 copay
Hospital Services
Inpatient hospital coverage
Tier 1
$425 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Outpatient hospital coverage
In-network: $0-$425 copay
Out-of-network: $0-$425 copay
Skilled nursing facility
Skilled nursing facility
Tier 1
$0 per day for days 1-20
$175 per day for days 21-100
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $250 copay
Out-of-network: $250 copay
Therapy services
Occupational therapy visit
In-network: $35 copay
Out-of-network: $35 copay
Physical therapy & speech & language therapy visit
In-network: $35 copay
Out-of-network: $35 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $35 copay
Out-of-network: $35 copay
Outpatient individual therapy with a psychiatrist
In-network: $35 copay
Out-of-network: $35 copay
Outpatient group therapy visit
In-network: $35 copay
Out-of-network: $35 copay
Outpatient individual therapy visit
In-network: $35 copay
Out-of-network: $35 copay
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Prosthetics (like braces, artificial limbs)
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Diabetes supplies
In-network: $0 copay
Out-of-network: $0 copay
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 | 35% coinsurance | $0 copay |
| Specialty Tier | 30% coinsurance | $0 copay |
Part B Drugs
Chemotherapy drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Other Part B drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Hearing
Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription
In-network: $550-$850 copay
Out-of-network: $550-$850 copay
Hearing aids - over the counter
Preventive Dental
Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Restorative services
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
Maxillofacial prosthetics
Oral and maxillofacial surgery
In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Adjunctive general services
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance
Vision
Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
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