LONG BEACH, Calif.–(BUSINESS WIRE)–Between now and December 7, Medicare-eligible individuals will be making
important decisions regarding their healthcare coverage for 2016,
weighing benefit options, provider networks and cost. Among the most
important consideration for seniors is pharmacy coverage, where benefits
and copays also vary between health plans.
“Most Medicare Advantage plans feature all of the basic benefits
traditionally covered under Medicare as well as a prescription drug
benefit (Medicare Part D), but out-of-pocket drug costs can vary quite a
bit among health plans,” said Cathy Batteer, general manager at the
not-for-profit SCAN Health Plan. “When evaluating plans it is important
to take a good look at pharmacy coverage and be prepared to ask the
Batteer recommends that consumers ask these three questions when
comparing pharmacy benefits.
1. Are my drugs covered? Most plans list the drugs they cover on
a formulary, which can be found on the health plan’s website and on the
Medicare website at www.medicare.gov.
“When considering a plan, be sure to look up any maintenance drugs you
currently take to see if they are covered and at what cost,” said
Batteer. She says SCAN ensures it provides coverage for safe and
effective medications its members use most.
2. What are the copays? Copayments can vary widely not
just from plan to plan, but also from county to county. Most plans
provide complete benefit information on their website and on the
Medicare website at www.medicare.gov.
3. Are there discounts to make maintenance medication more
affordable? For 2016 many of the SCAN plans (Classic, Balance, Heart
First and Signature Plans) will feature a dramatic savings opportunity
on prescription drugs. While copayments vary by county, these members
will be able to get a three-month supply (90 days) of Tier 1 and Tier 2
drugs and only pay for two months. “Many seniors take several
medications to help them manage chronic, long-term conditions; and we
don’t want the cost of these drugs to be a barrier to good health,” said
“We understand that the annual enrollment period can be a confusing time
given all of the choices and changes that take place from year to year,”
added Batteer. “SCAN is committed to providing stable, dependable
benefits plans – and keeping copayments as low as possible – so our
members can better budget for their healthcare costs.”
The annual enrollment period for selecting a Medicare Advantage plan for
2016 runs from October 15 to December 7, 2015. During this time seniors
and others on Medicare may choose to switch their health plan or move
from traditional Medicare to a Medicare Advantage plan (or move back to
Original Medicare) with their new elections taking effect January 1,
In 2016 the SCAN Classic plan will be available to Medicare-eligible
beneficiaries in 12 California counties: Los Angeles, Marin, Napa,
Orange, Riverside, San Bernardino, San Diego, San Francisco, San
Joaquin, Santa Clara, Sonoma and Ventura. SCAN has earned a 4.5-star
rating* in all 12 California counties it serves.
As governed by the Centers for Medicare & Medicaid Services, member
benefits vary by county. Specific information on SCAN’s 2016 benefit
plans is available at www.scan2016.com
or by calling 1-855-561-7226, 8 a.m. to 8 p.m., seven days a week.
TTY/TDD users may call 711.
SCAN Health Plan is an HMO plan with a Medicare contract. Enrollment
in SCAN Health Plan depends on contract renewal.
* 4.5-star rating applies to all plans offered by SCAN Health Plan
(HMO) in California except Healthy At Home (HMO SNP) and VillageHealth
(HMO SNP/HMO POS-SNP). Medicare evaluates plans based on a 5-star rating
system. Star ratings are calculated each year and may change from one
year to the next.
You must continue to pay your Medicare Part B premium. This
information is not a complete description of benefits. Contact the plan
for more information. Limitations, copayments and restrictions may
apply. Benefits, premiums and/or copayments/co-insurance may change on
January 1 of each year. The formulary, pharmacy network, and/or provider
network may change at any time. You will receive notice when necessary.
Y0057_SCAN_9526_2015F File & Use Accepted 10312015
for SCAN Health Plan