How Does a SCAN Medicare Advantage Plan Work?
Medicare plans and benefits can be complicated. Even long-time SCAN members tell us they’re not entirely clear on how their health plan works. So, whether you’re new to Medicare, new to SCAN or have been with SCAN for years, this Medicare plan and benefit information will help you make the most of your Medicare benefits and services.
SCAN—Medicare Advantage Plans
The Centers for Medicare and Medicaid Services (CMS) contracts with Medicare Advantage plans, like SCAN Health Plan New Mexico, to provide your Medicare benefits and services. This contract is reviewed every year. When you join a Medicare Advantage plan like SCAN Health Plan New Mexico, you must then go through your Medicare Advantage plan to make use of your Medicare coverage.
SCAN—Your Medicare Advantage Prescription Drug (MAPD) Plan
Medicare Advantage Plans are also known as Medicare Part C. MAPD plans combine Original Medicare’s Part A (hospital coverage), Part B (medical coverage) and Part D (drug coverage) into one comprehensive Medicare plan. CMS pays SCAN to provide your Medicare-covered medical and prescription drug benefits.
SCAN then uses those dollars from CMS to provide many extra and supplemental benefits that Original Medicare doesn’t offer—like dental, vision, and transportation.
Medical Providers
SCAN contracts with community-based medical groups, doctors, hospitals and other healthcare providers in California, Texas, Arizona, and Nevada to deliver your care and make healthcare decisions, like referrals for specialty care. If you disagree with a healthcare decision, SCAN can get involved to help.
Primary Care Doctor
Your primary care doctor oversees your healthcare. You’ll see your doctor for your annual physical or wellness visit, as well as for other healthcare needs. Most primary care doctors are part of larger medical group organizations that also offer specialty and urgent care.
Specialists
Your primary care doctor can refer you to specialists in their medical group. Depending on your medical group or SCAN Medicare Advantage plan, you may be able to visit certain specialists without a referral from your primary care doctor.
Hospitals
For a scheduled hospital stay, you will go to the hospital your doctor works with. In a medical emergency, you can go to the nearest emergency room.
Through SCAN Health Plan New Mexico you’ll have access to a large network of primary care doctors, specialists, and hospitals to help give you the Medicare coverage you need to live your best life. If you don’t have a Medicare Advantage plan, take a look at the benefits, award-winning service, and more, offered by SCAN Health Plan New Mexico.
