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- Home Scan 1 04 – Connected Home Security Scanner Frequencies
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SCAN Connections at Home (HMO SNP) is a 2018 Medicare Advantage Special Needs Plan plan by SCAN Health Plan. This plan from SCAN Health Plan works with Medicare to give you significant coverage beyond original Medicare. If you decide to sign up you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from SCAN Health Plan and not Original Medicare. All Medicare SNPs also provide Medicare additional Part-D drug coverage. SCAN Connections at Home (HMO SNP) EA-H5425 is a Dual Eligible Special Needs Plan (D-SNP). A Dual Eligible SNP is for beneficiaries who are eligible for both Medicare and Medicaid. If you have Medicare and get help from Medicaid you can join any Medicare SNP you qualify for or switch plans at any time.
2018 Medicare Special Needs Plan Details
Plan Name: | |
---|---|
Plan ID: | EA-H5425 |
Special Needs Type: | Dual-Eligible |
Provider: | SCAN Health Plan |
Plan Year: | 2018 |
Plan Type: | Local HMO |
Monthly Premium C+D: | $28.80 |
Coverage Area for SCAN Connections at Home (HMO SNP)
Calibre 2 67 0 download free. The SCAN Connections at Home (HMO SNP) EA-H5425 is available to residents in California, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. SCAN Connections at Home (HMO SNP) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you need special care for a physician specialist, your primary care physician will make the arrangements and tell you where you can go in the network. You will need your PCPs okay, called a referral. Without getting a referral or services received from out-of-network providers are not typically covered by the plan.
Part-C Premium
SCAN Health Plan plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
Part-D Deductible and Premium
The SCAN Connections at Home (HMO SNP) plan has a monthly drug premium of $28.80 and a $405.00 drug deductible. This SCAN Health Plan plan offers a $28.80 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by SCAN Health Plan above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $28.80. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Premium Assistance
Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The SCAN Connections at Home (HMO SNP) medicare insurance plan offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. Photostage 4 1 0 – easy slideshow maker downloads. And the payment is $7.20 for 75% low income subsidy $14.40 for 50% and $21.60 for 25%.
Part C Premium: | $0.00 |
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Part D (Drug) Premium: | $28.80 |
Part D Supplemental Premium | $0.00 |
Total Part D Premium: | $28.80 |
Drug Deductible: | $405.00 |
Tiers with No Deductible: | 1 |
Benchmark: | not below the regional benchmark |
Type of Medicare Health Plan: | Enhanced Alternative |
Drug Benefit Type: | Enhanced |
Full LIS Premium: | $0.00 |
75% LIS Premium: | $7.20 |
50% LIS Premium: | $14.40 |
25% LIS Premium: | $21.60 |
Initial Coverage Limit: | $3750 |
Gap Coverage: | Yes |
Gap Coverage
In 2018 once you and your plan provider have spent $3,750 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 35% for brand-name drugs and 44% on generic drugs unless your plan offers additional coverage. This SCAN Health Plan plan does offer additional coverage through the gap.
Health plan deductible
$0 |
---|
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures | $0 copay |
---|---|
Lab services | $0 copay |
Diagnostic radiology services (e.g., MRI) | $0 copay |
Outpatient x-rays | $0 copay |
Hearing
Hearing exam | $0 copay |
---|---|
Fitting/evaluation | $0 copay |
Hearing aids | $699-999 |
Preventive dental
Oral exam | $0 copay |
---|---|
Cleaning | $0 copay |
Fluoride treatment | Not covered |
Dental x-ray(s) | $0 copay |
Comprehensive dental
Non-routine services | Not covered |
---|---|
Diagnostic services | $0 copay |
Restorative services | $0-350 |
Endodontics | $0-395 |
Periodontics | $0-250 |
Extractions | $0-350 |
Prosthodontics, other oral/maxillofacial surgery, other services | $0-350 |
Vision
Routine eye exam | $0 copay |
---|---|
Other | Not covered |
Contact lenses | $0 copay |
Eyeglasses (frames and lenses) | $0 copay |
Eyeglass frames | $0 copay |
Eyeglass lenses | $0 copay |
Upgrades | Not covered |
Mental health services
$0 copay | |
---|---|
Outpatient group therapy visit with a psychiatrist | $0 copay |
Outpatient individual therapy visit with a psychiatrist | $0 copay |
Outpatient group therapy visit | $0 copay |
Outpatient individual therapy visit | $0 copay |
Skilled Nursing Facility
Home Scan 1 04 – Connected Home Security Scanner Lide
$0 copay |
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Rehabilitation services
Occupational therapy visit | $0 copay |
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Physical therapy and speech and language therapy visit | $0 copay |
Ambulance
$0 copay |
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Transportation
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$0 copay |
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Other health plan deductibles?
In-Network | No |
---|
Foot care (podiatry services)
Foot exams and treatment | $0 copay |
---|---|
Routine foot care | $0 copay |
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen) | $0 copay |
---|---|
Prosthetics (e.g., braces, artificial limbs) | $0 copay |
Diabetes supplies | $0 copay |
Wellness programs (e.g., fitness, nursing hotline)
Covered |
---|
Medicare Part B drugs
Chemotherapy | $0 copay |
---|---|
Other Part B drugs | $0 copay |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$0 In-network |
---|
Optional supplemental benefits
No |
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Inpatient hospital coverage
$0 copay |
---|
Outpatient hospital coverage
$0 copay |
---|
Doctor visits
Primary | $0 copay |
---|---|
Specialist | $0 copay |
Preventive care
$0 copay |
---|
Emergency care/Urgent care
Emergency | $0 copay |
---|---|
Urgent care | $0 copay |
Ratings for SCAN Connections at Home (HMO SNP) EA
2018 Overall Rating |
---|
Part C Summary Rating |
Part D Summary Rating |
Staying Healthy: Screenings, Tests, Vaccines |
Managing Chronic (Long Term) Conditions |
Member Experience with Health Plan |
Complaints and Changes in Plans Performance |
Health Plan Customer Service |
Drug Plan Customer Service |
Complaints and Changes in the Drug Plan |
Member Experience with the Drug Plan |
Drug Safety and Accuracy of Drug Pricing |
Member Experience with Health Plan
Total Experience Rating |
---|
Getting Needed Care |
Timely Care and Appointments |
Customer Service |
Health Care Quality |
Rating of Health Plan |
Care Coordination |
Member Complaints and Changes in SCAN Connections at Home (HMO SNP) Plans Performance
Total Rating |
---|
Members Leaving the Plan |
Complaints about Health Plan |
Beneficiary Access |
Health Plan Quality Improvement |
Health Plan Customer Service Rating for SCAN Connections at Home (HMO SNP)
Total Customer Service Rating |
---|
Timely Decisions About Appeals |
Reviewing Appeals Decisions |
Call Center, TTY, Foreign Language |
Staying Healthy, Screening, Testing, & Vaccines
Total Preventative Rating |
---|
Breast Cancer Screening |
Colorectal Cancer Screening |
Annual Flu Vaccine |
Improving Physical |
Improving Mental Health |
Monitoring Physical Activity |
Adult BMI Assessment |
Managing Chronic And Long Term Care for Older Adults
Home Scan 1 04 – Connected Home Security Scanner Feeds
Total Rating |
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SNP Care Management |
Medication Review |
Functional Status Assessment |
Pain Screening |
Osteoporosis Management |
Diabetes Care - Eye Exam |
Diabetes Care - Kidney Disease |
Diabetes Care - Blood Sugar |
Controlling Blood Pressure |
Rheumatoid Arthritis |
Improving Bladder Control |
Reducing Risk of Falling |
Plan - Cause Readmissions |
Home Scan 1 04 – Connected Home Security Scanner Compatible
Member Experience with the Drug Plan
Total Rating |
---|
Rating of Drug Plan |
Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
Total Rating |
---|
MPF Price Accuracy |
Drug Adherence for Diabetes Medications |
Drug Adherence for Hypertension (RAS antagonists) |
Drug Adherence for Cholesterol (Statins) |
MTM Program Completion Rate for CMR |
Ratings For Member Complaints and Changes in the Drug Plans Performance
Total Rating |
---|
Complaints about the Drug Plan |
Members Choosing to Leave the Plan |
Beneficiary Access |
Drug Plan Quality Improvement |
SCAN Connections at Home (HMO SNP) Drug Plan Customer Service ratings
Total Rating |
---|
Appeals Auto Forward |
Appeals Upheld |
Call Center, TTY, Foreign Language |
Source: CMS.
Plans as of September 2, 2017.
Star Rating as of September 6, 2017.
Home Scan 1 04 – Connected Home Security Scanner Software
For More Information on Ratings Please See the CMS Tech Notes Here.
Home Scan 1 04 – Connected Home Security Scanner Wireless
Notes: Data are subject to change. All contracts for 2018 have not been finalized. For 2018, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Part D benefit.
Home Scan 1 04 – Connected Home Security Scanner Frequencies
Includes 2018 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.