SCAN Walmart Medicare Advantage (HMO)

SCAN DESERT HEALTH PLAN, INC. · 2027 plan year

Plan ID H1822-009-000

HMO★ 3.5 CMS StarsNew for 2027
MOOP (in-network)
$2,500
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

Plan information

Contract / Plan / Segment
H1822-009-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$450/yr
Also owed
Your Medicare Part B premium, paid separately

More SCAN DESERT HEALTH PLAN, INC. plans in AZ

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$225/day for days 1–7, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$225/day for days 1–7, $0 after
Worldwide Urgent Care Coverage$45

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Mental Health — Group SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Hearing — Fitting & Evaluation for Hearing AidNo charge
Physical Therapy & Speech-Language Pathology$25
Other Health Care Professional Services$0-$25
Psychiatric ServicesSee plan details
Fitness BenefitNo charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services25% coinsurance
Dental — Endodontics (Root Canal)25% coinsurance
Dental — Periodontics (Gum Care)25% coinsurance
Dental — Removable Prosthodontics (Dentures)25% coinsurance
Dental — Fixed Prosthodontics (Bridges)25% coinsurance
Dental — Oral & Maxillofacial Surgery25% coinsurance
Dental — Adjunctive General Services25% coinsurance
Vision — Eye Exams$0-$25
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams$25
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$550-$950
Air Ambulance$250
Psychiatric Services — Individual Sessions$25
Psychiatric Services — Group Sessions$25
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$25
Intensive Cardiac Rehabilitation — Additional Sessions$25
Pulmonary Rehabilitation — Additional Sessions$25
Supervised Exercise Therapy (SET)$25
Emergency Services$150
Podiatry Services$25
Urgently Needed Services$0-$45
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Worldwide Emergency Transportation$250
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$20
Occupational Therapy Services$25
Physician Specialist Services$25
Ground Ambulance$250
Additional Telehealth Services (Part B)$0-$25
Opioid Treatment Program Services$25
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$0-$275
Therapeutic Radiology20% coinsurance
X-Ray Services$75
Outpatient Hospital Services$0-$295
Hospital Observation Services$225 per stay
Ambulatory Surgical Center (ASC)$0-$195
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25
Substance Abuse — Group Sessions$25
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Dental — Diagnostic ServicesNo charge
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)0%-20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices0%-20% coinsurance
Medical Supplies0%-20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies0%-20% coinsurance
Diabetic Therapeutic Shoes & InsertsNo charge
Diabetic Monitors0%-20% coinsurance
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Health EducationNo charge
Dental — Prophylaxis (Cleaning)No charge
Remote Access TechnologiesNo charge
Personal Emergency Response System (PERS)No charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$25
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge

Service area

  • AZ: 3 counties

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