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PlainMedicare

Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026

SCAN Affirm partnered with Included LGBTQ+ Health is not offered under this ID in 2027

H5425Contract096Plan

HMO · served 1 county in California in 2026

Run by SCAN Health Plan (contract H5425), sold as SCAN Health Plan, owned by SCAN Group

CMS crosswalk: members move into H5425-082

Folds into H5425-082

SCAN Affirm partnered with Included LGBTQ+ Health (H5425-096) is not offered under this ID in 2027: the CMS plan crosswalk of October 1, 2026 moves its members into SCAN Alta (H5425-082), which is sold in every county it served. 144 people were enrolled in it in September 2026; they can also choose another plan during open enrollment, October 15 to December 7, 2026.

What changes for its members in SCAN Alta?

For its members: this plan's 2026 amounts beside SCAN Alta (H5425-082) in 2027. The changed lines are marked and come first.
What you pay or get20262027Change
Plan nameSCAN Affirm partnered with Included LGBTQ+ HealthSCAN Altarenamed
In-network out-of-pocket limit$500$900up $400
Drug deductible$250$370up $120
Emergency room$90 copay$120 copayup $30
Eyewear, yearly limit$250 a year$100 a yeardown $150
Over-the-counter items, yearly$700 a year$80 a yeardown $620
Drug tier 5, specialty tier25% of the cost29% of the costup 4 points
15 lines do not change
Monthly premium$0$0no change
Part B premium reduction, monthlynonenoneno change
Primary care visit$0 copay$0 copayno change
Specialist visit$0 copay$0 copayno change
Medical deductible, in networknonenoneno change
Hospital stay, in network$0 a day for days 1–3, then $50 a day for days 4–7, then $0 a day for days 8–90$0 a day for days 1–3, then $50 a day for days 4–7, then $0 a day for days 8–90no change
Skilled nursing facility, in network$0 a day for days 1–20, then $50 a day for days 21–100$0 a day for days 1–20, then $50 a day for days 21–100no change
Ground ambulance, in network$75 copay$75 copayno change
Comprehensive dental, yearly limitnot offerednot offeredno change
Hearing aids, yearly limit for both earsnot offerednot offeredno change
Counties served11no change
Drug tier 1, preferred generic$7$7no change
Drug tier 2, generic$15$15no change
Drug tier 3, preferred brand$47$47no change
Drug tier 4, non-preferred drug35% of the cost35% of the costno change

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026. Your plan's Annual Notice of Change is the letter that confirms your 2027 plan; confirm on Medicare Plan Finder.

What can members do, and by when?

If you do nothing
You are moved into SCAN Alta on January 1, 2027.
October 15 to December 7, 2026
Open enrollment: choose another Medicare Advantage plan, or Original Medicare with a drug plan, instead.
January 1 to March 31, 2027
Medicare Advantage open enrollment: switch once to another Medicare Advantage plan or to Original Medicare.

Source: Medicare.gov, “Special enrollment periods” and “Joining a plan” (read Oct. 7, 2026).

Where did its members live?

Where its members lived in September 2026; each county and state page lists the 2027 plans sold there.

All 1 county, most members first; CMS hides counts under 11 per county, so the counties add up to a little less than the plan's total
CountyMembers, Sept. 2026For 2027
San Diego, CA142moves into H5425-082

Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).

What else should you check?