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Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

SCAN Allied, 2027

H5425Contract123Plan

HMO · 1 county in California

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

Renews for 2027

2026 star rating, contract H5425: 4 of 5

SCAN Allied (H5425-123) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $2,000 ($1,500 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get20262027Change
In-network out-of-pocket limit$1,500$2,000up $500
Drug deductible$250$75down $175
Part B premium reduction, monthly$130$125down $5
Emergency room$90 copay$150 copayup $60
Hospital stay, in network$0 a stay$110 a day for days 1–5, then $0 a day for days 6–90up $550for a 5-day stay
Skilled nursing facility, in network$0 a stay$0 a day for days 1–20, then $221 a day for days 21–100up $2,210for a 30-day stay
Comprehensive dental, yearly limit$2,500 a year$1,000 a yeardown $1,500
Eyewear, yearly limit$300 a year$200 a yeardown $100
Drug tier 5, specialty tier30% of the cost32% of the costup 2 points
12 lines do not change
Monthly premium$0$0no change
Primary care visit$0 copay$0 copayno change
Specialist visit$0 copay$0 copayno change
Medical deductible, in networknonenoneno change
Ground ambulance, in network$100 copay$100 copayno change
Hearing aids, yearly limit for both earsnot offerednot offeredno change
Over-the-counter items, yearly$780 a year$780 a yearno change
Counties served11no change
Drug tier 1, preferred generic$0$0no change
Drug tier 2, generic$0$0no change
Drug tier 3, preferred brand$43$43no change
Drug tier 4, non-preferred drug35% of the cost35% of the costno change

Source: 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; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked. The plan charges less at its preferred pharmacies
TierWhat the tier holds2026, standard pharmacy2027, standard pharmacy2027, preferred pharmacy
Tier 1Preferred Generic$0$0$0
Tier 2Generic$0$0$0
Tier 3Preferred Brand$43$43$42
Tier 4Non-Preferred Drug35% of the cost35% of the cost35% of the cost
Tier 5Specialty Tier30% of the cost32% of the cost32% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 70 plans open to everyone are sold for 2027, this one included. Against the others, 38 plans have a lower out-of-pocket limit, 1 the same, 30 a higher one. On the premium, 59 the same, 10 a higher one.

Out-of-pocket limits of the 70 plans open to everyone

$0 to under $2,00038 plans
$2,000 to under $4,000 (this plan)19 plans
$4,000 to under $6,0008 plans
$6,000 to under $8,0004 plans
$8,000 to $10,0001 plan

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 1 county: $0 a month and $2,000.

California

Los Angeles

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID
H5425-123
Legal name of the contract
SCAN Health Plan
Sold as
SCAN Health Plan
Parent company
SCAN Group
Plan type
HMO
2026 star rating of the contract
4 of 5 overall; health plan 4 of 5, drug plan 4 of 5
Members, September 2026
9,960
Plan website, as filed with CMS
www.scanhealthplan.com

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.