Contract H5943 HMO POS Special Needs Plan

SCAN HEALTH PLAN

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VillageHealth (SCAN Group)
N/R
Overall Star Rating
Monthly Premium
1
States

What the CMS Data Shows About SCAN HEALTH PLAN

SCAN HEALTH PLAN operates under CMS contract H5943, issued by VillageHealth (parent organization SCAN Group). The contract is classified as a HMO POS product, which governs how enrollees access care: the product rules govern provider access and cost-sharing for this contract. This contract is also flagged in CMS data as a Special Needs Plan (SNP), meaning enrollment is restricted to beneficiaries meeting specific eligibility criteria — chronic condition, dual Medicare-Medicaid status, or institutional residence. Service area spans 1 state (CA) and 3 counties, a geography set at the CMS service-area definition level.

The overall CMS Star Rating for this contract is not yet published by CMS. This rating synthesizes 19 individual quality measures spanning 8 CMS domains, including clinical outcomes, patient experience (CAHPS), member complaints and appeals, and plan operations. Ratings at 4+ stars trigger federal Quality Bonus Payments that insurers typically reinvest in supplemental benefits.

On costs, this contract lists a monthly plan premium of not reported. Beyond standard Medicare Parts A and B, the contract documents 4 supplemental benefits in the CMS benefits file — coverage extras such as dental, vision, hearing aids, fitness programs, and OTC allowances that Original Medicare does not provide. Before enrolling, verify that your preferred providers participate in the plan's network for your specific county, review the current Summary of Benefits, and confirm that your prescriptions appear on the plan formulary. All figures shown come from CMS public-use files for the 2026 contract year; this page is informational only and is not personalized Medicare counseling advice.

Quality Measures by Domain

Preventive Screenings

1 measures

Breast Cancer Screening

2

Managing Chronic Conditions

8 measures

Care for Older Adults – Medication Review

2

Care for Older Adults – Pain Assessment

3

Diabetes Care – Blood Sugar Controlled

1

Diabetes Care – Eye Exam

3

Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions

1

Getting Needed Care

3

Medication Reconciliation Post-Discharge

1

Transitions of Care

2

Member Experience

2 measures

Customer Service

3

Rating of Health Plan

3

Customer Service

2 measures

Call Center – Foreign Language Interpreter and TTY Availability

4

Call Center – Foreign Language Interpreter and TTY Availability

5

Drug Plan Experience

1 measures

MPF Price Accuracy

5

Drug Safety & Pricing

1 measures

MTM Program Completion Rate for CMR

4

Tests & Vaccines

3 measures

Annual Flu Vaccine

5

Colorectal Cancer Screening

2

Special Needs Plan (SNP) Care Management

2

Member Complaints and Changes in the Drug Plan’s Performance

1 measures

Rating of Drug Plan

3

Supplemental Benefits

BenefitCoveredMax BenefitCopay
Vision — Eye Exam✓ Yes
Vision — Eyewear✓ Yes

Medicare Advantage Star Rating Distribution

Percentage of Medicare Advantage plans at each CMS star rating level (2026 plan year)

8%5-Star Plans
38%4-Star Plans
34%3-Star Plans
14%2-Star Plans
6%1-Star Plans

Source: CMS Medicare Advantage Star Ratings 2026. Distribution reflects national plan-county records.

Frequently Asked Questions

What is the star rating for SCAN HEALTH PLAN?

SCAN HEALTH PLAN (Contract H5943) by VillageHealth has an overall CMS star rating of Not yet rated out of 5. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.

How much does SCAN HEALTH PLAN cost per month?

SCAN HEALTH PLAN has a monthly premium of data not available. Plan costs may vary by county.

What type of plan is SCAN HEALTH PLAN?

SCAN HEALTH PLAN is a HMO POS Medicare Advantage plan offered by VillageHealth. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs.

Where is SCAN HEALTH PLAN available?

SCAN HEALTH PLAN is available in 1 state (CA) across 3 counties. Coverage area can vary — check with the insurer or Medicare.gov for exact availability in your ZIP code.

What supplemental benefits does SCAN HEALTH PLAN offer?

SCAN HEALTH PLAN covers 4 supplemental benefits beyond standard Medicare, including vision eye exam, vision eyewear. Many Medicare Advantage plans include dental, vision, and hearing coverage not available under Original Medicare.

How is SCAN HEALTH PLAN rated on quality measures?

CMS evaluates SCAN HEALTH PLAN across 19 individual quality measures spanning 8 domains, including DD2: Member Complaints and Changes in the Drug Plan’s Performance, DD3: Member Experience with the Drug Plan, DD4: Drug Safety and Accuracy of Drug Pricing and more. These measures cover clinical outcomes, patient experience, and plan operations.

Data Source

Data from CMS Medicare Advantage 2026 Star Ratings and Plan Finder datasets. Contract ID: H5943. Last updated: 2026 plan year.

Important: PlainMedicare provides CMS data for informational purposes only. This is not medical or insurance advice. Consult a licensed Medicare counselor or insurance agent for personalized guidance. Always verify current plan details with the insurer or Medicare.gov before enrolling.

Related

Data sourced from official U.S. government datasets. See our methodology for details. Retrieved and formatted by Kiznis Studio Editorial