Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
SCAN Balance Texas, 2027
H8902Contract002Plan
HMO C-SNP · special needs plan, chronic or disabling condition · 6 counties in Texas
Run by SCAN Health Plan Texas, Inc. (contract H8902), sold as SCAN Health Plan, owned by SCAN Group
SCAN Balance Texas (H8902-002) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $2,000. It takes in the members of H8902-009.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Drug deductible | $0 | $450 | ▲up $450 |
| Emergency room | $90 copay | $115 copay | ▲up $25 |
| Hospital stay, in network | $95 a day for days 1–5, then $0 a day for days 6–90 | $125 a day for days 1–5, then $0 a day for days 6–90 | ▲up $150for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $140 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $810for a 30-day stay |
| Comprehensive dental, yearly limit | $3,500 a year | $3,000 a year | ▼down $500 |
| Over-the-counter items, yearly | $660 a year | $480 a year | ▼down $180 |
| Counties served | 4 | 6 | ▲up 2 |
| Drug tier 1, preferred generic | $0 | $3 | ▲up $3 |
| Drug tier 5, specialty tier | 33% of the cost | 28% of the cost | ▼down 5 points |
| 12 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $2,000 | $2,000 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $0 copay | $0 copay | no change |
| Medical deductible, in network | none | none | no change |
| Ground ambulance, in network | $225 copay | $225 copay | no change |
| Eyewear, yearly limit | $325 a year | $325 a year | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Drug tier 2, generic | $7 | $7 | no change |
| Drug tier 3, preferred brand | $47 | $47 | no change |
| Drug tier 4, non-preferred drug | 35% of the cost | 35% of the cost | no 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?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $3 | $0 |
| Tier 2 | Generic | $7 | $7 | $0 |
| Tier 3 | Preferred Brand | $47 | $47 | $42 |
| Tier 4 | Non-Preferred Drug | 35% of the cost | 35% of the cost | 35% of the cost |
| Tier 5 | Specialty Tier | 33% of the cost | 28% of the cost | 28% 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, 32 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 2 plans have a lower out-of-pocket limit, 29 a higher one. On the premium, 26 the same, 5 a higher one.
Out-of-pocket limits of the 32 chronic or disabling condition special needs plans
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 6 counties: $0 a month and $2,000.
Texas
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Which 2026 plans move into it, and what changes for their members?
For 2027 this plan takes in the members of 1 other plan, beside its own 1,190 members. In 2027 it costs $0 a month with a $2,000 limit; each row compares that with the plan its members had in 2026.
| 2026 plan | Members, Sept. 2026 | Members who move | Premium 2026 | Premium change | Limit 2026 | Limit change |
|---|---|---|---|---|---|---|
| SCAN Strive TexasH8902-009 | 1,735 | 1,697 | $0 | no change | $2,000 | no change |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision). Each moving plan's own page lists every line that changes for its members.
Who runs this plan?
- Plan ID
- H8902-002
- Legal name of the contract
- SCAN Health Plan Texas, Inc.
- Sold as
- SCAN Health Plan
- Parent company
- SCAN Group
- Plan type
- HMO C-SNP
- 2026 star rating of the contract
- not rated (too little data) overall; health plan not rated, drug plan 4 of 5
- Members, September 2026
- 1,190
- 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?
- Other 2027 plans in Bexar, TXWhere most of its members live; premiums and limits side by side
- Every SCAN Health Plan plan for 2027Its contracts, counties and plans that end
- The other 3 plans of contract H8902Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
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.