Your Medicare costs in 2026 may look different from what you expect. Many seniors see “$0 premium” and assume coverage is free — but the real question is what you’ll actually pay when you visit the doctor, pick up prescriptions, or hit your maximum out-of-pocket (MOOP) limit. The truth is, 2026 SCAN Medicare Advantage costs include not just premiums, but also copays, givebacks, and coverage caps that can make or break your budget.
Skyline Benefit is an independent Medicare insurance broker helping seniors in Los Angeles, Orange County, and across California compare SCAN with other top carriers. We confirm your doctors, check your drug list, and explain your real costs — all at no extra charge. Here’s the breakdown of what SCAN members can expect in 2026.
How Much Are 2026 SCAN Medicare Advantage Premiums?
SCAN is holding premiums steady across most of its Southern California service areas:
- Classic Prime (HMO): $0 monthly premium in Los Angeles and Orange Counties.
- Venture Plans: Premiums range from $20–$75, depending on county, but include up to $185/month Part B giveback (rebated into your Social Security check).
- Special Needs Plans (C-SNP/D-SNP): $0 premium, designed for dual-eligible and chronic condition members.
Even with $0 premium plans, you must still pay your standard Medicare Part B premium — unless you enroll in a plan with a giveback.
What Is the MOOP (Maximum Out-of-Pocket) for 2026?
The MOOP is the single most important number to protect your wallet. Once you hit it, all covered services are $0 for the rest of the year.
- Classic Prime: $2,400–$2,499 in-network MOOP.
- Essential Savings: $2,400 MOOP plus worldwide emergency coverage.
- Venture Plans: Slightly higher MOOPs, but offset by monthly Part B rebates.
For seniors managing chronic conditions or frequent doctor visits, hitting the MOOP can save thousands.
What Will You Pay at the Doctor’s Office in 2026?
SCAN keeps many common services affordable:
- $0 copays for primary care and most labs on Classic Prime.
- Specialist visits: $15–$20 copay depending on plan.
- Inpatient hospital stays: $0–$50 per day on most plans, with limits on the number of days covered.
- Emergency coverage: Worldwide emergency and urgent care capped at $100,000 per year.
Bottom line: You won’t pay much at the front door — but hospital and specialty care costs can add up if you’re not careful.
What About Prescription Drug Costs in 2026?
Prescription benefits are another highlight in 2026 SCAN Medicare Advantage costs:
- $0 copays for Tier 1 & 2 generics at preferred pharmacies.
- $2,100 annual drug out-of-pocket cap (federal mandate) — once you hit it, covered drugs are free.
- Insulin capped at $35/month.
- All ACIP-recommended vaccines at $0, including shingles and flu.
This makes SCAN one of the more predictable options for drug coverage in Southern California.
What Extra Benefits Do SCAN Plans Offer in 2026?
SCAN is doubling down on value-added perks:
- Dental upgrades: Up to $3,000 allowances, including implants and dentures.
- Vision and hearing: Routine exams plus eyewear/hearing aid benefits.
- FlexEssentials card: Preloaded for groceries, OTC items, utilities, and transportation.
- At-home support: Home safety modifications, post-hospital meals, and caregiver respite care.
- Fitness & wellness: SilverSneakers, gym access, and new caregiver coaching programs.
These extras can mean hundreds — even thousands — in savings if you use them fully.
When Can You Enroll in a 2026 SCAN Medicare Advantage Plan?
Enrollment happens during Medicare Open Enrollment (October 15 – December 7, 2025). Any changes you make take effect January 1, 2026. This is your window to switch into SCAN, compare carriers, or confirm your plan still works for your doctors and prescriptions.
Need Help With 2026 SCAN Medicare Advantage Costs?
Skyline Benefit is an independent Medicare broker that helps seniors review 2026 SCAN Medicare Advantage updates, compare costs and benefits, and make smart enrollment choices. We work for you — not the carriers — to ensure your coverage fits your health and financial needs.
Call us at: (714) 888-5112