SCAN Health Care in California provides a robust network of primary care physicians, specialists, hospitals, and various health care providers to ensure its members receive comprehensive medical services. Navigating your health plan effectively means understanding how to utilize this network to your advantage, ensuring you receive the care you need while maximizing your benefits.
For SCAN members in California, receiving routine health care services from providers within the SCAN network is essential. This in-network approach ensures that your care is covered, and you avoid unexpected out-of-pocket costs. In most situations, seeking routine medical attention from out-of-network providers will mean that neither Medicare nor SCAN will cover the expenses. It’s important to note exceptions for emergency care, urgent care situations, and out-of-area renal dialysis, where in-network restrictions may be waived due to necessity. Certain SCAN plans, such as VillageHealth (available in Riverside and San Bernardino counties in CA) and Embrace (covering San Bernardino County in CA, and Maricopa and Pima counties in AZ), which are HMO-POS SNP plans, may have different stipulations. For precise details related to your specific plan, it’s always recommended to consult your plan’s Evidence of Coverage (EOC) or contact SCAN directly for clarification. Remember that SCAN’s formulary, pharmacy network, and provider network are subject to change, and you will receive appropriate notification should changes occur.
To confirm whether a SCAN health care plan is available in your specific county in California, you can utilize the online Plan Search Tool provided by SCAN. Alternatively, you can directly contact SCAN for plan availability information.
For Existing SCAN Members: If you are currently a SCAN member and need to verify network providers or have questions about your coverage, SCAN Member Services is available to assist you. You can reach them at 1-800-559-3500 (TTY: 711). Please note their operating hours vary seasonally: from October 1 to March 31, they are available seven days a week, 8 a.m. to 8 p.m., and from April 1 to September 30, their hours are Monday through Friday, 8 a.m. to 8 p.m.
For Prospective SCAN Members: Individuals interested in becoming SCAN members can contact SCAN Telesales at (877) 452-5898 TTY: (888) SCAN-TTY to explore plan options and verify coverage in their area.
Messages left during holidays or outside of business hours will be addressed on the next business day.
SCAN is committed to providing timely access to necessary medical services. Here are the standard wait times you can expect for primary care and behavioral health services:
- Immediately: For emergency services or situations requiring urgent care.
- Within 7 Days: For medical attention needed for conditions that are not emergencies or urgently needed but still require prompt attention.
- Within 30 Days: For routine health care and preventative care services.
Understanding these access guidelines and network rules is key to effectively utilizing your Scan Health Care California plan and ensuring you receive timely and appropriate medical care within your network.
