2012 Premium & Cost Sharing Information

To assist you in making an informed decision about SCAN, below you will find links to our benefit materials.

SCAN benefits, formulary, pharmacy network, premium, co-payments and/or co-insurance may change on January 1, from year to year.

SCAN offers verbal interpreter services in your language. These materials may be available in other languages. SCAN also offers basic enrollee information in other formats to accommodate beneficiaries with disabilities. Please call SCAN for details, 1-800-559-3500, 7:00 a.m. – 8:00 p.m., seven days a week. TTY users call 1-800-735-2929. This information is available for free in other languages. Please contact our customer service number at 1-800-559-3500 for additional information.


Para ayudarle a tomar decisiones informadas sobre SCAN, encontrará a continuación enlaces a nuestros materiales de beneficios.

Los beneficios, el formulario, la red de farmacias, la cuota, los copagos y/o coseguro de SCAN pueden cambiar el 1 de enero de cada año.

SCAN ofrece servicios de interpretación en su idioma. Estos materiales pueden estar disponibles en otros idiomas. SCAN también ofrece información básica de la persona inscrita en otros formatos para los beneficiarios con discapacidades. Para más detalles, llame a SCAN al 1-800-559-3500 de 7:00 a.m. a 8:00 p.m., los siete días de la semana. Los usuarios de TTY llamen al 1-800-735-2929. Esta información está disponible gratuitamente en otros idiomas. Comuníquese a nuestro número de servicio al cliente al 1-800-559-3500 para obtener más información.


為了協助您做出有關SCAN的知情決定，您可以使用以下連結通往我們的福利資料。

每年 1 月 1 日起，SCAN 福利、處方集、服務網藥房、保費、共付額及（或）共同保險額可能有所變更。

SCAN以您的語言提供口譯服務。這些資料可能有其他語言。SCAN也提供其他格式的基本投保人資訊，以順應殘障受益人的需要。請在致電1-800-559-3500向SCAN洽詢詳情。TTY使用者請撥1-800-735-2929。本資訊有其他免費的語言版本。請致電1-800-559-3500向我們的客戶服務部洽詢詳情。

Để giúp quý vị có quyết định cân nhắc về SCAN, quý vị sẽ tìm thấy các liên kết ở bên dưới đến các tài liệu về phúc lợi của chúng tôi.

Các khoản phúc lợi, danh mục thuốc, mạng lưới các nhà thuốc, phí bảo hiểm, các khoản đồng thanh toán và/hoặc đồng bảo hiểm của SCAN có thể thay đổi vào ngày 1 tháng 1 của mỗi năm.

SCAN có cung cấp dịch vụ thông dịch bằng ngôn ngữ của quý vị. Những tài liệu này có thể được cung cấp bằng các ngôn ngữ khác. SCAN cũng cung cấp thông tin ghi danh cơ bản ở định dạng thay thế nhằm tạo điều kiện cho người hưởng bảo hiểm bị khuyết tật. Vui lòng gọi cho SCAN để biết chi tiết, 1-800-559-3500, 7:00 a.m. – 8:00 p.m., seven days a week. Người dùng TTY hãy gọi số 1-800-735-2929.Thông tin này được cung cấp miễn phí bằng các ngôn ngữ khác. Vui lòng liên hệ dịch vụ khách hàng của chúng tôi qua số 1-800-559-3500 để biết thêm thông tin.

Contra Costa Kern Los Angeles Orange County Riverside San Bernardino San Diego San Francisco San Joaquin Santa Clara Ventura

< Click the county link on the left to view the available materials. You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Los Angeles - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Los Angeles - My Choice (HMO-POS) Benefit Highlights Summary of Benefits Evidence of Coverage Los Angeles - SCAN Healthy at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage Important Information About Your Medi-Cal Benefits Los Angeles - Heart First (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage SCAN+Connections+(HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage SCAN Connections at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Orange County - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Orange County - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Orange - My Choice (HMO-POS) Benefit Highlights Summary of Benefits Evidence of Coverage Orange - SCAN Healthy at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Riverside - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Riverside - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Riverside - My Choice (HMO-POS) Benefit Highlights Summary of Benefits Evidence of Coverage Riverside - SCAN Healthy at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage Important Information About Your Medi-Cal Benefits SCAN+Connections+(HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage SCAN Connections at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat San Bernardino - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage San Bernardino - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage San Bernardino - My Choice (HMO-POS) Benefit Highlights Summary of Benefits Evidence of Coverage San Bernardino - SCAN Healthy at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage Important Information About Your Medi-Cal Benefits SCAN+Connections+(HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage SCAN Connections at Home (HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Ventura - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Kern - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat San Diego - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage San Diego - SCAN Signature (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat San Francisco - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage San Francisco - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Santa Clara - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Santa Clara - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat Contra Costa - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage Contra Costa - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage You will need Adobe Acrobat Reader to view these documents Click here to get Adobe Acrobat San Joaquin - SCAN Classic (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage San Joaquin - SCAN Options (HMO) Benefit Highlights Summary of Benefits Evidence of Coverage SCAN+Connections+(HMO SNP) Benefit Highlights Summary of Benefits Evidence of Coverage Click here for more information about areas we serve.

SCAN is committed to assist beneficiaries to make informed decisions about plan choices in the areas that we serve. If you have questions, please call Member Services at 1-800-559-3500, 7:00 a.m. – 8:00 p.m., seven days a week. TTY users call 1-800-735-2929.