SCAN Health Plan: In-Home Care and Respite Benefits Explained

SCAN Health Plan is one of the largest not-for-profit Medicare Advantage organizations in the United States, serving more than 285,000 members across California, Arizona, Nevada, Texas, and New Mexico. What makes SCAN especially interesting for families researching home care is that several of its plans now include personal in-home care and respite care as supplemental benefits at no extra cost beyond the standard Medicare Advantage premium. For seniors recovering from a hospital stay, a hip or knee replacement, or who need help with everyday activities, these benefits can mean dozens of free caregiver hours each year.

What Is SCAN Health Plan?

SCAN was founded in 1977 by a group of senior activists in Long Beach, California who believed older adults deserved better health care choices. Today SCAN operates as a Medicare Advantage organization, which means members get all of their Original Medicare (Part A and Part B) coverage through SCAN, plus extra benefits Medicare does not normally pay for. Those extras typically include prescription drug coverage, dental, vision, hearing aids, fitness memberships, and more recently, in-home support services.

The In-Home Care Benefit: How Many Hours and Who Qualifies

Several SCAN plans include a personal in-home care benefit that provides between 80 and 120 hours per year of non-medical caregiver assistance. The exact number depends on the plan you select. This benefit is typically triggered by one of the following situations:

• After a hospital discharge, to help with recovery at home.
• After a planned surgery such as a hip replacement, knee replacement, or other orthopedic procedure.
• For ongoing assistance when a member needs help with two or more activities of daily living, such as bathing, dressing, toileting, transferring, eating, or walking.

A trained caregiver visits the home and provides hands-on personal care, light housekeeping, meal preparation, mobility assistance, and companionship. The benefit is administered through approved home care providers in SCAN's network.

The Respite Care Benefit for Family Caregivers

SCAN plans also include a separate respite care benefit of 20 to 40 hours per year for unpaid family caregivers. Respite care gives the primary caregiver a break by sending a professional caregiver into the home to take over for a few hours or a full day. Family caregivers often skip vacations, miss medical appointments of their own, and burn out. Respite hours are designed to prevent that.

How to Find Out Exactly What Your Plan Offers

Benefit amounts vary by plan and by county. To check the specifics for any SCAN plan available in your area, follow these steps:

1. Go to scanhealthplan.com and select your state.
2. Choose your county.
3. Pick a plan and click "Explore Plan."
4. Scroll down to the Plan Documents section and download the Benefit Highlights PDF.
5. Inside the Benefit Highlights, find the Additional Benefits section, which is usually toward the end of the document. The in-home care and respite hours will be listed there.

For families and care advisors comparing multiple plans, it can help to build a simple spreadsheet listing each plan name, its in-home care hours, and its respite hours side by side.

Who Is Eligible for SCAN?

To enroll in any SCAN Medicare Advantage plan, you must:

• Be entitled to Medicare Part A and enrolled in Medicare Part B.
• Live in the SCAN service area, which currently includes parts of California, Arizona, Nevada, Texas, and New Mexico.
• Continue to pay your Medicare Part B premium.

Most SCAN plans have a $0 monthly premium beyond the standard Part B premium. Enrollment is open during the Medicare Annual Election Period (October 15 to December 7) and during a Special Enrollment Period if you qualify (for example, if you move, lose other coverage, or have certain health conditions).

How SCAN Compares to Other Coverage Options

If you are weighing SCAN against staying on Original Medicare or moving to a different Medicare Advantage plan, the in-home care and respite benefits are a real differentiator. Original Medicare does not pay for non-medical home care at all. It only covers limited skilled home health services after a qualifying event. Other Medicare Advantage plans may offer some supplemental in-home support, but the hours and eligibility rules vary widely.

For families already paying out of pocket for personal care, even 80 hours per year of free help can save several thousand dollars. At an average rate of $35 to $40 per hour for non-medical home care in California, 100 hours equals roughly $3,500 to $4,000 in covered services.

How to Use Your SCAN Benefit

Once enrolled, members can request the in-home care benefit by calling SCAN member services or working with their care manager. SCAN coordinates with approved home care agencies to schedule visits. The agency sends a caregiver to the home for the approved number of hours per week or per episode.

If you are recovering from surgery or a hospital stay, ask your discharge planner about activating the benefit before you leave the hospital. Many families do not realize the benefit exists until weeks or months later.

Important Considerations and Limitations

• The in-home care benefit covers non-medical personal care only. It does not replace skilled nursing or physical therapy, which are covered separately under home health benefits.
• Hours typically reset each calendar year and unused hours do not roll over.
• Approved providers may have wait times, especially during busy seasons. Schedule early.
• Always verify benefit details directly with SCAN member services since plan documents can change year to year.

Pairing SCAN Benefits with Private Home Care

Many families use SCAN's covered hours as a foundation and supplement with private-pay home care for additional hours. For example, if a parent needs four hours of help every weekday (about 80 hours per month), SCAN's 100-hour annual benefit covers roughly five weeks. The remaining hours can be filled by a private home care agency that you can switch to seamlessly.

Estimate Your Family's Need

Before contacting SCAN or any home care provider, get a clear picture of how much help is actually needed. Use our free Care Hours Estimator to project weekly hours and our Home Care Cost Calculator to budget the gap between what insurance covers and what you may pay privately.

Need Professional Home Care?

A licensed home care agency works with families navigating SCAN benefits, Medicare Advantage in-home care hours, and private-pay arrangements. Their caregivers in Chatsworth, California provide post-hospital recovery care, personal care, and respite support that complements covered insurance benefits. Compare agency options in your area, or use our free Find Your Care Match tool for a personalized home care recommendation.

This article is for informational purposes only and is not affiliated with or endorsed by SCAN Health Plan. Always verify benefits directly with SCAN before making coverage decisions.