The Members-First Approach: How SCAN Health Plan Is Fixing “Broken” Insurance

SCAN Health Plan has a blueprint for “fixing” health insurance – it all starts with the member

2026 will be a major transition year for Medicare Advantage, with several significant changes to the program taking effect. These include the first round of government-negotiated drug prices, ongoing updates to how prescription drug coverage is structured under Part D, and new federal rules that will reshape how plans are paid, how benefits are offered, and how quality is measured. These updates will affect everything from hospital stays to supplemental benefits like dental and vision care, as well as redesigns and regulatory changes that impact revenue and industry-wide drops in star ratings.

Now more than ever, seniors and caregivers will need to be educated and proactive in choosing the right Medicare Advantage plan during the current annual enrollment period ending on December 7.

Amid so much change, many Medicare Advantage plan providers are reducing their presence in existing markets altogether. But Long Beach-based SCAN Health Plan is instead fighting back and taking action on behalf of seniors – expanding thoughtfully, enhancing benefits and strengthening its commitment as both a steady advocate and trusted, compassionate partner to the people and communities it serves.

“We recognize that aging looks different for everyone, and we believe in the importance of meeting people where they are,” said Karen Schulte, SCAN Health Plan’s president of Medicare. “Our goal is to make Medicare easier to understand, so that older adults can make confident choices and then feel supported even beyond the time that they enroll.”

“Health Insurance is Broken”

Founded “by seniors for seniors” nearly 50 years ago, SCAN (Senior Care Action Network) is focused on simplifying and personalizing the healthcare experience to ensure that every one of its more than 312,000 members across California, Arizona, Texas, Nevada, New Mexico and – as of next year – Washington feels supported and understood.

While older adults are once again being bombarded with open enrollment ads portraying aging as carefree and perfect, SCAN Health Plan this year launched a bold new “Health Insurance is Broken” campaign. This confronts reality for seniors and commits to fixing what does not work. With nearly 42% of Medicare beneficiaries reporting delaying or skipping care due to cost or coverage gaps*, SCAN is spearheading a new conversation rooted in honesty, accountability and solutions.

“Our duty and responsibility, especially as a nonprofit, is to continue to challenge the status quo,” Schulte explained. “What that means is we’re going to continue to push the healthcare system to do better. I think we’re helping to make change throughout the industry, because older adults deserve more than what the broken health system is offering them today.”

SCAN’s commitment to advocacy and industry-wide change extends to the very highest levels. In July, SCAN Health Plan CEO Dr. Sachin H. Jain testified before Congress, telling the House Ways and Means Committee that, “For too many older adults, Medicare Advantage means the difference between stability and insecurity; prevention and crisis; dignity and decline.”

Mission-Driven & Member-Obsessed

As a not-for-profit company, SCAN can remain mission-driven and, as Schulte put it, “member-obsessed,” placing people and communities firmly before profit.

“Our responsibility is to our members, not shareholders, and it’s our mission that drives every decision that we make,” she said. “When we do well financially, that money goes directly back into better benefits, lower premiums and stronger support for our members.”

Conversely, in times of financial pressure, SCAN’s nonprofit status enables it to act as a responsible steward of its resources, prioritizing members’ well-being and maintaining benefit stability. And their mission transcends supporting individual members to also include investing in the health of the communities they serve, such as supporting programs that address issues that can plague older populations like isolation, inequity or housing insecurity. “We’re deeply connected to our communities,” said Schulte. “That means that we partner with local doctors, nonprofits and advocates who understand a given community and call it home.”

Member-Centered Innovation

SCAN Health Plan is committed to growing responsibly by sustaining strong, reliable benefits and quality, dependable care, all packaged with cost savings. This mission includes a robust benefit portfolio for every stage of the aging journey including SCAN Inspired (HMO), the industry’s first Medicare Advantage plan designed by women for women; SCAN Affirm (HMO) the first Medicare Advantage plan designed for LGBTQ+ older adults and innovative special-needs plans such as California’s largest Institutional Special Needs Plan SCAN Embrace (HMO I-SNP) for nursing home residents.

SCAN’s 2026 benefit lineup in Los Angeles includes plans that offer $0 copays for Primary Care Providers and many specialists; $0 copay for Tier 1 and Tier 2 prescription drugs plus access to around 90% of medications taken by members at $0**; significant dental allowances ranging from $2,500 to $4,000 per year; and enhanced vision coverage with yearly eyewear allowances from $150 to $350.***

You can enroll with SCAN Health Plan over the phone, where you will always speak to an actual person. If you prefer face-to-face interaction, a sales representative can visit you at home. SCAN Health Plan’s teams are rooted in their communities, reflecting their diversity through bilingual support and culturally relevant programs to ensure that every single member feels seen and heard.