Hoag and SCAN in 2027: What Orange County Medicare Members Need to Know

Hoag and SCAN in 2027: Hoag says its contract for SCAN Medicare Advantage HMO members expires December 31, 2026. Starting January 1, 2027, Hoag will be out-of-network for those members. This announcement concerns Hoag’s network participation; it does not, by itself, establish that your SCAN insurance plan is ending. See Hoag’s official announcement and FAQs.

Information reviewed September 30, 2026. Recheck official notices before making a coverage or care decision.

What the Hoag-SCAN change means for your care

Hoag identifies affected non-emergency access to its specialists and elective hospital/outpatient services, including its Newport Beach and Irvine hospitals, Hoag Medical Group and Hoag Physician Partners. Its FAQ also describes PCP reassignment during October-November 2026. Confirm your individual assignment and effective date with SCAN.

Separate three questions when reviewing a notice: Is my plan continuing? Is my doctor or medical group changing? Is my hospital or scheduled service changing? A yes or no to one question does not answer the others.

For background, Medicare explains that an HMO generally uses its contracted provider network, with specified exceptions. A primary care choice can also affect associated specialists and hospitals. Read Medicare’s provider-network guide and our 2027 California doctor-network checklist.

Emergency care is different from routine appointments

Hoag says this change does not affect access to emergency treatment at its hospitals. In an emergency, seek the nearest emergency department. That does not make routine visits or planned procedures covered at Hoag, and it is not a promise of zero cost.

For a future appointment, ask SCAN about the applicable coverage and cost sharing rather than assuming that emergency access establishes routine network participation. Do not delay urgent medical care while comparing insurance options.

Already in treatment? Ask about continuity of care

Hoag directs members to SCAN for continuity-of-care requests; eligibility and any permitted period depend on SCAN’s determination. Approval is not automatic.

Prepare a specific request instead of asking only whether you can keep your doctor. For example: “I have an ongoing treatment plan with this clinician and appointments on these dates. What information do you need to review continued care after the network change?”

• List the treating clinician, medical group, facility and upcoming appointments.
• Ask the clinical office which treatment records or care-plan information it can provide directly to SCAN.
• Ask which services and dates a determination would cover, what costs apply and whether authorization is required.
• Request written confirmation and a reference number; ask about next steps if the request is denied.

Call the customer-service number on your SCAN member ID card. Keep a dated call log and share the response with your care team. Do not assume an existing appointment or authorization answers every coverage question for the new year.

Use this checklist before comparing a replacement plan

A hospital name in a directory, a carrier logo or a friend’s recommendation is not enough to choose coverage. Build a short list of the care you want to preserve, then request plan-specific confirmation.

1. Your address and plan: Bring your residential ZIP code, current plan name and plan ID. For each alternative, record the exact 2027 plan name and ID.
2. Doctors and medical group: List your PCP, specialists and their practice addresses. Ask about the precise medical-group assignment and referral path.
3. Hospital and scheduled services: Identify the facility and any planned surgery, imaging, infusion, therapy or follow-up care. Ask whether the clinician and facility are both covered for the relevant service.
4. Prescriptions and pharmacies: Bring drug names, strengths, quantities and preferred pharmacies. Review the exact plan’s formulary, restrictions and estimated costs, not only its medical network.
5. Total costs and transition: Compare premiums, medical cost sharing, the medical out-of-pocket limit and prescription costs. Ask who will coordinate records, referrals and any needed authorizations.

Keep the carrier’s response, the document year and the date you checked. If a directory and a physician’s office give different answers, ask the plan to resolve the discrepancy before relying on either answer. Our 2027 Medicare Advantage comparison guide can help organize the broader review.

Know the enrollment dates, but do not assume a special right

Medicare’s annual Open Enrollment runs October 15-December 7. For the fall 2026 period, changes made within that window take effect January 1, 2027; the plan must receive your enrollment request by December 7. Confirm the requested effective date and keep your confirmation. See Medicare’s Open Enrollment guidance.

A network change does not automatically give every affected member the same Special Enrollment Period. Medicare lists significant provider-network changes among exceptional circumstances evaluated case by case. If you need another enrollment opportunity, contact 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) about your situation. Verify eligibility, deadlines and the effective date rather than assuming you qualify. Read Medicare’s Special Enrollment Period guidance.

Considering Original Medicare? Review the whole transition

Returning to Original Medicare is a different decision from changing Medicare Advantage plans. Medicare explains that you may need a separate drug plan and may want Medigap, which has its own enrollment limits. Do not assume fall Medicare Open Enrollment guarantees acceptance into a Medicare Supplement policy.

Outside Medigap Open Enrollment, medical underwriting may apply unless you have applicable protections; additional state rights may exist. Before leaving current coverage, verify your individual eligibility, available policies, premiums and effective dates with the insurer and appropriate counseling resources. Review Medicare’s guidance on buying Medigap. This article does not determine anyone’s guaranteed-issue rights.

Bring your questions to a local Medicare review

If keeping Hoag care matters to you, start with your providers and treatment needs, not an advertised extra benefit. Bring your notice, doctor list, medication list, preferred pharmacies and ZIP code to a review with Skyline Benefit.

We can help organize a comparison and the questions to ask SCAN, Hoag and prospective plans. We cannot guarantee provider participation, continuity-of-care approval, eligibility, prices or enrollment outcomes. Request a Medicare plan review with Skyline Benefit.

This educational article summarizes a provider-network announcement and planning considerations. It is not a complete description of benefits, legal advice or a coverage determination. Current carrier documents, provider participation, individual eligibility and plan rules must be verified. Skyline Benefit is independent of Hoag, SCAN and Medicare.

Official sources and update note

Sources checked September 30, 2026: Hoag’s SCAN contract FAQ; Medicare’s provider-network guide, Open Enrollment guidance, Special Enrollment Period guidance and Medigap buying guidance linked above. Recheck Hoag’s announcement and your plan’s notices before acting.