Pinnie logo

Company vs company · Los Angeles County, CA · 2027 plan year

Kaiser Permanente vs SCAN Health Plan Medicare Advantage plans

Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.

Text us about this comparison

Pinnie Direct is a free text line. Pinnie does not sell plans.

In most states, including California, you cannot count on getting Medigap later

You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in California can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later. California has a birthday rule, but it only lets people who already have Medigap switch to another Medigap plan. It does not help you get Medigap after you leave Medicare Advantage.

One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.

Read about Medigap rights on Medicare.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Plan G pays almost everything after the $292 yearly Part B deductible.

Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov

Medicare.gov lists $191 to $376 a month for a 65-year-old woman who does not use tobacco. We start at the lowest price. Health questions can raise the price after your first 6 months with Part B.

Original Medicare

With Medigap Plan G at $191 a month and Wellcare Value Script (PDP)

$7,337 a year

Premiums
$4,870
Medical costs
$292
Drugs
$2,175

Most you can pay in a bad year, before drugs: $5,162.

Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

HMO from Kaiser Permanente

$3,738 a year

Premiums
$2,514
Medical costs
$660
Drugs
$564

Most you can pay in a bad year, before drugs: $3,513.

SCAN Essential Savings (HMO)

HMO from SCAN Health Plan

$1,633 a year

Premiums
$294
Medical costs
$465
Drugs
$874

Most you can pay in a bad year, before drugs: $2,694.

With these settings, SCAN Essential Savings (HMO) costs about $2,105 less a year than Kaiser Permanente Senior Advantage LA, Orange Co. (HMO).

Tipping point for Kaiser Permanente Senior Advantage LA, Orange Co. (HMO): with this drug use, the plan costs less than Original Medicare with Plan G at every level of medical care.

Tipping point for SCAN Essential Savings (HMO): with this drug use, the plan costs less than Original Medicare with Plan G at every level of medical care.

These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.

Text us about this comparison

What you pay each time you get care

In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.

Primary doctor visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $0

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $0

  • SCAN Classic (HMO)

    $0 copay

  • SCAN Venture (HMO)

    $0 copay

Specialist visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $0

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $0

  • SCAN Classic (HMO)

    $0 copay

    Prior authorization

  • SCAN Venture (HMO)

    $0 copay

    Prior authorization

Lab tests

  • Original Medicare + Medigap Plan G

    $0

    most Medicare-covered tests

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $0

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $0

  • SCAN Classic (HMO)

    $0 copay

    Prior authorization

  • SCAN Venture (HMO)

    $0 copay

    Prior authorization

MRI or CT scan

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $0-$300

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $20-$300

  • SCAN Classic (HMO)

    $0 copay

    Prior authorization

  • SCAN Venture (HMO)

    $0-$75

    Prior authorization

Emergency room

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $150

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $150

  • SCAN Classic (HMO)

    $115

  • SCAN Venture (HMO)

    $115

Urgent care

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $0

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $0

  • SCAN Classic (HMO)

    $0 copay

  • SCAN Venture (HMO)

    $0 copay

Outpatient surgery

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $150

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $300

  • SCAN Classic (HMO)

    $0 copay

    Prior authorization

  • SCAN Venture (HMO)

    $0 copay

    Prior authorization

Ground ambulance

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $350

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $350

  • SCAN Classic (HMO)

    $200

    Prior authorization

  • SCAN Venture (HMO)

    $155

    Prior authorization

Hospital stay, 5 days

  • Original Medicare + Medigap Plan G

    $0

    Plan G pays the $1,788 Part A deductible

  • Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

    $800

    for a 5-day stay

  • Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

    $1,750

    for a 5-day stay

  • SCAN Classic (HMO)

    $0

    for a 5-day stay

    Prior authorization

  • SCAN Venture (HMO)

    $0

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare + Medigap Plan GKaiser Permanente Senior Advantage LA, Orange Co. (HMO)Kaiser Permanente Sr Advantage LA, Orange Value (HMO)SCAN Classic (HMO)SCAN Venture (HMO)
Monthly premiumPart B $209.50 + Medigap Plan G $191 + drug plan $5.30$0 + Part B $209.50$0 + Part B $209.50$0 + Part B $209.50$0 (pays back $33 a month of your Part B premium) + Part B $209.50
Yearly limit on what you payYou pay the $292 Part B deductible. Plan G pays the rest.$999 in network$2,900 in network$299 in network$1,000 in network
Medical deductible$292 Part B. Plan G pays the $1,788 Part A deductible.$0$0$0$0
Primary doctor visit$0, after the $292 yearly Part B deductible$0 copay$0 copay$0 copay$0 copay
Specialist visit$0, after the $292 yearly Part B deductible$0 copay$0 copay$0 copayPrior authorization$0 copayPrior authorization
Lab tests$0, most Medicare-covered tests$0 copay$0 copay$0 copayPrior authorization$0 copayPrior authorization
MRI or CT scan$0, after the $292 yearly Part B deductible$0-$300 copay$20-$300 copay$0 copayPrior authorization$0-$75 copayPrior authorization
X-rays$0, after the $292 yearly Part B deductible$0 copay$20 copay$0 copayPrior authorization$0 copayPrior authorization
Emergency room$0, after the $292 yearly Part B deductible$150 copay$150 copay$115 copay$115 copay
Urgent care$0, after the $292 yearly Part B deductible$0 copay$0 copay$0 copay$0 copay
Outpatient hospital$0, after the $292 yearly Part B deductible$0-$150 copay$0-$300 copay$0-$50 copayPrior authorization$25-$225 copayPrior authorization
Surgery center$0, after the $292 yearly Part B deductible$150 copay$300 copay$0 copayPrior authorization$0 copayPrior authorization
Ground ambulance$0, after the $292 yearly Part B deductible$350 copay$350 copay$200 copayPrior authorization$155 copayPrior authorization
Hospital stay$0, Plan G pays the $1,788 Part A deductible$160 per day for days 1-5; $0 per day for days 6-90$350 per day for days 1-5; $0 per day for days 6-90$0 per stayPrior authorization$0 per stayPrior authorization
Skilled nursing facility$0, Plan G pays days 21-100$0 per day for days 1-20; $221 per day for days 21-100$0 per day for days 1-20; $221 per day for days 21-100$0 per day for days 1-20; $50 per day for days 21-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-100Prior authorization
Mental health visit$0, after the $292 yearly Part B deductible$0 copay$0 copay$0 copayPrior authorization$20 copayPrior authorization
Physical therapy$0, after the $292 yearly Part B deductible$0 copayPrior authorization$0-$15 copayPrior authorization$0 copayPrior authorization$5 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copay$0 copay$0 copayPrior authorization$0 copayPrior authorization
Medical equipment$0, after the $292 yearly Part B deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization$0 copayPrior authorization0%-20% coinsurancePrior authorization
Part B drugs$0 after the $292 Part B deductible$0-$47 copay, 0%-20% coinsurance$0-$47 copay, 0%-20% coinsurance0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
Drug deductible (Part D)$700 with Wellcare Value Script (PDP)$0$0$370$370
Drug tiers (one month, retail)Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 40% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copayPreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: $47 copayNon-Preferred Drug: $100 copaySpecialty Tier: 30% coinsuranceVaccines: $0 copayPreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: $47 copayNon-Preferred Drug: $100 copaySpecialty Tier: 30% coinsuranceVaccines: $0 copayPreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: $42 copayNon-Preferred Drug: 35% coinsuranceSpecialty Tier: 29% coinsurancePreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: $42 copayNon-Preferred Drug: 30% coinsuranceSpecialty Tier: 29% coinsurance

Not sure which of these costs apply to you?

Text us what you have now. We will help you read this comparison and check it with Medicare.gov.

Text us for free

A higher drug plan premium is not, by itself, a reason to switch

With Original Medicare, you buy a separate drug plan. In California, 10 drug plans are for sale for 2027, from $5.30 to $252.60 a month. Half of them cost $150.55 a month or less.

  • Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
  • The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
  • A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
  • If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov

The two companies in Los Angeles County

Kaiser Permanente

  • 2 plans for 2027 (not counting special needs plans)
  • 2 with a $0 premium; 0 pay back part of your Part B premium
  • Yearly limits from $999 to $2,900
  • Star ratings 4.5 to 4.5

SCAN Health Plan

  • 10 plans for 2027 (not counting special needs plans)
  • 8 with a $0 premium; 3 pay back part of your Part B premium
  • Yearly limits from $299 to $2,499
  • Star ratings 4 to 4

Doctors, referrals, and prior authorization

Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.

Original Medicare

  • Any doctor or hospital in the U.S. that takes Medicare
  • No referrals
  • Prior authorization only for a short list of services

Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 5 services

Physical therapy, Occupational therapy, Medical equipment, Prosthetics, Diabetic supplies

Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 5 services

Physical therapy, Occupational therapy, Medical equipment, Prosthetics, Diabetic supplies

SCAN Classic (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

SCAN Venture (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareKaiser Permanente Senior Advantage LA, Orange Co. (HMO)Kaiser Permanente Sr Advantage LA, Orange Value (HMO)SCAN Classic (HMO)SCAN Venture (HMO)
DentalNoPreventive onlyPreventive onlyComprehensiveComprehensive
Eye examNoYesYesYesYes
Glasses or contactsNoNoYes, $250 allowanceYes, $100 allowanceYes, $100 allowance
Hearing aidsNoNoYes, up to $1,000Yes, copays from $450Yes, copays from $550
Over-the-counter allowanceNo$160 a year$240 a year$360 a year$200 a year
Fitness benefitNoYesYesYesYes
Rides to careNoYesYesYesNo
Meals after a hospital stayNoNoNoNoNo
Emergency care abroadPlan G and Plan N pay 80% after a $250 deductibleYesYesYesYes
Part B premium givebackNoNoNoNo$33 a month

What changed for 2027

Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)

Renewal Plan · 2026 plan H0524-003-0

  • In-network out-of-pocket maximum up from $699 to $999
  • Diagnostic radiology (MRI, CT): $0-$175 copay to $0-$300 copay
  • Outpatient hospital: $0 copay to $0-$150 copay
  • Ground ambulance: $225 copay to $350 copay
  • Inpatient hospital: $0 per day for days 1-90 to $160 per day for days 1-5; $0 per day for days 6-90
  • Skilled nursing facility: $0 per day for days 1-20; $100 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Yearly OTC allowance down from $200 to $160
  • Rides to care added

Kaiser Permanente Sr Advantage LA, Orange Value (HMO)

Renewal Plan · 2026 plan H0524-078-0

  • In-network out-of-pocket maximum up from $1,999 to $2,900
  • Diagnostic radiology (MRI, CT): $0-$250 copay to $20-$300 copay
  • Outpatient hospital: $0-$150 copay to $0-$300 copay
  • Ground ambulance: $250 copay to $350 copay
  • Inpatient hospital: $150 per day for days 1-5; $0 per day for days 6-90 to $350 per day for days 1-5; $0 per day for days 6-90
  • Skilled nursing facility: $0 per day for days 1-20; $100 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Yearly OTC allowance down from $300 to $240
  • Rides to care added

SCAN Classic (HMO)

Renewal Plan · 2026 plan H5425-006-0

  • In-network out-of-pocket maximum up from $199 to $299
  • Drug deductible up from $250 to $370
  • Emergency care: $90 copay to $115 copay
  • Outpatient hospital: $0 copay to $0-$50 copay
  • Skilled nursing facility: $0 per stay to $0 per day for days 1-20; $50 per day for days 21-100
  • Yearly OTC allowance down from $600 to $360
  • Eyewear allowance down from $300 to $100
  • Meals after a hospital stay removed

SCAN Venture (HMO)

Renewal Plan · 2026 plan H5425-084-0

  • Drug deductible up from $250 to $370
  • Part B giveback down from $55 to $33
  • Emergency care: $90 copay to $115 copay
  • Skilled nursing facility: $0 per day for days 1-20; $100 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Yearly OTC allowance down from $260 to $200
  • Eyewear allowance down from $150 to $100
  • Meals after a hospital stay removed

More 2027 plans in Los Angeles County

County guide: 2027 plans in Los Angeles CountyState guide: California

Questions about your choice? Text us.

Pinnie Direct is a free text line. Tell us what you have now and we will help you read this comparison.

Date of birth

Of the person we will be helping.

The number you will text us from.

Next, you will send these answers in a text to Pinnie Direct. Message and data rates may apply. Reply STOP to stop.

Sources and method

Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Medigap prices are the range Medicare.gov showed for ZIP 90012 on 2026-10-09. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.

Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

See all comparisons