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Policy Architecture Reference

Understanding the SCAN Health Plan Group ID

Why the concept of a "Group ID" creates confusion on Medicare Advantage plans and how to determine whether your policy has an assigned group number.

Direct Answer Summary

If you enrolled in SCAN Health Plan as an individual Medicare beneficiary, you do not have an insurance group ID. Commercial intake forms ask for one because they are built for employer coverage. On individual SCAN plans, clinical care is routed through your Medical Group (IPA), and portal forms can be satisfied by entering "NONE".

Two Types of SCAN Plans: Individual vs. Group

To understand why you might or might not have a Group ID, it helps to distinguish how you enrolled in SCAN Health Plan:

Individual Medicare Advantage (Most Members)

No Insurance Group ID

Members choose their plan directly during Medicare Annual Enrollment. Coverage is contracted individually with CMS. Clinical authorizations are handled by your assigned Medical Group / IPA.

Employer / Retiree Group Plans (EGWP)

Dedicated Group Number

Offered through union trusts, school districts, or municipal retiree systems. These specific policies carry an employer "Group #" printed directly on the front of the member card.

What to Enter on Registration Paperwork

When a hospital desk, diagnostic center, or online patient portal requests a Group ID:

Source Attribution & Policy Verification

Source: Centers for Medicare & Medicaid Services (CMS) Medicare Advantage HMO guidelines and official SCAN Health Plan Evidence of Coverage documentation.

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