Medicare Part D Benefits: File an Appeal

If you were recently denied coverage of (or payment for) a prescription drug, you have the right to ask us for a redetermination (appeal). You have 65...

SCAN Request Forms - SCAN Health Plan

Member ID Card Request Form

Caregiver Form

SCAN recognizes that taking on the responsibility of caring for a family member or friend can be difficult. Because of that, we look to work with our caregivers,...

Benefit Material Request for Prospects

Find contact forms, phone numbers, hours, and information requests.

SCAN Advertising List Removal

At SCAN, we realize receiving unwanted mail can be frustrating. To remove your name from our advertising mailing list, choose a response below, complete...

Fall Prevention Care Kit Request Form

To request a Fall Prevention Care Kit, please answer the questions below, and a kit will be mailed to your home address in 3 to 4 weeks. Be sure to answer...

Request a Formulary for Current Members

The Formulary provides a list of covered drugs.SCAN's Formulary search tool provides the most up-to-date listing of SCAN's covered drugs.  To search SCAN's...

Request a SCAN Form

SCAN Member Requests As a member of our plan you may ask a question, request a replacement member identification card, request member materials or change...

Appeals Grievances and Exceptions Report

SCAN Member Requests As a member of our plan you may ask a question, request a replacement member identification card, request member materials or change...