If your physician or pharmacist tells you a certain prescription requires a prior authorization or is exceeding a coverage limit, you may fill out the coverage determination form below and SCAN will assist in having your physician send medical justification to Express Scripts to make a decision on whether to cover your request. Otherwise you may contact SCAN Member Services at 1-888-540-7226, 8:00 a.m. - 8:00 p.m., 7 days a week. (TTY Users: call 800- 367-8939) for additional assistance in making this request. A decision about whether SCAN will cover a Part D prescription drug can be a "standard" coverage determination that is made within the standard timeframe typically within 72 hours. You may ask for a fast decision only if your physician believes that waiting for a standard decision could seriously harm your health or your ability to function. Once a decision has been made, Express Scripts will send a letter to you and your physician regarding the decision of the coverage determination. If you would like SCAN to make a decision on a Part D drug, such as a formulary or tier exception, you will need to complete a Coverage Determination Request Form. To find instructions on how to complete a Coverage Determination Request Form, click here.