Part D Redetermination / Appeal Process
An appeal to the plan about a Part D Drug Coverage Decision we made is called a
Redetermination (Appeal).
Use this process to ask us to review a Part D drug Coverage Decision made by us.
Note: You cannot request a Part D Redetermination (Appeal) if we have not issued a Coverage Determination.
What to do
- To start your Part D Redetermination (Appeal), you (or your representative or your doctor or other prescriber) must contact our plan:
- If you are asking for a standard appeal, make your appeal by mailing a written request via FAX to: 562-989-0958 or by mail to:
SCAN Health Plan
Attention: Grievances and Appeals Department
P.O. Box 22644
Long Beach, CA 90801-5644
- If you are asking for a fast appeal, you may make your appeal in writing or you may call our Member Services Department at:
1-800-559-3500, 7:00 a.m. – 8:00 p.m, 7 days a week
TTY users: 711, 7:00 a.m. – 8:00 p.m, 7 days a week.
- When making your written request be sure to include the following information:
- Member Name
- Member ID number - This can be found on your SCAN membership card
- Name of the Part D drug that you are asking us to review
- Reason you do not agree with the initial Coverage Determination
- Date of initial Coverage Determination notice
- Or you may download the 2013 SCAN Redermination Request Form:
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