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 requestvia FAX to: 602-778-3333 or by mail to:
  • SCAN Healthplan Arizona
    Attention: Member Services Department
    1313 E. Osborn Rd., Ste 150
    Phoenix, AZ 85014
    MemberServices@scanhealthplan.com

  • If you are asking for a fast appeal, you may make your appeal in writing or you may call our Member Services Department at: 1-888-540-7226, 8:00 a.m. – 8:00 p.m, 7 days a week. TTY users: 1-800-367-8939, 8:00 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 2012 SCAN Redermination Request Form:
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  • 2012 Redetermination Request Form

    Evidence of Coverage