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...

Schedule MTM

Login Help Form

If you are having issues retrieving your username, resetting your password, or logging into the website in general, please fill out the form below.  We...

File a Grievance

A “grievance” is a formal process for filing a complaint. If you are unhappy with your care or the service you’ve received, please let SCAN know so we...

Benefit Material Request for Members

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

Member ID Card Request Form

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...

SCAN Request Forms - SCAN Health Plan

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...