Part D Coverage Determinations and Appeals

Information on appealing a Medicare Part D coverage determination.

Part D Coverage Determination Process

Category: Part D Coverage Determinations & Appeals Coverage Determination A coverage determination is an initial coverage decision made by SCAN regarding...

Report an Issue

Here’s where you can report a potential compliance issue or alleged fraud, waste, and abuse (FWA), file a grievance or an appeal, and more.

Caregiver Support Benefit

Glossary

Here you can quickly access medical terms and definitions through an alphabetized listing.

Medicare Part D Prescription Benefits: File a Redetermination/Appeal

Category: File an Appeal An appeal to the plan about a Part D Drug Coverage Decision we made is called a Redetermination (Appeal). Use this process to...

Before and After Hospital Stay Information

Category: Information & Resources SCAN is here to help make the transition from hospital to home as smooth as possible. Going to the Hospital? SCAN Can...

Prior Authorization Forms

Where prior authorization is needed, please provide the information below. Call the ESI Prior Authorization Department for faster service. If complete...

Programs to Help Members Manage Medications Safely

Links to programs that help members manage their medication safely

Drug Utilization Management

For certain prescription drugs, special rules restrict how and when the plan covers them. A team of doctors and pharmacists developed these rules to help...