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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...
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...
I Have a Question
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...
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...
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...
Benefit Program Reimbursement Forms
Find a Benefit Program Reimbursement Form
Claims and Reimbursement Request Forms
Find a claim forms in English and in Spanish
