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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.
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...
Are you in the Medicare Part D Coverage Gap? Patient Assistance Programs can help.
How much you pay for your prescription drugs depends on which Medicare Part D drug payment stage you’re in when you get your prescription filled or refilled....