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Advance Directive

A formal document signed by an individual in advance of a severe illness or injury. An Advance Directive will guide treatment decisions in the event the individual can no longer make informed decisions.

Ancillary Services

Services over and above physician services, including laboratory, radiology, and physical therapy.

Annual Election Period

A set time each year when members can change their health or drugs plans or switch to Original Medicare. Also known as Annual Enrollment Period.

Appeal

An appeal is something you do if you disagree with our decision to deny a request for coverage of health care services or prescription drugs or payment for services or drugs you already received. You may also make an appeal if you disagree with our decision to stop services that you are receiving. For example, you may ask for an appeal if we don’t pay for a drug, item, or service you think you should be able to receive.

Appointed Representative

An individual, either appointed by a SCAN member or authorized under State or other applicable law, to act on behalf of the member in obtaining a grievance, coverage determination, or dealing with any level of the appeals process.