Formulary Documents
The SCAN Formulary is a list of prescription drugs covered by your plan.
To review or download your plan Formulary, please choose from the list below.
To search for a prescription drug in the Formulary, please use our Find a Formulary Drug search tool by clicking here.
If you’d like a printed copy of the Formulary mailed to your home, please click here and fill out the Formulary request form.
NOTE: If you choose to have your Formulary mailed to your home, all future Formularies will also be mailed to your home until you request otherwise by contacting Member Services.
- 2023 SCAN Health Plan Formulary (English/Spanish) Last Modified: 6/1/2023
- 2023 SCAN Health Plan Formulary (English/Chinese) Last Modified: 6/1/2023
- 2023 SCAN Health Plan Formulary (English/Korean) Last Modified: 6/1/2023
- 2023 SCAN Desert Health Plan Formulary (English/Spanish) Last Modified: 6/1/2023
- 2023 SCAN Health Plan Formulary - Clark and Nye Counties (English/Spanish) Last Modified: 6/1/2023
- 2023 SCAN Health Plan Formulary - Texas (English/Spanish) Last Modified: 6/1/2023
- 2023 VillageHealth Formulary – Los Angeles/Riverside/San Bernardino County (English/Spanish) Last Modified: 6/1/2023
Prior Authorization Forms
- 2023 Prior Authorization Criteria Last Modified: 6/1/2023
