How do I request an exception to the SCAN Golds Formulary?
You can ask SCAN Gold or SCAN Gold Select to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make. • You can ask us to cover your drug even if it is not on our formulary. • You can ask us to waive coverage restrictions or limits on your drug. For example, for certain drugs, SCAN Gold limits the amount of the drug that we will cover. If your drug has a quantity limit, you can ask us to waive the limit and cover more. • You can ask us to provide a higher level of coverage for your drug. For example, if your drug is usually considered a brand name drug, you can ask us to cover it as a generic instead. This would lower the amount you must pay for your drug. Please note, if we grant your request to cover a drug that is not on our formulary, you may not ask us to provide a higher level of coverage for the drug. Generally, SCAN Gold and SCAN Gold Select will only approve your request for an exception if the alternative drugs included on th
