How to appeal a SCAN Health Plan denial
Your appeal path depends on which kind of SCAN Health Plan plan you have. Find yours below — deadlines differ, and deadlines are everything.
If your SCAN Health Plan plan is
Medicare Advantage
You have a Medicare plan run by a private insurer (an “MA” or “Part C” plan) — the card says Medicare Advantage, and the insurer is a company like UnitedHealthcare, Humana, or Aetna.
STEP 1
Level 1 — Plan reconsideration
File within 65 days. The plan must use a different reviewer; medical denials need a physician reviewer.
STEP 2
Level 2 — Independent Review Entity (automatic)
If the plan says no again, it MUST forward your case to an outside reviewer automatically. You do nothing.
STEP 3
Level 3 — Administrative Law Judge
60 days to request a hearing if the amount in dispute meets the threshold.
Key deadlines: Standard service decision: 72 hoursExpedited decision: 24 hoursPayment decision: 14 calendar days