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Important Notifications

HHS Secretary Alex Azar declared a Public Health Emergency in CA due to the wildfires.  The declaration is attached and is retroactive to November 8, 2018. 

For public health emergencies the following must be put into place:

  • Part D – the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first. 
  • Part C – cessation of Part C Prior Auth requirements for non-contracted providers will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first. 
  • Claims – the time is extended on lifting denials for no authorization for 90 days.
  • Website – the informational statement must remain on the website for 90 days
  • Call Centers – please ensure your employees are responding to members and providers questions appropriately.

For more information, refer to this emergency declaration.

 

MEMBER ALERT- VERY IMPORTANT INFORMATION 

Due to Wildfires  in the State of California, Acting Governor Gavin Newsom declared a state of emergency in the following Counties: Los Angeles and Ventura

Your health and safety are our primary concerns and if you leave your home to avoid this emergency, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional.   

For our members who live in one of these impacted areas, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers.  You must still use Medicare certified facilities and providers.

Prior authorization for medical services or medication may still be needed for medical necessity. This change is in effect until the emergency notice is closed or 7 December 2018, whichever is earlier. 

For public health emergencies, the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first.

Due to the West Fire in the State of California, Governor Brown declared a state of emergency in the San Diego County.

Your health and safety are our primary concerns and if you leave your home to avoid this emergency, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional. 

  For our members who live in one of these impacted areas, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers.  You must still use Medicare certified facilities and providers.

Prior authorization for medical services or medication may still be needed for medical necessity. This change is in effect until the emergency notice is closed or August 6, 2018, whichever is earlier. 

For public health emergencies, the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first.

Read commonly asked questions or call 1-844-442-5047

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