Getting Care during a Disaster or Emergency
If you are a Medicare Advantage member and have been affected by a disaster or emergency declaration issued by the President of the United States or a State Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services in your geographic area, then the following will apply:
- Part A and Part B and supplemental Part C plan benefits are provided at specified non-contracted Medicare-certified facilities;
- Where applicable, requirements for referrals or prior authorizations are waived in full;
- Plan-approved out-of-network cost-sharing amounts are temporarily reduced; and
- The 30-day notification requirement to members is waived, as long as all the changes (such as reduction or cost-sharing and waiving authorization) benefits the member.
- At all times, and especially during a disaster and/or public health emergency situations, HMSA will ensure that you have adequate access to covered Part D drugs dispensed at out-of-network pharmacies if you are unable to obtain covered Part D drugs at a network pharmacy. If requested and available at the time of refill, HMSA will allow an affected member to obtain the maximum extended day supply.
When the Disaster Ends
Once the President of the United States, a State Governor, the U.S. Secretary of Health and Human Services or The Centers of Medicare & Medicaid Services (CMS) has determined that the disaster or emergency is over, or after a minimum of 30 days have passed when there is no end date declared, you will need to use the plan provider network to receive services and the normal pre-authorization/referral requirements and cost sharing will resume and as described in your Evidence of Coverage.
If we are unable to resume normal operations, we will continue to keep you informed about how to receive covered care and prescription drugs by posting updates on our website and when you call us at 808-948-6000 on Oahu or 1-800-660-4672 toll-free, 8 a.m. to 8 p.m. seven days a week. TTY users, call 711 . We will also notify the Centers of Medicare and Medicaid Services.