Medicare Disaster Events

In the event of a Presidential emergency declaration, a Presidential (major) disaster declaration, a declaration of emergency or disaster by a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services,

EmblemHealth must:

  • Waive approvals and referrals (permission from your primary care doctor to see a specialist).
  • Reduce cost-sharing (your share of the cost) amounts for out-of-network service to in-network cost-sharing (your share of cost) amounts.
  • Make plans for care such as:
    • Being discharged from a facility.
    • Home care approvals.
    • Durable medical equipment.
    • Provide transportation.
    • Move the member from a facility in our network (a place we contract with) to one out-of-network (a place we do not contract with).
    • Help the member return to the prior facility.
  • Make sure members can get covered Part D drugs filled at out-of-network (places we do not contract with) pharmacies if the member is not able to get covered Part D drugs at a network (a place we do contract with) pharmacy.
  • Allow the member to get the maximum supply of part D drugs if it is in supply at the time of refill.

For further assistance, click here.

Last Updated 12/31/2019 

Y0026_ 127364 Accepted 10/1/19

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