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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,
- 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.
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Last Updated 10/1/2020
Y0026_ 200570 Accepted 9/29/20