IMPORTANT NOTICE FOR HURRICANE IDALIA
Important Notice
The Health Plan has established a Disaster and Emergency Declaration policy in accordance with state and federal laws and related regulations.
Plan Counties affected: Citrus, Hernando, Pasco, and Pinellas.
During this period:
- For any medical emergency please contact 911
- The plan will allow Part A/B benefits to be furnished at non-contracted (out of network) facilities
- Plan will waive requirements for obtaining gatekeeper (PCP) referrals.
- The Plan will temporarily reduce plan-approved out-of-network cost sharing to in-network cost-sharing amounts;
- Enrollees will have adequate access to covered Part D drugs dispensed at out-of-network pharmacies when those enrollees cannot reasonably be expected to obtain covered Part D drugs at a network pharmacy, and when such access is not routine;
- The Plan will lift "refill-too-soon" edits. You can get your refills at your pharmacy with no problem. Talk to your pharmacist. They can help you fill a prescription.
- Affected enrollee can obtain the maximum extended day supply, if requested and available at the time of refill.
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When calling the member services phone numbers, you may experience long waits or be directed to voice mail.
We are working diligently to address all of your needs and all voice mails will be returned as soon as possible.
If experiencing a medical emergency, please contact 911.
Authorization Requirements
Hurricane Idalia - Authorization requirements for designated State of Emergency areas
Due to Hurricane Idalia, the Governor of Florida has issued a state of emergency for 49 counties under Executive order 23-117.
Please visit www.flgov.com/2023-executive-order for a list of impacted counties.
Prior authorizations
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Effective August 29, 2023,
for any designated State of Emergency county, we have waived prior authorization requirements
for covered and critical life-sustaining services such as oxygen, nebulizer, ventilator,
feeding pump, dialysis, insulin/insulin administration, DME, skilled nursing facility services,
and chemotherapy until such time that we communicate a change back to normal processes.
- We respectfully request notification of SNF/Inpatient admissions within 24 hours so that
we may assist our provider, facilities, and members in coordinating any post-discharge services,
including transportation or transfers. Inpatient Rehab and LTAC continue to require prior authorization.
- We will not deny a continued inpatient facility stay for late submission of clinical
information and will accept verbal concurrent reviews until such time that we communicate a change
back to normal processes.
- For further information please contact your Provider Services Representative.
Transportation:
There may be long waits for members calling for transportation services, including emergency transportation, in some areas that may be affected by the hurricane. If you need transportation and it is not an emergency, please call back at a later date.
This will ensure we can help people who are in need right away.
If you are experiencing a medical emergency, please contact 911.
OVER THE COUNTER (OTC) ORDERS:
Due to the hurricane, there may be delays in receiving your orders.
LINKS TO WEATHER RELATED WEBSITES
