Declaration of Disaster or Emergency

If you are affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, resulting in a disruption of access to healthcare there is certain additional support available to you.

• Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities).
• Where applicable, requirements for gatekeeper referrals are waived in full;
• Plan-approved out-of-network cost-sharing to 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 of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.