You can never predict what will occur in the aftermath of a disaster, and in addition to basic needs, we understand that our members may not be able to access their health insurance information and documents during these times to obtain services or prescriptions. With this in mind, we formed a crisis response team and implemented a response plan in the event of a crisis or emergency to provide support and outreach to our impacted employer groups and members. This allows us to quickly respond to our impacted members and offer assistance as needed.
Our crisis response plan for members includes:
- Outlining available options for accessing their health care
- Assisting with finding network providers, hospitals or dialysis centers
- Communicating benefit information
- Ordering new ID cards
- Accessing medical records
- Providing early refills for prescription medications
- Ensuring continuity of care or transition of care needs
- Toll-free hotlines that members can call for help with locating providers, pharmacies, dialysis centers and other services
In addition, we have established procedures in case of evacuations due to significant disasters that may necessitate a more serious crisis response. Exceptions to standard business practices for members may include the waiving of network provider requirements, especially in the case of emergency surgeries, dialysis, cancer treatments and other care for serious or critical conditions, and grace periods for premium payments for employers and members.
Prime Therapeutics, our pharmacy benefits manager, provides these additional benefits:
- Early replacement of prescription medications destroyed or lost during a disaster (overriding the “refill too soon” restriction)
- Shipping of prescription medications to a new address
- An override of local 10-day fill or three-day fill restrictions
- Transferring of PrimeMail prescriptions to a local retail pharmacy, or member assistance with obtaining a new retail prescription