Using Medicare in case of disaster or emergency

Medicare Advantage Plan or other Medicare health plans may make temporary changes to rules when health plan services get disrupted during a declared emergency or disaster. People can check their plan’s website or contact their Medicare rep to learn more.

• This plan allows people to see certain doctors or go to certain hospitals that accept Medicare patients, even if the doctor or hospital isn’t in the beneficiary’s plan network and his or her health concern isn’t an emergency. People can also contact their plan for help if they have problems using an out-of-network doctor or provider during a declared disaster or emergency.

• Thisplancan’tmakepeopleget a referral for out-of-network services. If people usually pay more for out-of-network or out-of-area care, their plan will apply the in-network rate. If the plan agrees to apply the in-network rate and later people go to an out-of-area or out-of-network provider and pay more for the service, they can save the receipt and ask their plan to refund a difference.

• People can contact their plan as soon as possible to find out if there are any other changes and when the emergency or disaster will be over. People can find their plan’s contact information on their plan membership card.

Those with Medicare drug coverage living in the area that has been declared an emergency or disaster can contact their plan for help.

• In case of emergency under this plan, people can find another in-network pharmacy nearby that would agree to provide members of certain Medicare plans with services and supplies at a discounted price. In some Medicare plans, the prescriptions are only covered if filled at in-network pharmacies.

• This plan allows the replacement of lost or damaged drugs or replacement of a drug people couldn’t take with them when they evacuated; and getting the drugs at an outof- network pharmacy when people can’t reasonably get to an in-network pharmacy.

• Underthisplan,peoplewillbe able to move most prescriptions from one in-network pharmacy to another and back to their regular pharmacy when the emergency or disaster ends. For help finding the closest in-network pharmacy, people can contact their Medicare plan. When they buy drugs at an out-of-network pharmacy, they’ll probably have to pay full cost for the drugs at the time they fill their prescriptions. If people paid full cost for the drugs, they can save their receipts and ask their plan if it’ll refund the costs, but they won’t get a refund for the out-of-network cost-sharing amount.

For more information, contact Sandra Teel, insurance broker specializing in Medicare, at 657-204-4224 or email steelmedagent@ gmail.com.