Benefits During a Disaster

Some of the covered benefits and services during disasters may include:

• Medicare Parts A and B services and supplement Part C services at non-network facilities.
• Refill guidelines waived for Medicare Part D drugs.
• Referral and approval terms waived.
• Cost-sharing for services – the same as if they were given by a network provider.
• Prescriptions at an out-of-network pharmacy (if you can't find a network pharmacy).

• You can get an emergency supply of your prescription drugs from the pharmacy where you normally get your prescription filled.
• If the pharmacy is closed, you can call Health Net at 1-800-400-8987 for help.

Health Net members can call Managed Health Network (MHN) for mental health support. MHN can offer referrals to:

• Mental health counselors
• Local services
• Phone consultations

These services can help you cope with grief, stress or trauma as a result of a disaster. MHN operates its hotline 24 hours a day, seven days a week. You can reach MHN at 800-675-6110 (TTY:711).

Health Net will provide access to telehealth services at no cost if you can't reach your primary care doctor during a declared State of Emergency.

To make an appointment, refer to the back of your Health Net ID card for more information on how to access telehealth services. You can find the same information when you sign up and log in at Health Net.

Doctors and nurse practitioners can call Health Net at 800-641-7761 for help with:

• Emergency prescription refill guidelines
• Expediting approvals to reduce turnaround times
• Approval for out-of-network treatments (when in-network resources are not available)

Depending on how long our members need help, Health Net may take more steps to ensure you have access to needed healthcare services.

Note: Check the published press release for specific benefit coverage for each county or situation.

You should call your pharmacy prior to going there to pick up medication. Many of the chain pharmacies also close their websites for online orders.

If you're using a chain pharmacy you may get your medication at a different pharmacy within that chain. (e.g. You can get a refill from any CVS retail store if your CVS pharmacy is closed.)

If you’re using an independent pharmacy, you will have to get a new prescription from your doctor and have it filled at a new pharmacy. Many pharmacies will agree to call your doctor for a new prescription.

Inform the new pharmacy that they can call the Health Net Prior Authorization Department to allow the prescription to be refilled.

Under a State of Emergency Health Net will:

• Allow you to get early refills. You can also have refill limits cancelled if needed.
• Relax time limits for prior approvals. You will be charged your normal cost share, if it applies.
• Allow for the maximum day supply of medication covered under your benefit plan.
• Reimburse filled prescriptions from out-of-network pharmacies. You may be required to pay the full cost of the drug at an out-of-network pharmacy. But you can submit your claims and pharmacy receipts to Health Net for reimbursement. Customer Service will also help you find nearby in-network pharmacies if possible.

Note: If Health Net is unable to operate or resume normal business processes due to a disaster or public emergency, we will notify the Centers for Medicare and Medicaid Services (CMS). If you have any questions or need help with getting access to your drugs, contact us.