Medicare disaster and emergency policy

Getting care during a disaster or emergency for Medicare Advantage and Prescription Drug Plan members

When health care is disrupted during a disaster or emergency, Blue Shield will act in your best interest. We will respond quickly to members in need. We will also follow all of the Center for Medicare and Medicaid Services (CMS) requirements. In an emergency, we will send information to members on accessing healthcare in many ways. These may include direct outreach through phone calls, mail, email, webpage, member portal, and more. This will depend on member preference and CMS requirements.

A disaster will be declared in one of these ways:

  • Presidential declaration of a disaster or emergency under the Stafford Act or National Emergencies Act
  • Secretarial declaration of a public health emergency under section 319 of the Public Health Service Act
  • Declaration by the governor of a state or protectorate

When a disaster or emergency is declared and access to care is disrupted:

  • Blue Shield of California will cover benefits furnished to you by out-of-network providers.
  • You will not need referrals or prior authorization.
  • You will have the same cost-sharing as if the benefit was furnished by an in-network provider.
  • You can refill prescriptions early if needed.

When the disaster has ended, it will be declared in one of these ways:

  • The source that declared the public health emergency or state of disaster declares an end.
  • The Center for Medicare and Medicaid Services (CMS) declares an end to the public health emergency or state of disaster.
  • If thirty (30) days have passed since the declaration of the public health emergency or state of disaster, and no end date was identified by the original source of CMS, it will be considered the end of the disaster.

If you have any questions, please contact Blue Shield of California Customer Service for your specific plan:

Medicare Advantage Prescription Drug Plans  
Phone: (800) 776-4466 (TTY: 711) – 8 a.m. to 8 p.m., seven days a week
 

Dual Special Needs Plans
Phone: (800) 452-4413 (TTY: 711) – 8 a.m. to 8 p.m., seven days a week

Medicare Prescription Drug Plans
Phone: (888) 239-6469 (TTY: 711) – 8 a.m. to 8 p.m., seven days a week

Y0118_24_428A_M 
H2819_24_428A_M

Page Last Updated: 10/1/2024

*Free copy with no obligation to enroll.

© California Physician’s Service DBA Blue Shield of California 1999-2024. All rights reserved.

California Physician’s Service DBA Blue Shield of California is an independent member of the Blue Shield Association.

Blue Shield of California 601 12th Street, Oakland, CA 94607.

For Blue Shield Medicare Advantage Plans: Blue Shield of California is an HMO, HMO D-SNP, PPO and a PDP plan with a Medicare contract and a contract with the California State Medicaid Program. Enrollment in Blue Shield of California depends on contract renewal.

 
 
The company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability. La compañía cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye ni trata de manera diferente a las personas por su raza, color, país de origen, identificación con determinado grupo étnico, condición médica, información genética, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad, ni discapacidad física ni mental. 本公司遵守適用的州法律和聯邦民權法律，並且不會以種族、膚色、原國籍、族群認同、醫療狀況、遺傳資訊、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡、精神殘疾或身體殘疾而進行歧視、排斥或區別對待他人。