In response to the wildfires raging throughout California, several Health Plan carriers have created quick reference guidance for access to care:

ANTHEM (click here for Anthem Quick Guide)

Between August 18, 2020 and September 17, 2020, Anthem is making changes for California members who live in Sonoma, Napa, Monterey and Nevada counties impacted by wildfires.

These changes also apply to members who live anywhere in California and must temporarily leave their home because of extreme hot weather. 

For impacted Anthem health plan members, Anthem is:

  • Relaxing time limits for prior authorizations
  • Facilitating early emergency prescription refills at any pharmacy (in or out-of-network)
  • Allowing replacement of medical equipment or supplies
  • Extending filing deadlines for claims

Again, these relaxed medical and pharmacy guidelines are effective between August 18, 2020 and September 17, 2020 for impacted members who live in Sonoma, Napa, Monterey and Nevada counties and members in any part of California who are displaced due to extreme heat, unless further extended. In addition, Anthem health plan members who have been impacted can access Anthem’s Employee Assistance Program (EAP) which provides support services to help with stressful situations and financial or legal concerns. These services will be offered at no cost and are available 24/7 at (877) 208-8240.  For additional information, please call Anthem at (833) 285-4030.

BLUE SHIELD

Blue Shield’s focus is with ensuring the safety of all affected members and responding to their immediate care needs.

For impacted Blue Shield health plan members and to ensure continuity of care, Blue Shield is:

  • Performing active outreach to members is care and disease management programs
  • Facilitating early prescription refills for members in mandatory evacuation areas
  • Allowing replacement of medical equipment or supplies
  • Allowing temporary access to out-of-network providers at in-network benefit levels

Please see the following link for more information:

Blue Shield will also temporarily offer free access to Magellan Health, Blue Shield’s contracted managed care plan for behavioral health needs.  Members can reach Magellan at (800) 327-7451.

KAISER

Even though wildfires are currently burning in multiple parts of California, Kaiser’s Northern and Southern California facilities have not been impacted.  All California facilities are currently open and operating during normal business hours.

Express Scripts (Click here for Express Scripts Emergency preparedness planning)

Express Scripts has a plan pre-established for public safety emergencies to assist members that might hit the “refill too soon” barrier preventing them from obtaining an adequate supply that will carry them through this wildfire crisis.  Pharmacies have access to override these barriers at all times.  Additional measures may be taken if the emergency continues.  See attached for additional information.

For more information reach out to our Employee Benefits Specialist, Naomi Whatley at our Employee Benefits Department.