How Alignment Health Plan supports Medicare Advantage members during disasters
When the president, governor or secretary of Health and Human Services declares a disaster or a public health emergency, we take actions to ensure our Medicare Advantage members in the affected areas can get the medical care they need.
The actions we take include:
- Covering Medicare parts A and B services and supplemental Part C plan benefits at non-network hospitals and other medical facilities
- Waiving all requirements for primary care physician (PCP) referrals
- Providing enrollees with the same cost-sharing they would get at an in-network facility
- Removing prescription drug limitations such as “Refill too soon” rejection notices that prevent replacing lost medications
All of those changes become effective immediately.
The actions end when:
- the president, governor or secretary of Health and Human Services declares the public health emergency or disaster has ended; or,
- 30 days have passed since the disaster or emergency was declared, and no end date was identified.
If Alignment is also affected by the disaster and cannot resume operations by the end of the disaster or public health emergency, we will notify the Centers for Medicare and Medicaid Services (CMS) and will update the Alignment Health Plan website, when and if we are able, to provide information about Alignment’s operational capabilities.