In Case of Disaster

When the president, governor or secretary of U.S. or State Health and Human Services declares a disaster or a public health emergency, Jefferson Health Plans acts to assure that our members in the affected areas can get the medical care and prescription drugs that they need.

In case of a declared disaster, we will:

• Cover Medicare Part A and Part B services, as well as services covered through supplemental plan benefits, at out-of-network hospitals and other facilities
• Assure members have the same cost-sharing they would have for services provided in-network
• Waive all requirements for referrals by primary care providers
• Remove prescription drug limitations such as “refill too soon” rejections that would prevent replacing lost medications, and allow the use of out-of-network pharmacies if warranted by the situation

Those changes will remain in effect until the public health emergency or disaster is declared to have ended, or 30 days have passed since the disaster or emergency was declared and no end date was identified.

If Jefferson Health Plans is 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 & Medicaid Services (CMS) and will update our website as soon as possible to provide information about Jefferson Health Plans’ operational capabilities.

Please check our website for additional information and updates about our actions specific to any declared disaster or public health emergency.