Care for Medicare Members During a Disaster

In the event of a Presidential emergency declaration, a Presidential (major) disaster declaration, a declaration of emergency or disaster by a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, the following will be offered to Care Wisconsin Dual Medicare Advantage members:

  • Access to Part A and Part B and supplemental Part C plan benefits at specified non-contracted facilities
  • Waiving in full, requirements for gatekeeper referrals where applicable;
  • Temporary reduction of plan-approved out-of-network cost-sharing to in-network cost-sharing amounts; and
  • Waiving of the 30-day notification requirement to enrollees as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the enrollee.

Typically, the source that declared the disaster will clarify when the disaster or emergency is over. If, however, the disaster or emergency timeframe has not been closed 30 days from the initial declaration, and if the Centers for Medicare & Medicaid Services has not indicated an end date to the disaster or emergency, we will resume normal operations 30 days from the initial declaration.

If the President has declared a major disaster or the Secretary has declared a public health emergency, we may also lift restrictions on refills on Part D prescription drugs.

H5209-002_CWWEB9-15-16 CMS Approved 10/11/2016
Last Updated 9/30/2016

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