Benefits During a Disaster
Health Net is here for you when a disaster strikes
When the President, Governor or the Secretary of Health and Human Services declares a disaster or public emergency, Health Net works to ensure you have access to benefits and services. Some of the offered coverage during disasters may typically include:
- Covering Medicare Parts A and B services and supplement Part C services at non-contracting facilities;
- Waiving requirements for refills of Medicare Part D drugs;
- Waiving requirements for referrals and authorizations;
- Providing the same cost-sharing for services as if the service or benefit was provided by a plan-contracted provider;
- Covering your prescription filled at an out-of-network pharmacy, if you cannot use a network pharmacy.
We implement these changes immediately upon notification of a disaster or public emergency. Check the published press release for specific benefit coverage for each County or situation. Health Net makes all of these changes that help our members, effective immediately. Health Net's benefits protection will remain in place until:
- The President, Governor or the Secretary of Health and Human Services declares the disaster or public emergency has ended, or
- 90 days have passed since the declaration of the disaster or public emergency.
If Health Net is unable to operate or resume normal business processes due to a disaster or public emergency, we will notify the Centers for Medicare and Medicaid Services (CMS). If you have any questions or need help with getting access to your drugs, contact us.
Health Net Pharmacy FAQs
Members that need prescription medication refilled at pharmacies that closed due to damage or feel unsafe to open due to the civil unrest or rioting may go to another pharmacy to obtain their refills that share prescription drug files e.g. Chain pharmacies. Members that are using independent pharmacies that are closed should contact their physician to obtain a new prescription to fill at another pharmacy. The new pharmacy may also be able to reach to the Member's physician to obtain a new prescription.
A: Members using a Chain pharmacy may obtain their medications at a different pharmacy within that chain. e.g. Members can obtain a refill from any CVS retail if their CVS pharmacy is closed.
A: Members will have to obtain a new prescription from their physician and have it filled at a new pharmacy. Many pharmacies will make the call to the member's physician for a new prescription.
A: The new pharmacy can call the Health Net prior authorization department to obtain an override to allow the prescription to be refilled.
A: Under a State of Emergency Health Net will:
- Allow members to obtain early refills and receive an override of refill limitations and restrictions, as needed. The Plan will relax time limits for prior authorizations. Members will be charged their usual cost-share, if applicable.
- May obtain the maximum extended day supply of medications covered under their benefit plans.
- Reimburse filled prescriptions from out-of-network pharmacies. Members may be required to pay the full cost of the drug at an out-of-network pharmacy. Members may submit their claims and pharmacy receipts to Health Net for reimbursement. Customer Service will also assist members in finding nearby in-network pharmacies if applicable.
A: Members should call their pharmacy prior to going there to pick up medication. Many of the Chain Pharmacies are including closure of their pharmacies on line.
- 02/04/21 – Health Net Assisting Members in Monterey and San Luis Obispo Counties During State of Emergency
- 11/20/20 – Health Net Assisting Members in Mono County Due to Fire
- 09/29/20 – Gov. Gavin Newsom’s declared state of emergency in California (Los Angeles, Del Norte, Napa, Shasta, Sonoma and Mendocino counties)
- 09/08/20 – Gov. Gavin Newsom’s declared state of emergency in California (Fresno, Madera, Mariposa, San Bernardino and San Diego Counties)
- 08/20/20 – Health Net Providing Special Assistance to Members Affected by Wildfires
- 6/2/20 – Health Net Assisting Members in Los Angeles County During State of Emergency
- 10/27/19 – Statewide Due to Fires, Extreme Weather Conditions (PDF)
- 10/25/19 – Sonoma and Los Angeles Counties Due to Fires (PDF)
- 10/13/19 – Los Angeles and Riverside Counties Due to Fires (PDF)