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Medica disaster planning policy

For Medicare members

Getting care during a disaster

If the State Governor, the U.S. Secretary of Health and Human Services, or the President of the United States declares a disaster or emergency near you, we'll ensure you get the services you're entitled to from your plan.

During a declared state of disaster or emergency, here's what you need to know if you need care and can't make it to a Medica network facility, medical office, or pharmacy:

  • We'll cover medically necessary plan benefits you get from out-of-network providers and pharmacies
  • You don't need to get a referral or prior authorization to go outside the network
  • You'll only be responsible to pay your in-network cost share for these services
  • You'll be able to receive Part D drugs prior to the refill date if appropriate
  • You can get the maximum extended day supply of Part D drugs if available at time of refill

When the disaster ends

Once the State Governor, the U.S. Secretary of Health and Human Services, or the President of the United States declares the disaster or emergency is over, or after 30 days have passed when there's no end date declared, you'll need to use the plan provider network to get services. The normal pre-authorization/referral requirements and cost sharing also will resume as described in your Evidence of Coverage.

If we can't resume normal operations, we'll notify the Centers for Medicare & Medicaid Services.

Contact us

Medica Prime Solution (Cost)
1-800-234-8755 (TTY: 711)

Medica Advantage Solution (HMO-POS) and Medica Advantage Solution (PPO) in Minnesota
Toll free: 1-866-269-6804 (TTY: 711)

Medica Signature Solution
1-866-810-5032 (TTY: 711)

Medica Advantage (PPO)
- Iowa and Nebraska: 1-866-398-7374 (TTY: 711)
- North Dakota and South Dakota: 1-877-407-8494 (TTY: 711)

Medica Group Advantage Solution (PPO) and Medica Group Prime Solution w/Rx (Cost)
1-800-575-2330 (TTY: 711)

Hours

8 a.m. - 9 p.m. CT, daily

Access to representatives may be limited at times.


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Last Updated: December 2023