March 06, 2023
Support for impacted Wellcare members
On March 1, 2023, Governor Gavin Newsom declared a state of emergency in Amador, Kern, Los Angeles, Madera, Mariposa, Mono, Nevada, San Bernardino, San Luis Obispo, Santa Barbara, Sierra, Sonoma, and Tulare counties due to recent severe winter storms. These storms that began in late February brought damaging winds and significant rain, including snowfall in areas not accustomed to snow. They continue to cause damage and closures to highways and roads, power outages and forced evacuations stranding residents and motorists.
Wellcare is providing assistance to members affected by the severe winter storms. We want to help ensure that members who have been impacted, because they or their usual health care providers have been temporarily displaced, have continued access to health care services and prescriptions during the state of emergency.
Here is what you need to know.
Prior authorization, precertification, and referrals
Wellcare is taking steps to ensure that participating providers in areas affected by the severe winter storms are able to continue providing care for members’ medical needs. Participating providers may call the Provider Services Center at 866-999-3945 for guidance on:
- Shortening time limits for health care service plans to approve prior authorization, precertification, or referrals, and extending the time that prior authorizations, precertification, and referrals for treatment remain valid.
- Approving out-of-network services in the event a contracting provider or facility becomes unavailable.
- Authorization for the replacement of medical equipment or supplies.
Filing claims
The deadline to file claims for providers impacted by the severe winter storms will be extended. Providers may contact the Provider Services Center at 866-999-3945 for additional guidance on claims extension time frames.
Prescription information
Wellcare will approve any essential prescription medications (with current copayments and deductibles) for any member in an area impacted by the severe winter storms whose medication was lost or could not be obtained due to storm conditions. Wellcare will also suspend prescription refill limitations and allow an impacted enrollee to refill their prescriptions at an out-of-network pharmacy. Providers should inform their patients that to obtain an emergency supply, affected members can return to the pharmacy where the original prescription was filled. If the pharmacy is not open due to the state of emergency, affected members can contact Wellcare at 866-999-3945 for questions or assistance.
Member insurance cards and health care information
Members whose insurance cards have been lost or left behind due to the state of emergency and members who have health care questions during the state of emergency can contact the Wellcare at 866-999-3945 for questions or assistance.
Coping assistance
Members who lost their homes or have been evacuated due to the severe winter storms may contact 866-999-3945 for referrals to mental health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss or other trauma resulting from the severe winter storms.
Additional information
Depending on how the severe winter storms and their impacts progress, Wellcare may make additional changes to its policies as needed to ensure members have access to necessary health care services.
If you have questions regarding the information contained in this update, contact the Provider Services Center by phone or through the provider website at provider.wellcare.com/california.
