December 20, 2024
Support for Wellcare members impacted by the bird flu
On December 18, 2024, Governor Gavin Newsom declared a state of emergency to streamline and expedite the state’s response to Avian influenza A (H5N1), commonly known as “Bird Flu.” This action comes as cases were detected in dairy cows on farms in Southern California, signaling the need to further expand monitoring and build on the coordinated statewide approach to contain and mitigate the spread of the virus. The virus has spread in 16 states among dairy cattle, following its first confirmed detection in Texas and Kansas in March 2024. California has already established the largest testing and monitoring system in the nation to respond to the outbreak. Wellcare is providing assistance to members who could be affected by the bird flu.
We want to help ensure that members who could be impacted have continued access to health care services and prescriptions during the state of emergency.
Prior authorization, precertification and referrals
Wellcare is taking steps to ensure that participating providers in areas affected by this state of emergency are able to continue providing care for members’ medical needs.
Participating providers may call the Provider Services Center using the contact information below this page 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 with Wellcare patients impacted by this state of emergency will be extended. Providers may contact the Provider Services Center using the contact information below 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 affected by this state of emergency. 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, affected members can contact Wellcare at 866-999-3945 for questions or assistance.
Member insurance cards and health care information
Members affected by this state of emergency who have lost their insurance card or who have health care questions during the state of emergency can contact Wellcare at 866-999-3945 for questions or assistance.
Coping assistance
Wellcare members who need behavioral health assistance due to this state of emergency may call Wellcare at
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 bird flu.
Additional information
Depending on how the bird flu and mitigation efforts by the state 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 at 866-999-3945 or through the provider website at provider.wellcare.com/california
If you have questions regarding the information contained in this update, contact 866-999-3945.
