On September 11, 2024, Governor Gavin Newsom and declared a state of emergency in Los Angeles and San Bernardino counties in response to the Bridge Fire and in Orange and Riverside counties in response to the Airport Fire. The Governor was also briefed by CAL FIRE and emergency response officials of the ongoing response to the Bridge and Airport fires in Southern California. California has secured federal assistance to support the response to the fast-moving Bridge and Airport fires, which ignited in the last week, burning predominantly on federal lands. Wellcare is providing assistance to members in the counties affected by the fires.
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 fires 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 fires 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 L.A., San Bernardino, Riverside and Orange counties whose medication was lost in a fire or remained behind during an evacuation. 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 Wellcare at 866-999-3945 for questions or assistance.
Coping assistance
Wellcare members who lost their homes or have been evacuated due to the fires 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 fires.
Additional information
Depending on how the fires 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 provider.wellcare.com/california.
