November 29, 2022
Support for Wellcare members impacted by Route Fire
In support of ongoing response and recovery efforts, on November 19, 2022, Governor Gavin Newsom declared a state of emergency in Los Angeles County to address Route Fire impacts.
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
We are taking steps to ensure that participating providers in areas affected by the Route fire are able to continue providing care for members’ medical needs.
Participating providers can call 866-999-3945 for guidance on:
- Easing of time limitations for prior authorizations, precertification and referrals for treatment.
- Approval for out-of-network services in the event a contracting provider or facility becomes unavailable.
- Authorization for the replacement of medical equipment or supplies.
The deadline to file claims for providers impacted by the Route Fire will be extended. Providers can call 866-999-3945 for additional guidance on claims extension time frames.
We will approve any essential prescription medications (with current copayments and deductibles) for any member in Los Angeles County whose medication access continues to be impacted by the Route Fire. Providers should inform their Wellcare 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 Pharmacy Services at 866-999-3945 for questions or assistance.
Members who lost their homes, have been evacuated or suffered other loss due to the Route Fire may contact Wellcare at 866-999-3945 (TTY: 711), Monday – Sunday, 8 a.m. to 8 p.m. 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 Route Fire.
Depending on how the effects of the Route Fire 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 866-999-3945.