By: The My Medicare Matters Team
In the recent months, there have been several natural disasters across the United States that displaced millions of people, many of them older adults. While recovering from these emergency situations, having the resources you need can make all the difference, especially adequate health care. If you are enrolled in Medicare and your community has been impacted by a natural disaster or emergency, the typical rules for your health care coverage may change for a short period of time.
Here are some important facts you need to know about your Medicare coverage if you live in an area that has been declared an emergency or disaster by the President or your governor.
Medicare Special Enrollment Period
As a result of Hurricanes Harvey, Irma, and Maria, the Centers for Medicare & Medicaid Services (CMS) has authorized special enrollment periods for all Medicare beneficiaries and certain individuals seeking health plans offered through the Federal Health Insurance Exchange. This special enrollment allows Medicare beneficiaries affected by these hurricanes to enroll, dis-enroll or switch Medicare Advantage and/or prescription drug plans. It is available at the start of the incident period and runs through the end of the calendar year, December 31, 3017. Individuals may contact 1-800-MEDICARE to request enrollment using this special enrollment opportunity.
Visiting your doctor
If you are enrolled in Original Medicare and need medical attention, but cannot access a provider that takes Medicare, you may be able to get Medicare covered services at an airport from a military provider. Call 1-800-MEDICARE (1-800-633-4227) to get more information about seeing doctors during a disaster or emergency.
If you have a Medicare Advantage or other Medicare health plan check their website or call them to find out if temporary changes to their rules have been made and how long they will be in effect. Your plan will be able to inform you if you’re allowed to see doctors or go to hospitals outside of your provider network during an emergency.
Your plan may also be able to apply the in-network rate to services you receive out-of-network during the emergency or disaster period. If they agree to apply the in-network rate and you go to an out-of-area or out-of-network provider and pay more for the service, save the receipt and ask your plan to give you a refund for the difference. You can find your plan’s contact information by calling 1-800-MEDICARE or search by plan name on the Medicare.gov site.
Accessing prescription drugs
Contact your Medicare Advantage or Part D plan if your usual network pharmacy is unable to replace your prescription drugs, you had to leave your home without your medicine, or your medicine has been damaged or lost because of the disaster. They can help you find another nearby network pharmacy and when the emergency ends, you will be able to move your prescription drugs back to your old pharmacy.
If you are unable to get your prescription at a network pharmacy, your plan can help you get it at an out-of-network pharmacy, but you may pay more out of pocket. If you paid full cost for your medication you may be able to get a refund from your Medicare drug plan. You will need to submit a paper claim along with your purchase receipts and ask your plan where to send your claim.
Consider asking your plan if you can get an extended-day supply (a 60- to 90-day supply) of your medication just in case you cannot return home for a while.
Getting treatments and medical equipment
Original Medicare may cover the cost to repair or replace your durable medical equipment (DME) or supplies that get damaged during a disaster or emergency. Medicare typically covers the cost of rental for replacement items during the time your equipment is being repaired. You can get more information on replacements by calling Medicare or your Medicare Advantage plan directly to find out how it replaces DME or supplies damaged or lost in an emergency or disaster.
If you have additional questions about your Medicare coverage contact 1-800-MEDICARE (1-800-633-4227) or contact your Medicare Advantage or Part D plan directly. You can search your plan’s contact information at Medicare.gov.
Plans don’t typically change their normal rules for payment of monthly premiums during an emergency or disaster. So, you will still responsible for paying your premium on time. You may be disenrolled from your plan if your premium is not paid on time, but a reconsideration may be made if you request one. To ensure your premium will be paid consider either getting your premium withheld from your Social Security check or paying by electronic funds transfer through your bank.
Replacing lost Medicare cards
To replace your lost or damaged Medicare card, you can request one from Social Security either online (ssa.gov) or by telephone at 1-800-772-1213 (TTY users, call 1-800-325-0778). Social Security will mail you a new card in about 30 days. If you need it sooner, let Social Security know and they can give you proof that you can use until you get a replacement card. Also, contact Social Security if you temporarily or permanently change your address.
Contact your Medicare Advantage plan or Medicare prescription drug plan directly to replace a lost or damaged membership card.
For any other assistance including financial, housing and/or food during a natural disaster we recommend visiting BenefitsCheckUp disaster assistance page for additional resources.