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Medicare Advantage plans relax their rules in the event of an emergency, allowing you to see out-of-network providers or refill prescriptions early
Original Medicare plans are accepted anywhere, allowing you to get coverage anywhere Medicare is accepted.
If you need to relocate due to a disaster, you qualify for a Special Enrollment Period where you can enroll in a new plan.
That’s why various disaster relief measures are built directly into the Medicare system. In the wake of a hurricane, earthquake, flood, wildfire, or any other natural disaster, you can focus on the safety of yourself and your family. Here’s a breakdown of all the disaster assistance Medicare offers.
When it comes to Medicare and disaster relief, there may actually be more useful benefits than initially meets the eye. For this article, we’ll consider three broad scenarios: Remaining In-Place, Evacuation, and Relocation. These aren’t formal categories, but they do affect how Medicare interacts with disaster assistance. These disasters are presented in order of disruptiveness, and a disaster can shift from one to the other unexpectedly.
Ideally, you should be able to remain in or return to your home following a natural disaster, though you may experience some disruptions to services. Mail service might be suspended, and your local doctor and pharmacy may be closed. That is why certain measures are taken when the President, your Governor, or the Department of Health and Human Services has declared a state of public health emergency.
If you have Original Medicare, seeking medical services (including dialysis and chemotherapy) as well as financial assistance with your healthcare is relatively simple. You just need to go to another health care provider that accepts Medicare.
Medicare Advantage plans are a bit more complicated: since they use networks, you may be unable to see an in-network provider. In that case, contact your plan. As a rule of thumb, if a procedure is necessary to keep you alive, Medicare plans will likely cover it in an emergency, even if you see an out-of-network provider.
Rules vary between disaster assistance and non-emergency treatment. Some plans will relax their networks or allow you to become a filer of claims for reimbursement. Check the terms of your plan for more details as well as the effective date of this assistance.
Medicare Part D Prescription Drug coverage works similarly. If your pharmacy is closed, going to another in-network pharmacy and providing information on your prescriptions is all you need to do. If an in-network pharmacy is unavailable, contact your plan. You may need to pay upfront and become a filer of a claim for reimbursement.
It’s important to note that premium payments are not suspended during a disaster. You’ll still owe your monthly payment, so be sure to set up autopayments through Social Security or your bank to avoid issues. If you’re removed from a plan due to non-payment, you can contact your plan to appeal the decision once communications can be re-established. Thankfully, you also don’t need to worry about disaster relief affecting your Social Security benefits, so your income will remain safe.
If conditions are too dangerous for you to remain in place, you may be asked to evacuate. Many of the same conditions for staying in place apply here, but some unique elements exist.
First, you should have an evacuation plan no matter where you live. Know where you’re going to stay, and make a note of doctors and pharmacies you may need while in that area. Doing so in advance can help reduce the risk of dealing with filing claims for disaster assistance or paying out-of-pocket.
Depending on your plan, your insurer may allow you to order 60 or 90-day supplies of drugs. In places at risk for seasonal disasters, it is a good idea to use this option if it is available to you.
Consider setting up a go-bag with at least a seven-day supply of your medication and any medical supplies you may need. Print a copy of your Medicare card (including cards for any Medicare Advantage plans) and keep them in your go-bag. Just make sure your go-bag is in an accessible but secure location, accessible enough to grab it quickly in an emergency and secure enough to not be easily stolen.
Unfortunately, many disasters strike when you least expect them, leaving no time to prepare. In these cases, you may lose access to medications, durable medical equipment, and insurance information.
Recovering your insurance information is fairly easy. Simply go to medicare.gov to print or order a replacement for your Medicare card. Private plans may allow you to print your card or store them in a digital wallet. Libraries and schools always have printers available, and many of these places also serve as shelters following an emergency.
If you’ve lost your medication, contact your insurer and inform them immediately. Refill restrictions are relaxed during an emergency, and it’s relatively easy to get a temporary supply. Restricted drugs for conditions like ADHD may be more difficult to get a hold of, so keeping a go-bag is especially important for those situations.
If you’ve lost durable medical equipment due to the disaster, such as a walker or wheelchair, Original Medicare will cover replacements if purchased from an approved vendor. Medicare Advantage plans will vary, but will typically allow a replacement from an in-network vendor as well.
In the worst-case scenario, the disaster will cause enough damage to force you to relocate for an extended period, possibly even permanently. In this case, you’re probably going to need a new plan.
Many plans are limited to specific coverage areas, and will disenroll you if you spend an extended amount of time outside of that area. Fortunately, natural disasters are a qualifying incident for a special enrollment period, allowing you to enroll in a new plan outside the open enrollment period as a form of disaster relief. Speak to an insurance agent once it is safe to do so to see if you’re eligible for this disaster assistance.
Medicare benefits for natural disasters, including Medicare benefits for earthquakes, Medicare benefits for hurricanes, and Medicare benefits for tornadoes, include increased access to mental health services. These services are often made available through telehealth services. If you’re feeling distress due to your experience, don’t be afraid to reach out to someone.
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