In the event a disaster or public health emergency is declared, Healthfirst will be there to assist our members by:
- Covering Medicare Part A, Part B, and supplemental Part C plan benefits provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities).
- Waiving referral requirements and prior authorizations, where applicable
- Allowing out-of-network services and benefits at in-network cost sharing
- Making changes that benefit you effective immediately, without a 30-day notification requirement.
In the event a disaster or public health emergency is declared, Healthfirst will ensure that members have adequate access to covered Part D Drugs by:
- Covering formulary Part D drugs filled at out-of-network pharmacies and may:
- Remove restrictions that stop you from getting refills too soon.
- Covering the maximum extended day supply, if requested and available at the time of refill.
Disasters and public health emergencies may be declared by:
- A presidential declaration of disaster or emergency under either
- The Stafford Act
- The National Emergencies Act
- The Federal Emergency Management Agency (FEMA)
- A secretarial declaration of a public health emergency under Section 319 of the Public Health Service Act
- A declaration of emergency or disaster by the governor of New York
The public health emergency or disaster ends 30 days after any of the following occur:
- All sources that declared a disaster or emergency declare an end.
- The emergency or disaster has expired and has not been renewed.
- There is no longer a disruption of access to healthcare.