How CarePlus Supports Medicare Advantage Plan Members During Disasters

When the president, governor, or secretary of Health and Human Services declares a disaster or a public health emergency, we take actions to ensure our Medicare Advantage plan members in the affected areas can get the medical care they need.

The actions we take include:

  • Covering Medicare Parts A and B services and Part C plan benefits at non-network hospitals and other medical facilities
  • Waiving all requirements for primary care physician (PCP) referrals
  • Providing CarePlus members with the same cost-sharing they would get at an in-network facility
  • Removing prescription drug limitations such as “refill too soon” rejection notices that prevent replacing lost medications

All of the above changes become effective immediately after the declaration of a disaster or a public health emergency.

These actions remain in effect until:

  • The president, governor, or secretary of Health and Human Services declares the public health emergency or disaster has ended; or,
  • 30 days have passed since the disaster or emergency was declared, and no end date was identified.

If CarePlus is also affected by the disaster and cannot resume normal operations by the end of the public health emergency or state of disaster, we will notify the Centers for Medicare & Medicaid Services (CMS) and will update the CarePlus website, when and if we are able, to provide information about CarePlus operational capabilities.