Important Reminders Hurricane and States of Emergency Guidelines

Hurricane season runs from June 1 through November 30.

In the event of a state of emergency for a natural disaster (hurricanes, tropical storms, etc.), use the information below to assist your Florida Blue, Florida Blue Medicare, and Truli for Health clients (referred to as Florida Blue).

Note: We may not communicate these specific guidelines before every state of emergency. However, if other business procedures are impacted, we will share those with you. Keep this information handy so you can refer back to it during hurricane season. Please direct members to our BlueAnswers(https://www.floridablue.com/answers/breaking-news/hurricane-information) hurricane page on FloridaBlue.com, where we will share resources and information relative to each situation.

During a state of emergency, the following measures will be put in place for members in affected areas:

Early Refills of Prescription Drugs: Florida Blue takes additional steps to make sure members can get medical care and prescriptions during a state of emergency. When a state of emergency is declared by the governor, we will automatically let our Commercial and Medicare members get up to a 30-day emergency supply of non-controlled, maintenance medications (controlled substances include opioids, and stimulants). This would apply to members in the affected counties listed in the governor’s order. Prime Therapeutics will notify all in-network pharmacies about how to process these prescriptions for the specified emergency time period. If members need to use an out-of-network pharmacy, or need approvals for controlled substances, specialty drugs or prior authorizations, they should call customer service at the number on the back of their member ID card for assistance in obtaining authorization.

Exceptional Circumstance Special Enrollment Period (SEP): Individual Under 65 (IU65) consumers who are impacted by the state of emergency may be eligible for an exceptional circumstance SEP which allows them to enroll in a different plan or in a different location, if needed. If CMS grants a different type of SEP for a situation, we’ll provide an article with separate SEP updates when all the details are available.

Customer Service: Customer service will be available for our members, even when we have closures of certain offices. Members can still call us at the number on the back of their member ID card. If wait times are longer than usual, all the normal self-service functions are available via their member account.

Getting Care During and After the Storm

We encourage members to call their doctor’s office to see if they are open, since they may be offering virtual visits as well as in-office visits during this time. This is the member’s best first step since their doctor knows them and their health concerns and have access to all of their medical records. This includes primary care doctors, behavioral therapists, and other providers. Depending on the emergency, some benefit flexibilities, other services and support, or process changes, such as the following, might be provided. We will update you on the given situation.

• Bilingual Help Line: Lucet/New Directions Behavioral Health usually works with Florida Blue to offer emotional support to members during a state of emergency. Specially trained behavioral health counselors will be available via a 24-hour, toll-free help line: 1-833-848-1762. Help is offered in English and Spanish.*

Teladoc—Talk to a Provider by Phone or Video Chat at No Extra Cost: Instead of driving to a doctor’s office or urgent care center in dangerous conditions, or if their doctor’s office is closed due to the weather conditions or storm damage, members may be able to use Teladoc at no extra cost. Teladoc is available 24/7 to provide medical care via a phone call or a video chat from a computer or mobile device.*

• Members must call the Teladoc National Disaster Hotline at 1-855-225-5032 to get these services at no charge.

• Expanded Access to Care: Because evacuations, closures and other issues linked to a natural disaster may prevent members from getting medically necessary care in the usual way, we may relax some requirements.* If so, we will communicate specific guidance regarding these flexibilities which may include:

• Claims will not be denied for failure to get a referral or prior authorization, but they will still be reviewed for medical necessity.

• If needed due to access issues, evacuation or relocation, members may get medical care from an out-of-network provider and receive reimbursement at the in-network rates. Members should call the number on the back of their ID card to discuss their options in these cases.

• Medicare: If there is a disruption to care, other special requirements for Medicare members may apply. We will communicate specific changes, depending on the situation.

*Note: Some of the above benefit adjustments may not apply to commercial self-funded group members (ASO groups). They should call us at the number on their member ID card or check with their benefit administrator with any questions.

Community Resources

Help finding local resources for food, water or other community services. We encourage members and anyone in the community impacted by a hurricane or other natural disaster to call a Florida Blue Center Community Specialist for help with community and social services like food programs, transportation services, financial and housing assistance programs, community support resources, and many other types of relief programs. They can stop by one of our centers or call 1- 877-352-5830, Monday - Friday, 9am - 7pm or Saturday, 9am - 4pm, and we’ll be glad to help. There will be a flyer available for impacted areas, and it will provide local community resources.