January 6, 2023
Support for Wellcare members impacted by winter storms
On January 4, 2023, Governor Gavin Newsom declared a state of emergency statewide due to the winter storms that began on Dec. 27, 2022. Wellcare is providing assistance to members across the state affected by these winter storms.
We want to help ensure that members who have been impacted, because they or their usual health care physicians or other providers have been temporarily displaced, have continued access to health care services and prescriptions during the state of emergency.
Here is what you need to know.
Prior authorization, precertification and referrals
Wellcare is taking steps to ensure that participating physicians and other providers in areas affected by the winter storms are able to continue providing care for members’ medical needs.
Participating physicians and other providers may call the Provider Services Center using the contact information in the right-hand column of this page for guidance on:
- Shortening time limits for health care service plans to approve prior authorization, precertification, or referrals, and extending the time that prior authorizations, precertification, and referrals for treatment remain valid.
- Approving out-of-network services in the event a contracting physician, other provider or facility becomes unavailable.
- Authorization for the replacement of medical equipment or supplies.
The deadline to file claims for physicians and other providers impacted by the winter storms will be extended. Physicians and other providers may contact the Provider Services Center using the contact information in the right-hand column of this page for additional guidance on claims extension time frames.
Wellcare will approve any essential prescription medications (with current copayments and deductibles) for any member in the state whose medication was lost or remained behind during an evacuation. Wellcare will also suspend prescription refill limitations and allow an impacted enrollee to refill their prescriptions at an out-of-network pharmacy. Physicians and other providers should inform their Wellcare patients that to obtain an emergency supply, affected members can return to the pharmacy where the original prescription was filled. If the pharmacy is not open due to the state of emergency, affected members can contact Wellcare at 866-999-3945 for questions or assistance.
Wellcare members who lost their homes or have been evacuated due to the winter storms may contact Wellcare for referrals to mental health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss, or other trauma resulting from the winter storms. Affected members may contact Wellcare at 866-999-3945.
Depending on how these winter storms progress, Wellcare may make additional changes to its policies as needed to ensure members have access to necessary health care services.
If you have questions regarding the information contained in this update, contact the Wellcare Provider Services Center within 60 days, by phone or through the Wellcare provider website.
This update applies to:
- Ancillary Providers
- Independent Practice Associations