In the event of a Presidential emergency declaration, a Presidential (major) disaster declaration, a declaration of emergency or disaster by the Governor, or an announcement of a public health emergency by the Secretary of the U.S. Department of Health and Human Services (HHS), MCS Classicare may take the following actions to ensure members can get health care as needed:
MCS Classicare may allow Medicare Parts A and B services and supplemental Part C plan benefits to be furnished at non-contracted facilities (note that facilities that furnish covered Part A/B benefits must have participation agreements with Medicare).
MCS Classicare may waive, in full, requirements for gatekeeper referrals where applicable.
MCS Classicare may allow you to obtain care from out-of-network providers at in-network cost sharing amounts.
If you have prescription drug coverage and do not have access to a network pharmacy during a disaster or emergency, you may be able to obtain your prescription drugs at an out-of-network pharmacy. Moreover, MCS Classicare may lift the “refill-too-soon” edits as well as allow you to obtain the maximum extended day supply, if requested and available at the time of refill.
These actions may be in effect until the termination of the public health emergency, the end of a declared disaster or emergency, or as notified by CMS.
To find out if Puerto Rico has been declared a disaster or emergency state, please visit http://www.fema.gov/states/puerto-rico. To find out if the Secretary of HHS has declared a public health emergency, please visit https://aspr.hhs.gov/legal/PHE/Pages/default.aspx.
If you have questions about how to get care during a disaster or emergency declaration, contact your plan at the phone numbers indicated in Contact us