Health Insurers Ease Rules for Harvey Victims

Health, Managing Health Insurance
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Several major health insurance companies are relaxing some plan rules for their members in the wake of Hurricane Harvey.

The Texas Department of Insurance released guidance for companies that provide health insurance in the disaster area. The insurance department recommends that all health insurers:

Waive penalties and restrictions when affected members get necessary care out of the plan’s network, and not deny any out-of-network payments. The network is the group of doctors and facilities your health plan prefers — typically you pay less when you use the network options.

Extend claim filing deadlines in the affected areas.

Waive requirements for referrals, medical-necessity reviews and prior authorization, which is the requirement that doctors get permission to order certain tests and services.

This insurance guidance from the state isn’t a requirement, so see details below about your insurer, and numbers to call with questions about getting care and medicine and filing claims.

Aetna

Care and medicine

  • Covered medical services will be treated as “in-network,” so members won’t be denied care or pay higher out-of-network rates
  • Members can refill prescriptions early at any local pharmacy. Customers who normally get prescriptions via mail can get replacements at local pharmacies or other delivery locations, like a post office or drugstore.

Claims

  • Claim filing and appeal deadlines will be extended in the affected areas
  • Through Oct. 30 in the affected areas, the insurer is waiving pre-certification, which is the requirement that doctors get permission to order certain tests and services. This is also known as prior authorization.

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  • Its employee-assistance program is being extended to all victims in the area (not just Aetna members) for emotional support and help finding resources like shelters, referrals and government aid. The number is 888-238-6232.
  • For Aetna member services, call 800-443-2386

Blue Cross Blue Shield of Texas

Care and medicine

  • The insurer is providing members with access to their clinical summaries to make it easier for doctors to treat patients they haven’t seen before. Patients can access the summaries in their online member portal, and doctors will see the summaries via a physician portal.
  • The insurer is helping members who need to find a doctor or hospital, have to replace a member ID card, or need to fill a prescription
  • Members with pharmacy benefits through Prime Therapeutics can get assistance filling or replacing prescriptions, getting authorization from the insurer for a drug, using an out-of-network pharmacy or getting mail order prescriptions. Other members should call customer service at 972-766-6900 for pharmacy help.
  • The company plans to follow all of the Texas Department of Insurance’s recent guidance for health insurers

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  • For more information or customer support, call the number on the back of your card or one of the numbers on this page. The general information phone number is 972-766-6900.

Cigna

Care and medicine

  • In the affected areas, Cigna will waive prior authorization, which is the requirement that doctors get permission to order certain tests and services, for acute medical and behavioral health services
  • Members can refill prescriptions early

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  • Cigna opened a help line available to anyone in affected areas to provide assistance and support, including emotional support. It’s available 24 hours a day through Oct. 15. The number is 866-912-1687 for nonmembers; Cigna members should call 800-244-6224 for the same services.
  • Other Cigna customer service numbers are available here

Humana

Care and medicine

  • Humana is waiving requirements for referrals and prior authorization, which is the rule that doctors get permission to order certain tests and services, for the affected areas
  • The insurer is also treating covered services as in-network in disaster areas, so members won’t be denied care or pay higher out-of-network rates
  • Members can refill prescriptions early, up to a 90-day supply, without authorization from the insurer or a physician

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  • The company is extending its employee-assistance program to people in hurricane-affected communities; anyone in the area can call for emotional or other assistance. The number is 866-440-6556.
  • Humana’s customer support line is 800-4HUMANA (800-448-6262)

Superior HealthPlan

Care and medicine

  • Requirements for referrals and prior authorization — the rule that doctors must get permission to order certain tests and services — are waived for members in areas hit by Harvey
  • The insurer will provide assistance for members who need emergency prescription refills or replacement of necessary medical equipment or supplies
  • The company will provide 24-hour phone access to a nurse by calling member services at one of the numbers here
  • Members with any Harvey-related health question can call 877-391-5921

UnitedHealthcare

Care and medicine

  • Covered medical services will be treated as “in-network,” so members won’t be denied care or pay higher out-of-network rates
  • Prior authorization — the requirement that doctors get permission to order certain tests and services — is waived in affected areas
  • Members can refill prescriptions early, with up to a 90-day supply
  • The insurer is replacing durable medical equipment as needed

Claims

  • Claims filing and appeal deadlines in affected areas will be extended

More

  • The company is extending its free emotional help line to all members of the community via its health services division, Optum. The line is available at 866-342-6892, 24 hours a day, for as long as necessary.
  • Members can call the phone number on the back of their ID cards, or 866-633-2446, for replacement member ID cards. UnitedHealthcare’s customer service directory has phone numbers by state.

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