Wellcare State of Emergency Information

During declared States of Emergency, Wellcare empowers members with seamless medication access and no-cost telehealth solutions. We also support providers with enhanced flexibility in administrative protocols to maintain continuous, high-quality patient care.

Member Prescription Information

During a declared State of Emergency, impacted members have two options to secure an emergency supply of their medications:

1. Members can fill their prescription at the original pharmacy if it is open.
2. If the original pharmacy is not open, members can call Wellcare at 1-866-999-3945 (TTY: 711) We will suspend refill limitations so they can get their prescriptions at an out-of-network pharmacy.

Coping Support for Members

Members can call Wellcare for crisis support 24 hours a day, seven days a week by calling 1-866-999-3945 (TTY: 711). This includes:

• Support to help them deal with grief, stress or trauma
• Referrals to mental health counselors, local services and telephone consultations

Members: Video Medical Appointments

If members cannot reach their primary care provider during a declared State of Emergency, Wellcare offers telehealth services at no cost. Members can find appointment instructions in two places:

1. On the back of their Wellcare ID card
2. On Wellcare.com after registering and signing in

Access to Social Services

To connect with local community resources, members can call 2-1-1 or visit 211.org for help with:

• Emergency shelter, food and transportation
• Social services and financial assistance
• Legal guidance from verified agencies

Medicare Member Information

Some of the covered benefits and services during disasters may include:

• Medicare Parts A and B services and supplement Part C services at non-network facilities.
• Refill guidelines waived for Medicare Part D drugs.
• Referral and approval terms waived.
• Cost-sharing for services – the same as if they were given by a network provider.
• Prescriptions at an out-of-network pharmacy (if you can't find a network pharmacy).

Information for Healthcare Providers

During a declared State of Emergency, doctors and nurse practitioners may call Wellcare at 1-866-999-3945 (TTY 711) for assistance. To support these participating providers in affected areas, Wellcare will:

• Extend grace periods for notifications, beginning on the admission date, for acute services, post-acute care, durable medical equipment (DME), medical supplies and home health care services
• Waive prior authorization – however, our notification requirement will remain in effect despite relaxed deadlines

In addition, Wellcare will:

• Authorize out-of-network services if a contracting provider or facility becomes unavailable
• Grant post-admission notification approvals for impacted facilities.
• Accept updated clinical documentation for continued-stay reviews.
• Authorize the replacement of medical equipment or supplies.
• Suspend prescription refill limitations for impacted enrollees

Other Important Information

Depending on the duration of additional member assistance, Wellcare may implement further measures to ensure members receive necessary healthcare services.