Participant Winter Weather Alert

Date: 03/12/18

Due to severe winter weather in the State of PA , Governor Tom Wolf declared a state of emergency in the following Counties: Berks, Bradford, Bucks, Carbon, Chester, Columbia, Dauphin, Delaware, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Monroe, Montgomery, Montour, Northampton, Northumberland, Philadelphia, Pike, Schuylkill, Sullivan, Susquehanna, Wayne, Wyoming and York.  Your health and safety are our primary concerns and if you leave your home to avoid this <disaster or emergency>, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional. 

For our participants who live in one of these impacted areas, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers.  You must still use Medicare certified facilities and providers.

Prior authorization for medical services or medication may still be needed for medical necessity. There has been an emergency declaration issued for the following PA counties:  Berks, Bradford, Bucks, Carbon, Chester, Columbia, Dauphin, Delaware, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Monroe, Montgomery, Montour, Northampton, Northumberland, Philadelphia, Pike, Schuylkill, Sullivan, Susquehanna, Wayne, Wyoming and York.  Highlighted counties are in the PA plan’s service area.

For public health emergencies, the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first.