Insurers Offer Assistance, Relax Rules for Los Angeles Wildfire Victims

As the worst wildfires in Los Angeles history continue to ravage the area and drive people from their homes, health insurers are stepping in to provide needed care to patients and assistance to employees. Insurers have submitted plans to the state for how they will respond to the emergency, including relaxing prescription refill limits and allowing members to seek care at out-of-network facilities for in-network costs. The plans were in response to directions issued by California’s insurance commissioner and the Department of Managed Health Care as the fires continued to displace tens of thousands of people. “With so many Angelenos displaced by these wildfires, the last thing they should worry about is access to necessary health care and whether they can get their prescriptions,” Insurance Commissioner Rico Lara said in a statement. “We are doing everything within our power to ensure the health and safety of wildfire survivors and are calling on health insurance companies to guarantee access to care for our most vulnerable during these extraordinarily challenging times.” Health plans must address how they will ensure barrier-free access to emergency refills, allow for 90-day supplies of medication, and maintain a toll-free phone number and a prominent website page to communicate with customers. The fires have burned more than 60 square miles and destroyed more than 20,000 structures. Around 85,000 residents have been ordered to evacuate. Insurers have stepped up to ensure continuity of care for displaced patients and those affected by closures of pharmacies or other medical buildings. The chief medical officer for L.A. Care, the largest publicly operated health plan in the U.S., tells AIS Health that it is helping members deal with respiratory concerns, lost medications and interrupted care. “Members can fill prescriptions early or fill them at an out-of-network pharmacy if their medications were lost in the fire, left behind during evacuation or their regular pharmacy is shut down due to the emergency,” says Sameer Amin, M.D. “L.A. Care will also accommodate changes to medical transportation needs that might have been impacted by the fires. The health plan will also help make reservations for a future date or alternative facility if needed.” L.A. Care, which serves more than 2.5 million members in Los Angeles Country (most of whom are in Medicaid),is leveraging its community resource centers for disaster relief. The insurer collaborates with Blue Shield of California’s Promise Plan to offer free health and wellness classes, health screenings, vaccination clinics, food pantries and other free services to the public at the centers. The 13 L.A. Care Blue Shield Promise Plan Community Resource Centers are accepting donations of essential items. They are also offering special Saturday hours to provide help and resources to those affected by the fires, Amin tells AIS Health, a division of MMIT. Health Plans Leverage Community Partnerships SCAN Health Plan, a not-for-profit Medicare Advantage insurer based in Long Beach, California, is pivoting to help employees affected by the wildfires, says Karen Schulte, SCAN’s president of Medicare. “We’ve deployed a range of benefits and resources to help them through this challenging time, from emotional support and counseling to financial assistance and flexible work arrangements,” Schulte explains. “By taking care of our employees first, we ensure they are in the best position to support our members and the broader community.” SCAN is also leveraging relationships with community and provider partners to support the needs of patients. “For example, our community arm, Independence at Home, quickly launched efforts to ensure that older community members impacted or at risk have access to the support and resources they need through proactive outreach,” Schulte says. “In addition, they are launching community hubs where community members can find sanctuary and access help with services, supplies and programs.” SCAN’s Healthcare in Action medical team is exploring ways to assist the area’s unhoused patients, she adds. Patients displaced by the fires can seek care at any Medicare-certified facility at no additional cost during the declared emergency, Schulte says. Prior authorization will not be required for any necessary medical services, she adds. Molina Healthcare, Inc. also headquartered in Long Beach, says it is working with community partners to offer medical care and other services to those in need. “Molina has deployed two RVs for long-term mobile clinic support in collaboration with MAHI International and Medical Mission Adventures to establish Eaton Health Village. The services offered will include medical, dental, vision, mental health, along with prescription services,” a Molina spokesperson explains to AIS Health. “Additionally, community resources and essential goods will also be distributed to those in need.” In its contracted and non-contracted hospitals, Molina has removed or reduced “unnecessary barriers to the efficient admission, transfer and discharge of plan enrollees,” the spokesperson said. Insurers, Providers and Pharmacies Offer Assistance Other health plans and pharmacies are following many of the same efforts: offering prescription refills without dispensing limits, allowing patients to use an out-of-network pharmacy without additional cost sharing, and allowing patients to seek care at out-of-network facilities at in-network cost. Many are also offering additional services and making donations to relief efforts, including the following: Telemedicine provider Teladoc is offering free non-emergency virtual care for first responders and people displaced by the fires. Anthem Blue Cross is pledging $10 million for relief efforts to community partners through its Anthem Blue Cross Foundation. Blue Shield of California is offering immediate prescription refills, even if they aren’t yet due. It is also offering care at out-of-network facilities at in-network benefit levels. Those who are displaced can also seek replacement of medical equipment and supplies. As of Jan. 15, all Kaiser Permanente facilities in Southern California are open, including those that closed due to evacuations. Kaiser is waiving same-day and next-day prescription delivery fees for people who live in affected areas. People who have evacuated and are not near a Kaiser pharmacy can get their prescription transferred to any retail pharmacy. Displaced patients can also seek assistance through the insurer’s Medical Financial Assistance program. They are also helping to staff 24/7 shifts at the Pasadena Convention Center evacuation site with pharmacists, physicians, nurses and nonmedical staff and are helping with prescription support, refill assistance and over-the-counter products. CVS Health Corp.’s Caremark PBM is enabling one-time emergency refills for a 30-day supply of medication. CVS’s Aetna is enabling members to seek emergency care wherever they need, including out-of-network facilities. The insurer is also expanding its Resources for Living program to all Aetna members in affected areas, even if it’s not part of their benefits. The program offers mental health services and a dedicated crisis support website. Walgreens Boots Alliance is dispensing emergency refills to affected patients without prescriber authorization. It will also provide free same-day prescription delivery in the affected areas through Feb. 9. Patient advocates are contacting Walgreens Specialty Pharmacy patients in the area to arrange any needed alternate delivery plans. Walgreens is also providing support to evacuated employees.