The EPH Continuity of Member Care Emergency Response (COMCER) Plan provides procedures for sustaining essential care of EPH Members in response to a Federal Emergency Management Agency (FEMA) or Governor declared disaster, or during recovery from a service disruption.
Affected Members will be granted access to out-of-network Providers if they are unable to access covered services from an in-network Provider. Affected Members will also be granted access to formulary drugs dispensed at out-of-network pharmacies when formulary drugs at a network pharmacy cannot be obtained. Prior authorization requirements and “refill-too-soon” edits at the pharmacy will be lifted during the declared disaster. Utilization management staff will accept prior authorization for extensions or transfers to new Providers without additional requirements.
You may contact
Member Services for more information.
For more information about Medicare, call 1-800-MEDICARE (
1-800-633-4227) (TTY 711). You can call 24 hours a day, 7 days a week. Or, visit
www.medicare.gov on the web.
