In response to the fires and evacuations in Northern and Southern California, Anthem Blue Cross Life and Health Insurance Company (Anthem) is revising its medical and pharmacy guidelines to help ensure our members and participating providers who have been impacted by these latest events have access to essential prescription medications and other health care related services and are able to provide needed care to our members.
- If your Anthem patient has an Anthem prescription drug plan they can get up to a 30-day emergency refill of their medications at any pharmacy now.
- If your Anthem patient uses Anthem’s mail-order pharmacy they can update their temporary mailing address information by calling us.
- Time limits for prior authorization, pre-certification or referral requirements will be relaxed — there will be no late penalties. Please call us for an extension if you need it.
- Anthem patients can get replacement medical equipment (also called Durable Medical Equipment or DME) if theirs was lost or damaged.
- Anthem patients and providers are being given more time to file claims, if needed. Please call us for an extension if you need it.
- Anthem patients can get emergency or urgent care services by doctors and hospitals, even if they’re not in their plan network — and claims will be paid as if they’re in the Anthem network.
- If the Anthem patient’s in-network provider is unavailable due to the disaster, or not available because the patient is out of the area due to a displacement as a result of the disaster, the patient can call us and we will help them find a new provider.
- If the Anthem patient is currently participating in a care management program, and need to reach them, the patient can contact Anthem toll-free at (833) 285-4030.
- If the Anthem patient received a bill directly from Anthem for their monthly insurance premium and are experiencing financial difficulties as a result of the disaster, they can call us to discuss options.
- Members with Anthem Blue View Vision can contact us at (833) 285-4030 to request the following:
- Out of network coverage at in-network benefit levels for emergent and urgent claims only
- Replacement vision supplies if yours are lost or damaged (beyond frequency limits)
- More time to file claims, if needed
- Anthem’s Employee Assistance Program (EAP) provides support services to help with stressful situations and financial or legal concerns. EAP can be accessed at no cost. Call our 24/7 crisis line toll-free at (877) 208-8240.
These relaxed guidelines were previously effective from October 11, 2019 through November 10, 2019 for impacted members in Los Angeles and Sonoma counties. Effective October 25, 2019 through December 2, 2019 the relaxed guidelines are extended to impacted members who live in any part of California. They apply to members with Anthem group or individual and family health plans. They do not apply to Federal Employee Health Benefit Plan members, Medi-Cal, Medicare Advantage, and Medicare Part D plans - these programs have their own specific guidelines.
Anthem continues to monitor the fires and evacuations and may be taking additional steps to best serve its members and participating providers.
If your Anthem patient needs additional support, please have them call us toll-free at (833) 285-4030
If you have immediate questions in regards to member care and this notification, please contact the Provider Service phone number on the back of your patient’s ID card. If your office or location has closed due to the fires please contact CAContractSupport@Anthem.com.
November 2019 Anthem Blue Cross Provider News - California