Wellcare By Health Net 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.
  3. 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 By Health Net 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 By Health Net offers telehealth services at no cost. Members can find appointment instructions in two places:

  1. On the back of their Wellcare By Health Net ID card
  2. On our website 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 contact Wellcare By Health Net for assistance. To support these participatingproviders in affected areas, Wellcare By Health Net 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 By Health Net 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 By Health Net may implement further measures to ensure members receive necessary healthcare services.