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Using Your Plan During a Disaster or Emergency

If a disaster or public health emergency is declared in your area, some of your plan’s usual rules may not apply. This helps us make sure you can still get the care you need. 

How does my plan change during a disaster or public health emergency?

From the time a disaster or public health emergency is declared until it ends:

  • You can see out-of-network providers for the same cost as in-network providers
  • You won’t need any referrals, even if your plan usually requires them
  • Any changes that benefit you will start right away, without the usual 30 days to tell you in advance

If a disaster or public health emergency is declared in your area, we’ll give you more details about the payment terms and conditions for out-of-network providers during the emergency. 

There may be exceptions to these rules. 

For example, sometimes a disaster or public health emergency may be officially declared, but it’s not keeping people from getting the care they need. If that happens, Medicare may tell us we can follow our usual rules about referrals and out-of-network providers. 

Who can declare a disaster or public health emergency?

There are 3 government officials who can declare a disaster or public health emergency:

  • The president*
  • The Secretary of Health and Human Services**
  • The governor of your state or territory

If the president declares a state of disaster, the Secretary of Health and Human Services can also make temporary changes to Medicare requirements.***

When does a disaster or public health emergency end?

The disaster or public health emergency ends when any of these things happen:

  • The official who declared the disaster or public health emergency says it's over
  • Medicare says the disaster or public health emergency is over
  • It’s been 30 days since the disaster or public health emergency was declared, and Medicare or the official who declared it hasn’t given a different end date

*Under the Stafford Act or National Emergencies Act 

**Under Section 319 of the Public Health Service Act

***Under Section 1135 of the Public Health Service Act