SAN FRANCISCO (February 28, 2019) – Blue Shield is closely monitoring the winter storm conditions in Amador, Calaveras, El Dorado, Glenn, Humboldt, Lake, Los Angeles, Marin, Mendocino, Modoc, Mono, Monterey, Orange, Riverside, San Bernardino, San Diego, San Mateo, Santa Barbara, Santa Clara, Shasta, Sonoma, Tehama, Trinity, Ventura, and Yolo counties in response to the Governor’s State of Emergency declaration. The nonprofit health plan has established, documented and implemented emergency response procedures to ensure that affected members had timely access to covered medical and behavioral health services.
Blue Shield has confirmed that these emergency procedures have been adopted and have been implemented by its contracted health care service administrators, including Magellan, American Specialty Health Plan and Medical Eye Solutions.
These emergency response actions include, but are not limited to:
- Providing access to appropriate out-of-network providers when participating providers are displaced or unavailable due to the storms for 30 days.
- Providing benefit reimbursement for out-of-network providers at the in-network benefit level when participating providers are displaced or unavailable due to the storms for 18 months. Claims submitted after that time will be reviewed for circumstances on a case by case basis.
- Relaxing time limits for requesting authorizations, precertification and/or referrals for 30 days.
- Providing authorizations for the replacement of medical equipment or supplies for 30 days
- Blue Shield is allowing for the immediate refill of prescriptions for members in areas with emergency declarations, even if they are not yet due to be refilled.
- The health plan is conducting outreach to affected members who are currently participating in a care management program to ensure continuity of care.
- Magellan Health, Blue Shield’s contracted managed care plan for behavioral health, is providing free access to resources, materials and counseling services through its dedicated hotline: 1-800-327-7451.
- Blue Shield vision plan members in these states can obtain a replacement pair of lost or broken glasses, and can use out-of-network providers as needed with claims paid at in-network costs. Members can contact Vision Customer Service for assistance, 877-601-9083.
Blue Shield of California members who need immediate assistance can contact customer service at 800-393-6130.
Members who may have lost or misplaced their identification card can print a new card on our website at https://www.blueshieldca.com/. Alternatively, members can use the Blue Shield of California mobile app to access their ID card on their mobile device.
We will continue to monitor activity and may make further adjustments to continue to best serve our members.
About Blue Shield of California
Blue Shield of California strives to create a health care system worthy of our family and friends that is sustainably affordable. We are a not for profit, independent member of the Blue Cross Blue Shield Association with care for four million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 and headquartered in San Francisco, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare health care service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities.
For more news about Blue Shield of California, please visit www.news.blueshieldca.com.
