Disaster Declarations and Public Health Emergencies: Member Support

Ensuring you get the help you need when it’s needed the most.

For all active disaster declarations, please visit News | Office of the Texas Governor | Greg Abbott

Important Update if Enrolling Using a Disaster/Emergency Special Election Period (SEP)

Attention Medicare Advantage Beneficiaries: Beginning with enrollments effective on or after April 1, 2025, individuals wishing to use the Disaster/Emergency SEP must call 1-800-MEDICARE ((800) 633-4227) to make an election. As a result of the new CMS regulation, Health Plans will no longer be able to accept elections directly from beneficiaries using the Disaster/Emergency SEP.

Prepared and Ready When You Need Us

Memorial Hermann Health Plan believes in a proactive approach to care, and this mindset doesn’t change when it comes to natural disasters and public health emergencies. When those difficult events occur, the last thing you need to worry about is your healthcare coverage. Memorial Hermann Health Plan understands this and is ready to implement plans and procedures to ensure your access to pharmacies, hospitals, and providers as soon as possible.

What is Considered a Disaster or Public Health Emergency?

An emergency declaration can be issued by the President, the state Governor, or the Federal Motor Carrier Safety Administration (FMCSA). Emergency declarations typically are a result of a natural event or disaster that has caused severe damage. A public health emergency is defined as an occurrence or imminent threat of an illness or health condition that poses a substantial risk to humans by either causing a significant number of deaths or permanent or long-term disability. The Secretary of the Department of Health and Human Services (HHS) declares public health emergencies.

Some of the “Rules” Change During an Emergency

To make it easier for members to receive care during a disaster or health emergency that disrupts access to care, CMS* (Centers for Medicare and Medicaid Services) has provided health plans with the following guidance and requirements:

  • Allow access to out-of-network providers at the same cost as network providers if members can’t access covered services from network providers.
  • Waive referral requirements
  • Suspend prior authorization requirements
  • Follow appropriate guidance to lift refill-too-soon edits, as applicable
  • Any changes that benefit a member will start immediately, without the usual 30-days to inform the member in advance

*Some of the above benefit adjustments may not apply to commercial self-funded group members.

Connecting You to Those Who Can Help

If you're a member in an impacted county and have a medical issue or a concern about maintaining access to your benefits, please check this web site to receive up-to-date information and details. You can also contact Memorial Hermann Health Plan Customer Service at (855) 645-8448 (TTY: 711) or call the appropriate number on the back of your ID card for assistance.

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 issued an extension.

Helpful Tips and Phone Numbers

  • For emergencies, call 911 or go directly to the nearest hospital.
  • For non-emergencies, contact Customer Service to find a doctor or healthcare professional in your network.
  • If you have a question about your prescription medication or where you can go to get a refill, call our dedicated pharmacy line at (888) 227-7940 (TTY: 711).
  • Talk to a nurse 24/7 by calling (844) 632-0074 (TTY: 711).
  • If you have your Memorial Hermann Health Plan member ID card, bring it with you when you receive care.
  • If you don't have your ID card, contact Customer Service or view/print a replacement card at our Member Portal (If you have not accessed your portal before, please read the instructions provided).

More Information

H7115_MKDisasterDec_C IA 12/10/2024

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