FOR IMMEDIATE RELEASE
Dec. 31, 2021
- Marc Williams, Colorado Department of Health Care Policy & Financing
- Vincent Plymell, Colorado Division of Insurance
- AnneMarie Harper, Colorado Department of Public Health and Environment
Some residents who were ordered to evacuate their homes, may have done so without bringing their prescription medications with them or may not have access to their prescription drugs. It’s important people maintain their medication regimen to manage any number of health conditions they have, particularly during this difficult time.
During declared emergencies such as the Boulder Fires, impacted individuals can get prescription refills even if it would otherwise be too early to refill their prescriptions. The following guidance will help those evacuees in need of getting their prescriptions refilled.
People with Prescription Drug Coverage from Private and Employer Insurance Plans
Nearly all insurance providers request members to call their health insurance company or prescription drug plan to inform them of their circumstance and the need to obtain early prescription refills. People should look for their prescription drug plan contact information on the back of their insurance cards and contact their plan as soon as possible.
Further, the Colorado Division of Insurance has communicated to health insurance companies to step up to help people impacted by these fires and is directing health insurance companies to do the following.
- Waive any prior authorization for prescription refills or durable medical equipment for consumers in the fire-affected areas
- Waive any prior authorization, utilization review, or medical necessity determination for patients transferred or discharged in the fire-affected areas
The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), can help people with their insurance questions. Contact the Consumer Service Team at 303-894-7490 / 800-930-3745 (outside of the Denver metro area) / DORA_Insurance@state.co.us or visit our website, doi.colorado.gov.
People with Prescription Drug Coverage from Medicare
If people are not able to go to their usual network pharmacy to replace their prescriptions, they should contact their Medicare drug plan to find another network pharmacy nearby. A network pharmacy is a pharmacy that agrees to provide members of certain Medicare plans with services and supplies at a discounted price. In some Medicare plans, prescriptions are only covered if the member gets them filled at network pharmacies.
People should contact their Medicare drug plan if they had to leave home without their medications, or their drugs have been damaged or lost because of the fire/evacuation. They can help people find another network pharmacy.
If people are not able to return home for a long time, they may be able to get an extended-day supply (a 60- to 90-day supply) of their medications. They should ask their Medicare drug plan whether it offers extended-day supplies and which pharmacies to use to get them.
If someone can't reasonably get to a network pharmacy, their plan can help get drugs during an emergency or disaster at an out-of-network pharmacy. However, people may pay more for drugs you get at an out-of-network pharmacy.
For more information on Medicare coverage during disasters click here, or call 1-800-MEDICARE
People with Prescription Coverage from Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+)
For Health First Colorado and CHP+ members whose medications have been destroyed, damaged or are not available, Health First Colorado and CHP+ will cover any needed refills. Health First Colorado and CHP+ members should contact their pharmacy to advise them of their circumstances and request refills as soon as possible. For additional support, CHP+ members should call their health plan’s member services contact center, which can be found on the back of their member ID cards.
Some new medications may need prior authorization before the pharmacy can fill the new prescription. In the event the pharmacy cannot receive the prior authorization approval in a timely manner, the Department of Health Care Policy & Financing has authorized its enrolled pharmacies to dispense a 72-hour emergency supply (3 days).
About the Colorado Department of Health Care Policy & Financing: The Department administers Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus, and other programs for Coloradans who qualify. For more information about the Department, please visit HCPF.Colorado.gov.