The Governor of California has expanded the state of emergency for the following counties due to the California debris flow: Monterey, San Luis Obispo and Santa Cruz. There are provisions being made for affected members. Aetna (the Plan’s Administrator) waives precertification/prior approval requirements for members identified as potentially being affected. If you are impacted by the emergency or have questions regarding precertification/prior approval, please call us at 1-800-593-2354.
Express Scripts (the Plan’s Pharmacy Benefit Manager) has activated an emergency benefit override that allows pharmacies, at the point of sale (POS), to override certain benefit coverage/edits such as an early refill during a government-defined emergency. In addition, if your home delivery of medications is affected by the emergency, you may provide a temporary alternate address (either online at www.express-scripts.com or by calling 1-800-818-6717) or request a local fill as needed. The Emergency Access to Benefits/Refill Too Soon override process is implemented with an effective date of Jan. 29, 2021, and an expiration date of Mar. 2, 2021.