The Governor of Texas has expanded the state of emergency to include the following counties due to Hurricanes: Anderson, Angelina, Bowie, Cass, Cherokee, Dallas, Fort Bend, Franklin, Gregg, Grimes, Harrison, Houston, Leon, Madison, Marion, Montgomery, Morris, Nacogdoches, Panola, Polk, Red River, Rusk, Sabine, San Augustine, San Jacinto, Shelby, Smith, Titus, Travis, Trinity, Tyler, Upshur, Walker, Waller, Wharton, and Wood. 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 Aug. 24, 2020, and expiration date of Sept. 25, 2020.
