Due to wildfires throughout California, CalPERS asked its health plans to provide information for members who may become impacted and/or displaced due to a wildfire.

Below are answers to the following questions as of November 19, 2018:

Health Plan Services Available
Anthem HMO (Traditional & Select)
  • Standard rules are applied and will consider circumstances if a member reaches out.
  • Virtual visits: Basic plans include access to Live Health Online, a web-based visit with a doctor via either a mobile device (download through app store) or web browser.
  • Member services: (855) 839-4524
PERSCare/Choice/Select(Anthem Blue Cross PPO)
  • Members continue to have access to the nation’s largest network.
  • Relaxed policies are applied.
  • Virtual Visits: Basic plans include access to Live Health Online, a web-based visit with a doctor via either a mobile device (download through app store) or web browser.
  • Member services: (877) 737-7776
Blue Shield Access +
  • Members have access to non-emergency care through urgent care centers outside of their normal service area. Members can use their Blue Shield of California (BSC) mobile app to find the nearest contracted urgent care centers or view a copy of their ID card. If the member needs assistance locating an urgent care, needs a confirmation of coverage letter or ID card emailed to them/provider or is having difficulty accessing care, they can contact Concierge directly for assistance at (800) 334-5847.
  • Members continue to have access to the nation’s largest network.
  • The Life Referrals program is available 24/7 and connects members with a team of experienced professionals ready to assist with a wide range of personal, family and work issues. Life Referrals can be reached at: (800) 985-2405 or www.LifeReferrals.com (Enter access code "BSC").
  • BSC is allowing for the immediate refill of prescriptions, even if they are not yet due to be refilled. Authorizations for the zip codes affected by the fires are out in place so calls will not have to be made for exceptions. If members have any issues filling their medications they are urged to call BSC’s concierge lines for immediate assistance at (800) 334-5847.
  • Magellan Health (crisis line), Blue Shield’s contracted managed care plan for behavioral health, is providing free access to resources, materials and counseling services through its dedicated hotline: (800) 327-7451.
  • Members can speak to a licensed doctor by phone or mobile app/web browser in minutes. Call 800 Teladoc (or (800) 835-2362) or visit  www.teladoc.com.
Health Net (SmartCare & Salud y Más)
  • Members are covered for emergency services out of the area or routine care, they would need to coordinate through their PCP and medical group.
Kaiser
  • Getting prescriptions if affected or displaced: If members need a prescription or refill, they can go to any Kaiser pharmacy.
  • If there is no nearby Kaiser Permanente pharmacy or if other assistance is needed, including redirecting mail order prescriptions, members can call the Kaiser Permanente Pharmacy Call Center at (888) 218-6245.
  • For information about member coverage or how to redirect or replace prescriptions, or if their Kaiser ID card has been lost, call Kaiser’s Member Service at (800) 464-4000, TTY: 711.
  • Members with appointments at the closed Medical Office Buildings are being notified of the closures.
  • Video visits and telephone appointments are available for most primary care needs.
  • Members with questions about scheduled appointments or who want to make an appointment at a facility they don’t normally use should contact the Appointment and Advice Call Center at:
    • Northern California: (866) 454-8855 (24 hours a day, 7 days a week)
    • Southern California: (833) 574-2273 (Advice 24/7, appointments during local business hours)
  • If a member needs a prescription or refill, they can go to any Kaiser Permanente pharmacy. None of our pharmacies is closed due to the fires. If there is no nearby Kaiser Permanente pharmacy or if other assistance is needed, including redirecting mail order prescriptions, members should call our Kaiser Permanente Pharmacy Call Center at:
    • Northern California: (888) 218-6245 (Monday - Friday 8:00a.m. - 8:00p.m., Saturday 8:00a.m. - 6:00p.m., Sunday 9:00a.m. - 6:00p.m.)
    • Southern California: (866) 206-2983 (Monday - Friday 7:00a.m. - 7:00p.m.)
Sharp
  • Members are covered for emergency room and urgent care services outside of San Diego County.
  • Members also have access to Sharp Nurse Connection®, Sharp’s nurse advice line, for medical assistance during evenings and weekends contact (855) 995-5004.
UHC Signature Value Alliance
  • Impacted members who need help finding a care provider in the UnitedHealthcare network can call UHC’s customer care team at (877) 359-3714
  • Members should also contact their assigned medical group/PCP.
  • Emotional support help line 24/7: (866) 342-6892
  • Members have access to seeing a provider virtually via our Virtual Visits programs:
UHC MA PPO
  • Impacted members who need help finding a care provider in the UnitedHealthcare network can call UHC’s customer care team at (888) 867-5581, TTY: 711.
  • Members should also contact their assigned medical group/PCP.
  • Emotional support help line 24/7: (866) 342-6892
  • Members have access to seeing a provider virtually via our Virtual Visits programs:
Western Health Advantage (WHA)

WHA will have a resource page on its website specific to those impacted by the wild fires that will include:

  • Magellan Health has the following:
    • Toll-free, 24-hour crisis line at (800) 327-7451 for all individuals affected by wildfires in California.
  • Nurse 24 – Nurses in the program would be provided information on the current status of the fires, evacuation procedures and available resources.
  • WHA Hospitals – all hospital facilities are open and continue to service members. However, it is important to note hospitals are triaging services, which could mean a service that was scheduled in advance may be delayed.
Optum Rx

OptumRx’s Natural Disaster Standard Operating Procedure (SOP) is in place. The Government Program SOP abides by FEMA guidelines and aligns with the Centers for Medicare and Medicaid Services.

Refill edits for members in the impacted areas will be lifted for the duration of the disaster as declared by FEMA. Some may extend longer than others.

OptumRx Member Service numbers:
Basic: (855) 505-8110
EGWP: (855) 505-8106

Health Plan Services Available
Anthem HMO (Traditional & Select)
  • Standard rules are applied and will consider circumstances if a member reaches out.
  • Virtual Visits: Basic plans include access to Live Health Online.
PERSCare/Choice/Select(Anthem Blue Cross PPO)
  • Members continue to have access to the nation’s largest network
  • Relaxed policies are applied.
  • Virtual Visits: Basic plans include access to Live Health Online.
Blue Shield Access +
  • Blue Shield of California’s concierge team will provide members support if providers are unwilling to see members based on non-emergency conditions due to the member displacement. The concierge team has the resources and capabilities to call out to the providers to make sure care is not interrupted. If they are out of the service area, the claims will come into Blue Shield directly and will review them for payment based on the circumstances
  • Appeals and Grievances will waive the 180-day time limitation for members to file a grievance if the member states that they were unable to file timely due to a natural disaster.
Health Net (SmartCare & Salud y Más)
  • Members are covered for emergency services out of the area.
  • For routine care, they would need to coordinate through their PCP and medical group.
Kaiser

Member Service Contact Center: If members have questions, they can call Kaiser’s Contact Center, open 24 hours a day, 7 days a week (closed holidays) at (800) 464-4000, TTY: 711

  • When calling, members should let Kaiser representatives know they’ve been affected by the wildfires. Kaiser will continue to evaluate the situation and provide more information should something change.
Sharp
  • Members are covered for emergency room and urgent care services outside of San Diego County.
  • Members also have access to Sharp Nurse Connection®, Sharp’s nurse advice line, for medical assistance during evenings and weekends - Contact (855) 995-5004
UHC SignatureValue Alliance
  • UHC’s customer care team will work with any affected members at (877) 359-3714.
UHC MA PPO
  • UHC’s MA PPO customer care team will work with any affected members (888) 867-5581, TTY 711.
Western Health Advantage (WHA)
  • Nurse 24 – WHA’s nurse advice line is available from Optum’s Nurse24 provides 24/7 support through Telephone Triage. Nurses in the program would be provided information on the current status of the fires, evacuation procedures and available resources.
  • WHA Hospitals – all hospital facilities are open and continue to service members. However, it is important to note hospitals are triaging services which could mean a service that was scheduled in advance may be delayed.
Optum Rx

OptumRx’s Natural Disaster Standard Operating Procedure (SOP) is in place. The Government Program SOP abides by FEMA guidelines and aligns with the Centers for Medicare and Medicaid Services.

Refill edits for members in the impacted areas will be lifted for the duration of the disaster as declared by FEMA. Some may extend longer than others.

OptumRx Member Service numbers:
Basic: (855) 505-8110
EGWP: (855) 505-8106

Health Plan Services Available
Anthem HMO (Traditional & Select)

All facilities are open

Anthem Medicare Preferred

All facilities are open

PERSCare/Choice/Select(Anthem Blue Cross PPO)

All facilities are open

Blue Shield Access +

All facilities are open

Health Net (SmartCare & Salud y Más)

All facilities are open

Kaiser

Northern California:
No impact to any Kaiser Permanente facilities
 

Southern California:
Open: Kaiser Permanente Thousand Oaks Medical Office Building 2 (mental health) at 145 Hodencamp Road, Thousand Oaks, CA 91360
Open: Kaiser Permanente Thousand Oaks Medical Office Building 3 (primary care) at 322 E. Thousand Oaks Blvd., Thousand Oaks, CA 91360
Open: Kaiser Permanente Thousand Oaks Medical Office Building 1 at 365 E. Hillcrest Drive, Thousand Oaks, CA 91360 — staff is being consolidated here

Sharp

All facilities are open

UHC SignatureValue Alliance

All facilities are open

UHC MA PPO

All facilities are open

Western Health Advantage (WHA)

All facilities are open

General Information:

In Butte County, patients from Feather River Hospital in Paradise have been transferred to Enloe Medical Center in Chico. All elective surgeries are being cancelled and will be rescheduled. In the event Chico area hospitals are ordered to evacuate, patients could be transferred to medical facilities in the Oroville area.

Health Plan Services Available
Anthem HMO (Traditional & Select)

Call customer service to request a plan ID card: (877) 737-7776.
Members can access their ID card by logging in to: http://www.anthem.com/ca/calpers

Anthem Medicare Preferred

Call customer service to request a plan ID card: (877) 737-7776.
Members can access their ID card by logging in to: http://www.anthem.com/ca/calpers

PERSCare/Choice/Select(Anthem Blue Cross PPO)

Call customer service to request a plan ID card: (877) 737-7776.
Members can access their ID card by logging in to: http://www.anthem.com/ca/calpers

Blue Shield Access +

Call customer service to request a plan ID card:  (800) 334-5847.
Members can access their ID card by logging in to: www.blueshieldca.com/calpers

Health Net (SmartCare & Salud y Más)

Call customer service to request a plan ID card: (888) 926-4921
Members can access their ID card by logging in to: www.healthnet.com/

Kaiser

Call customer service to request a plan ID card. Members should indicate that they are impacted by the fires: (800) 464-400
Members can access their ID card by logging in to: www.kp.org/

Sharp

Call customer service to request a plan ID card: (855) 995-5004
Members can access their ID card by logging in to calpers.sharphealthplan.com/

UHC SignatureValue Alliance

Call customer service to request a plan ID card: (877) 359-3714
Members can access their ID card by logging in to www.MyUHC.com

UHC MA PPO

Call customer service to request a plan ID card: (888) 867-5581
Members can access their ID card by logging in to www.MyUHC.com

Western Health Advantage (WHA)

Call customer service to request a plan ID card: (888) 942-7377
Members can access their ID card by logging in to www.mywha.org

Optum Rx
  • Members can have the pharmacy contact OptumRx member services to obtain processing information.
  • Basic members who need a replacement card need to contact their health plan. However, OptumRx can provide their ID number and billing information to obtain prescriptions. Basic Members:
    (855) 505-8110
    Medicare Part D Members: (855) 505-8106
  • www.optumrx.com/calpers Members can print a temporary card by selecting ID Card under the Benefits and Claims tab on the top banner.
General Information:

Members can:

  • Call their health plan customer service
  • Go online to the health plan website and print a temporary ID card
  • Contact their primary care provider to be directed to the appropriate site of care
  • Call CalPERS customer service who can coordinate with the health plan