Aware of the increasing magnitude of these tragic wildfires, the APWU Health Plan is taking a proactive approach to provide support and help ease the burden of our Health Plan members.
The APWU Health Plan has altered the benefits for any Health Plan member that has been or are currently being impacted by the wildfires in the affected zip code areas of Butte, Los Angeles, and Ventura counties in California. The affected area and time frame will be extended as conditions warrant. The following accommodations will be provided to members in the High Option and Consumer Driven Option who reside in the affected zip codes no matter where services are rendered from 11/9/18 through 12/9/18:
- All member claims will be paid as in-network regardless of the provider’s network status.
- The Health Plan will waive precertification requirements for all in-patient admissions (medical). Beacon Health Options will use maximum flexibility in approving requests for inpatient mental health services.
- Telephonic counseling will be available for all affected membership; members should call Beacon Health Options at 888-700-7965 to speak to a
- Extensive provisions have been made with your pharmacy administrator so that members can obtain their prescriptions for both retail and mail order. For assistance with prescriptions, High Option members should call Express Scripts at 800-841-2734 and Consumer Driven Option members should contact Optum RX at 800-718-1299. The following exceptions will be made:
- 30 day supply or refills can be obtained at a network retail pharmacy
- Refills can be obtained before the refill date for members that have lost their prescription
- Paper claims submitted by affected members will be identified and processed at the normal retail copay
- Mail orders of narcotics and temperature-sensitive medications for impacted areas will be held; members should contact their pharmacy administrator to discuss alternative delivery options to ensure safe and accurate delivery
- Mail orders can be shipped to a temporary alternate address by calling your pharmacy administrator
- If a member is unable to receive their order by mail it can be transferred to a retail pharmacy for dispensing by calling your pharmacy administrator
- Orders that have already been shipped can be reprocessed. Up to a seven-day supply obtained through a retail pharmacy at no cost to the member; members should visit a retail pharmacy to obtain the order or refill