Getting care during a disaster

If you are a PrimeWest Health member and health care access is disrupted because of a disaster or emergency, the following applies:

• If you cannot use a network provider during a declared disaster or emergency, you may get care from qualified out-of-network providers at no cost to you.
• You will not need to get a Service Authorization for a covered service before getting the service.
• If you cannot use a network pharmacy during a declared disaster or emergency, you may fill your drug prescriptions at an out-of-network pharmacy. Your copay will be the same as if you had used a network pharmacy. You will be able to fill a one-month supply (31 days).
• PrimeWest Health may make changes to its plan rules for your benefit without telling you first.  

This applies during the disaster or emergency and for 30 days after the disaster or emergency ends.

A disaster or emergency is declared in one of the following ways:

1. A presidential declaration of a disaster or emergency under the Stafford Act or National Emergencies Act
2. A secretarial declaration of a public health emergency under section 319 of the Public Health Service Act
3. A declaration by the governor of a state

A declared disaster or emergency will end when one of the following occurs:

• The declared disaster or emergency expires or ends.
• Health care access is no longer disrupted.

PrimeWest Health will notify you when a declared disaster or emergency is over and when operations go back to normal.

If you are getting services through your county, contact the county for coverage of those services. If you have other questions, call PrimeWest Health Member Services at 1-866-431-0801. TTY users call 1-800-627-3529 or 711. These calls are free.

PW_08-17_344
DHS_Approved_02/09/2024
Updated_02/13/2024