When the President, Governor, or Secretary of Health and Human Services declares a disaster or a public health emergency, Quartz ensures our Medicare Advantage members in the affected geographic areas can get the benefits and medical care they need by:
- Covering Medicare Parts A and B services and supplemental Part C benefits at non-contracted facilities
- Waiving referral requirements for out-of-network care
- Providing the same cost-sharing benefits as if the service had been furnished in-network
- Providing in-network cost-sharing for any Part D prescriptions filled at an out-of-network pharmacy and removing drug limitations such as “refill too soon” rejections that prevent members from obtaining necessary medications.
A disaster ends when any of the following occur:
- The source that declared the public health emergency or state of disaster declares an end
- CMS declares an end of the public health emergency or state of disaster
- Thirty days have passed since the declaration of the disaster and no end date was identified
Your health care provider will need to bill Quartz for any care you receive during the disaster, regardless of the status of their contract with Quartz.
If Quartz is also affected by the disaster and cannot resume normal operations by the end of the public health emergency or state of disaster, we are required to notify CMS.