The Governor of New Jersey has issued a state of emergency for the following counties due to winter storm: Alfalfa, Beckham, Blaine, Caddo, Canadian, Cleveland, Comanche, Cotton, Creek, Custer, Dewey, Ellis, Garfield, Grady, Grant, Greer, Harmon, Harper, Jackson, Jefferson, Kay, Kingfisher, Kiowa, Lincoln, Logan, Major, McClain, Noble, Oklahoma, Osage, Pawnee, Payne, Pottawatomie, Roger Mills, Stephens, Tillman, Washita, Woods, and Woodward. 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 Feb. 1, 2021, and an expiration date of Feb. 8, 2021.
