January 10, 2025 - LOS ANGELES — On Thursday, Insurance Commissioner Ricardo Lara sent a Notice to all California health insurers directing companies to submit emergency plans detailing how they will ensure continued access to medically necessary health care services for the duration of the declared State of Emergency due to the Palisades, Eaton, and other fires. These include allowing for 90-day prescription drug refills and suspending refill waiting periods for all drug tiers, including specialty drugs. Health insurers are required to file their plans within 48 hours of the emergency declaration.  

“With so many Angelenos displaced by these wildfires, the last thing they should be worried about is access to necessary health care and whether they can get their prescriptions. This is why I am ordering health insurance companies to submit their plans to my Department removing any unnecessary barriers to accessing treatment,” said Commissioner Lara. “We are doing everything within our power to ensure the health and safety of wildfire survivors and are calling on health insurance companies to guarantee access to care for our most vulnerable during these extraordinarily challenging times.”

The action exercises the Commissioner’s existing authority under state law that requires health insurance companies to file an emergency plan with the California Department of Insurance. The emergency plan must address:

• How the insurer will remove barriers to access to outpatient prescription drugs, including suspension of prescription fill/refill limitations and refill waiting periods for all drug tiers, including specialty drugs, to allow for policyholders to order a 90-day supply, waiver of charges for home delivery, and streamlining/eliminating drug access processes such as step therapy and prior authorization.
• How the insurer will cover access to medically necessary health services.
• The insurer’s plan for replacement of medical equipment or supplies.
• How the insurer will ensure networks provide access to medically appropriate care from a qualified provider, and how the insurer will arrange to provide for available and accessible providers outside the network, with the patient responsible only for in-network cost-sharing, if care cannot be provided within the network.
• How the insurer will communicate with consumers, including maintaining a toll-free telephone number.
  
   Notes: 

• Link to Notice.
• Additional resources and information for consumers on wildfires are available from the Department of Insurance. Download a free home inventory guide from the Department website, or receive a hardcopy by calling the Department of Insurance Consumer Hotline at 800-927-4357.
• If you have any questions or need assistance, the Department of Insurance is here to help. Please call: 1-800-927-4357 or visit www.insurance.ca.gov.
  Source: CA. Dept. of Ins.