Important Information About Getting Care During the State of Emergency
Here is some important information about getting care during the state of emergency.
The 24/7 Nurse Call Line is open 24 hours a day, seven days a week, at 1-888-765-6375 (TTY 711). If you have an emergency, please dial 911.
If you are trying to reach us by phone, you may experience longer than usual hold times. Please know your call is important to us, and we thank you for your patience.
Please note that normal prior authorization requirements for medical services will be relaxed for the duration of the declared state of emergency to ensure member needs are met:
- Members may refill their regular medications earlier than usual to ensure a sufficient supply.
- Use of out-of-network pharmacies is authorized when access to in-network pharmacies is unavailable or when traveling to in-network pharmacies is difficult, unsafe, or not practical. Please note that Keystone First VIP Choice members can access a large network of pharmacies (including CVS, Rite Aid, Walgreens, Walmart, and others) in any state.
- All requests for emergency inpatient hospital admissions, as well as admissions to skilled nursing facilities, nursing facilities, and rehabilitation and long-term acute care facilities, will be approved by the plan as needed.
- All urgent outpatient procedures requiring prior authorization will be approved by the plan as needed.
- Essential medical supplies and equipment for those members impacted will be approved by the plan, as needed.
- Use of Medicare-certified out-of-network and/or out-of-state providers will be allowed for medically necessary services.
- Providers, please note that administrative denials for late notification will be waived at this time.
- Medically necessary emergency care will be covered. If you are having an emergency, please call 911 or seek medical attention immediately.
- Face coverings are available to order through the over-the-counter (OTC) benefit offered to our members. According to the Centers for Disease Control and Prevention (CDC), everyone should wear a face covering in public settings and when around people who don’t live in their own household. Both reusable and disposable face coverings are now available through our over-the-counter benefit supplier. You can view the over-the-counter items here. For information on how to place an order, call 1-844-981-1614 (TTY: 711), Monday - Friday 8 am - 5 pm, Saturday from 9 am - 5 pm and Sunday from 10 am - to 5 pm. Cloth face coverings should not be placed on young children under age 2; anyone who has trouble breathing; or anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance. Continue to keep about 6 feet between yourself and others. A cloth face covering is not a substitute for social distancing.
We will provide further information and updates as they become available.
Important numbers and resources
Keystone First VIP Choice Member Services: 1-800-450-1166 (TTY 711), Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31.
24/7 Nurse Call Line: 1-888-765-6375 (TTY 711), 24 hours, seven days a week.
Keystone First VIP Choice prior authorization:
- 1-855-294-7046 (phone).
- 1-855-809-3202 (fax).
For up-to-date information on coronavirus disease (COVID-19), visit the CDC's website.