CurrentBlue Cross Blue Shield - South CarolinaPolicy N/A

Access to Benefits During a Disaster or Emergency

Describes how BlueCross BlueShield of South Carolina applies coverage rules and administrative flexibilities for members when a declared disaster or public health emergency disrupts access to healthcare, including coverage at noncontracted facilities and waived referrals.

Policy Summary

PayerBlue Cross Blue Shield - South Carolina

PolicyAccess to Benefits During a Disaster or Emergency

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionWaive referral requirements where applicable and apply the same cost-sharing for out-of-network services as in-network during a declared disaster or public health emergency.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Medicare A & B + Part Cservices covered at noncontracted facilities during a declared disaster

30 daystimeframe after which a disaster officially ends

Immediatetiming of implemented changes

Waivedreferral requirements

Apply sameout-of-network cost-sharing

Coverage and Operational Criteria During Disasters

Coverage and operational criteria during disasters

When a disaster or public health emergency is declared and access to healthcare is disrupted:

ALL of the following

Medicare Parts A and B services and supplemental Part C plan benefits provided at noncontracted facilities are covered.
Referral requirements are waived where applicable.
Services rendered at out-of-network facilities will have the same member cost-sharing as in-network facilities.
The payer may implement immediate operational or coverage changes that benefit members without the usual 30-day notice.
ALL of the following

Policy Summary

PayerBlue Cross Blue Shield - South Carolina

PolicyAccess to Benefits During a Disaster or Emergency

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionWaive referral requirements where applicable and apply the same cost-sharing for out-of-network services as in-network during a declared disaster or public health emergency.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coding and Timeframes

Medicare and supplemental parts covered at noncontracted facilitiesmixedCovered

Medicare Part A	Medicare Part A services provided at noncontracted facilities
Medicare Part B	Medicare Part B services provided at noncontracted facilities
Supplemental Part C	Supplemental Part C plan benefits provided at noncontracted facilities

Disaster end determination timeframe

Official end timeframeA disaster or public health emergency officially ends 30 days after the declaring entity states it has ended or when all applicable declarations have concluded or access to healthcare is no longer disrupted.

Trigger: declaring entity statementIf the entity that declared the disaster or emergency states it has ended, the official end is 30 days after that statement.

Trigger: no end date identifiedIf no end date was identified, the official end is 30 days after all applicable emergencies or disasters declared have concluded by expiration or renewal.

Trigger: restoration of accessIf disruption in access to healthcare services ends, the disaster or public health emergency officially ends 30 days after that restoration.

Authorization and Provider Flexibilities

Prior Authorization

Authorization flexibilities and immediate operational changes during declared disasters

During a declared disaster or public health emergency, waive referral requirements where applicable; treat services rendered at out-of-network facilities with the same member cost‑sharing as in‑network; and implement these operational changes immediately without the usual 30‑day notice.

Waive referral requirements where applicable.
Apply the same cost‑sharing for out‑of‑network services as for in‑network services.
Implement changes immediately that benefit members without the usual 30‑day notice.

Key Definitions

Declared disaster or public health emergency

PresidentCan declare under the Stafford Act or the National Emergencies Act.

HHS SecretaryCan declare a public health emergency under Section 319 of the Public Health Service Act.

State or territory governorCan declare an emergency or disaster for the state or territory.

End of disaster/public health emergency

Definition of endA disaster or public health emergency ends 30 days after the declaring entity states it has ended, or when all applicable declarations have concluded or access to healthcare is no longer disrupted.

All applicable declarations concludedIf no end date was identified, the end occurs 30 days after all applicable emergencies or disasters declared have concluded by expiration or renewal.

End tied to access restorationThe official end also applies 30 days after there is no longer a disruption in access to healthcare services.