Emergency planning for an older parent

The preparation that actually changes the outcome

Skip the generic supply list — FEMA publishes it and this page links to it. Four things specific to an older adult decide how an emergency actually goes, and three of them are paperwork.

1. A current medication list, kept somewhere reachable from outside the house. Drug name, dose, prescriber, and the pharmacy. Every prescription entitlement below depends on somebody being able to say what the drugs are; from memory, in a shelter, nobody can.
2. The plan card, or the plan's name. If it is lost, 1-800-MEDICARE will supply the plan's contact details — but knowing which plan it is saves hours at the worst possible time.
3. What needs electricity, and for how long it can go without. Oxygen concentrators, CPAP, powered beds, refrigerated medication. This is the question that decides whether staying is survivable, and it is worth asking your utility about medical-baseline or priority-restoration registration before a storm rather than during one.
4. Who is coming, and how they get in. A named person with a key, who knows the medication list exists and where it is. FEMA's own guidance for older adults is built in three steps — assess your needs, make a plan, engage your network — and the third step is the one families skip.

If your parent has Original Medicare, one thing is already true and does not need any declaration: they can go to any doctor or hospital that accepts Medicare, anywhere in the country. Evacuation does not by itself interrupt their care. A Medicare Advantage plan works differently and that question has to be put to the plan.^{Source 1}

What "declared" means, and why it is worth checking twice

Almost every protection below switches on when an emergency is declared — and three different authorities can declare one, each publishing its own list of affected areas.^{Source 1}

• The President declares an emergency or disaster — FEMA publishes the affected areas.
• The Secretary of Health and Human Services declares a public health emergency — HHS publishes those areas.
• A governor declares an emergency or disaster — the state government's own site is where that appears.^{Source 1}

A family that checks only the federal list can conclude that nothing applies to them when a governor's declaration covers their county. If in doubt, ask the plan directly rather than deciding from a news report.^{Source 1}

Medication: replaced, moved, or filled somewhere else

This is the entitlement families need first and hear about last. In a declared emergency, a Medicare drug plan can help with medication that was lost, damaged, or simply not picked up on the way out of the door.^{Source 2}

• Replacing drugs that were lost or damaged, or that your parent could not take with them when they evacuated.
• Moving most prescriptions to another in-network pharmacy — and back to the regular one when the emergency ends. The new pharmacy needs the name of the usual pharmacy and the list of drugs.
• Filling at an out-of-network pharmacy where getting to a network one is not reasonable. Expect to pay the full cost at the counter.
• A 60- to 90-day supply if the displacement is going to be long. Ask the plan whether it offers them and which pharmacies can dispense them.^{Source 2}

Keep the receipts. An out-of-network fill is paid in full at the counter and refunded on a claim — so the receipt that gets thrown away during an evacuation is the thing that costs the money. Photograph each one as you go.^{Source 2}

Equipment: Medicare will usually replace it

Where Original Medicare already paid for durable medical equipment — a wheelchair, a walker — or supplies such as diabetic supplies, and they were lost or damaged in a disaster, Medicare will in most cases cover repair or replacement. Where the item can be repaired, Medicare will usually cover a rental in the meantime.^{Source 3}

The condition is the whole rule: it must come from a Medicare-approved supplier. A replacement wheelchair bought in a hurry from whoever is open is not covered, and the same wheelchair from an approved supplier is. Find the supplier before buying, even when it takes another day. A Medicare Advantage plan sets its own rules and must be asked directly.^{Source 3}

The deadline a disaster can reopen

Medicare's late-enrollment penalties are permanent — they attach to the premium for life. So a missed enrollment window is normally an expensive, irreversible event.^{Source 4}

A declared emergency that kept someone from signing up, switching or dropping a plan during a qualifying enrollment period can open a Special Enrollment Period — for Part B and premium Part A under Original Medicare, and for joining, switching or dropping a drug plan or Medicare Advantage plan. It is claimed through 1-800-MEDICARE, and it is claimed rather than granted: nobody offers it.^{Source 4}

If a hurricane, wildfire, flood or public health emergency overlapped a window your parent needed to use, this is worth a phone call even months later. The worst outcome of asking is being told no.

The federal money afterwards, and four things that are easy to miss

Where a major disaster or emergency has been declared by the President, FEMA's individual assistance program pays for uninsured or under-insured necessary expenses and serious needs. The program description is easy to find. Four provisions of the regulation behind it are not, and each answers a reason somebody decides not to apply.

One trap sits in the same section. An applicant is expected to accept the FIRST offer of housing assistance, and an unwarranted refusal may forfeit future housing assistance. Ask what accepting means before declining anything.

Assistance runs for a period not exceeding eighteen months from the date of the declaration, extendable in extraordinary circumstances, and it covers losses during the incident period the declaration sets — which is why the dates on the declaration matter as much as the damage.