How Insurers Responded to Disasters

When wildfires began ripping through Southern California this winter, officials from SCAN Health Plan sprang into action. “There was so much chaos and so many unknowns” that the Long Beach, California-based insurer set up a command center with a core team that met twice a day to coordinate responses, says Karen Schulte, M.H.A., president of SCAN’s Medicare division.

The initial focus was on those who had been displaced and most needed help, such as high-risk members living in long-term care or assisted living facilities, Schulte says. Two facilities burned down, and 15 others were evacuated. In some cases, care was delivered bedside to those being housed temporarily in evacuation centers. “Needs changed daily — even by the hour,” Schulte says.

Karen Scnulte, M.H.A.

Insurers in Southern California and across the country have grappled with challenges posed by the natural disasters that have hit the United States in recent months. Before the Southern California fires in January 2025, Hurricane Helene wreaked havoc in the Southeast, especially in North Carolina, in September 2024, and Hurricane Milton hit Florida the next month.

“Our north star, our purpose is that people get care when they need it,” says Colleen Briggs, MBA, vice president of communications and corporate responsibility for Blue Cross and Blue Shield of North Carolina (Blue Cross NC), after Hurricane Helene devastated the western part of the state. “We’ve committed to being there as long as needed.”

In one instance, a Blue Cross NC member required regular dialysis treatment, but their provider was shut down by the storm. The insurer coordinated with local emergency management officials to transport the member to another facility for treatment three times a week until alternate care was available, Briggs says.

Sameer Amin, M.D.

Insurers undertook various other measures to smooth the way for members to access care. Blue Cross NC, for example, allowed early prescription refills, extended deadlines for premium payments and made it easier for members to access out-of-network providers and telehealth.

At L.A. Care Health Plan, the insurer temporarily ended prior authorization requirements so members could be discharged from facilities, according to Sameer Amin, M.D., the insurer’s chief medical officer. L.A. Care team members also contacted providers to assess the state of their healthcare facilities and reached out to providers’ customers who lived in evacuation areas, starting with those who were at highest risk, Amin says.

CVS Health, the parent company of Aetna, contacted patients who needed specialty medications to ensure their medications would be delivered to temporary addresses if they had been displaced by the wildfires, and members affected by the fires could seek emergency care anywhere.

Affected employees

Both the insurers and their employees took an active role by pitching in to help those in need.

For example, some L.A. Care employees who had to evacuate because of the fires went to community resource centers operated by the insurer to work and help others who needed assistance, Amin says. The wildfires forced dozens of L.A. Care employees to evacuate, and 10 lost their homes in the fires.

In western North Carolina, employees from Blue Cross NC volunteered at a center that became a hub for the community. It provided residents with access to computers and electricity for charging devices and hosted events such as a bingo night, according to Briggs. Blue Cross NC employees also donated supplies and money to help those impacted by Hurricane Helene, she says.

Insurers have also assisted their employees who have been impacted by natural disasters. Blue Shield of California created a Blue Shield Disaster Assist Fund so employees could donate to aid colleagues impacted by the wildfires, says Haley Mixon, M.H.R.M., the insurer’s chief human resources officer. Donations can be used by employees to pay for expenses such as housing, food and transportation. Blue Shield of California’s employee assistance program provides counseling and other services.

Haley Mixon, M.H.R.M.

Employees who had to evacuate and were unable to work could access emergency paid time off, Mixon says, and other employees could donate their time off to help their colleagues. “We believe it’s essential to support our communities — especially in times of crisis,” says Mixon.

Blue Cross NC employees who were impacted by the hurricane could apply for financial assistance from the company and also receive time off as needed to deal with the disaster.

SCAN contracted with a vendor to provide support and information for members and employees to help them know what to do in a crisis or if they are displaced, Schulte says, giving them the ability to “talk through what to do.” Employees were allowed time off and were connected to community resources. “As an employer, we want them to take care of themselves first,” says Schulte. The insurers in the disaster areas also expanded access to behavioral care. L.A. Care, for example, set up a 24-hour crisis line through Carelon, a part of Elevance Health. The stress caused by the disaster “is not something that is going to be remedied with the abatement of the fires,” notes Amin.

Long-term impacts

The ultimate impact of natural disasters on healthcare can be difficult to gauge. Months after Hurricane Helene devastated western North Carolina, “there are still huge needs in the region,” Briggs says. “This is going to require long-term support for rebuilding efforts. The needs are so profound.”

Although the California wildfires created major disruptions and hardships for some people, most people have returned to receiving regular medical care, Amin says. “We’re not seeing a major disruption,” Amin says. “It’s not as severe as a pandemic, which stresses the entire safety net.”

Schulte agrees. “I don’t know that it will have an impact on healthcare utilization. It’s different from the pandemic, where everything was shut down.”

But a disaster such as the wildfires does “affect the already-stressed healthcare system,” Amin says.

Sue Anne Bell, Ph.D

“This is just layering on top of that,” says Sue Anne Bell, Ph.D., an associate professor of nursing at the University of Michigan, who is part of a federal team that responds to major disasters such as Hurricane Maria in Puerto Rico in 2017 and the wildfire in Paradise, California, in 2018. In the immediate aftermath of a disaster, people are seeking assistance for injuries and trauma, says Bell. They also may be struggling to get refills of their medications, access chemotherapy or get assistance with chronic disease management, she adds.

If someone has to go to another city for chemotherapy, for example, “it can cause setbacks in treatment” or lead to communication issues between the old and new providers, says Bell.

Bell, who studied the impact of Hurricane Katrina, which slammed Louisiana in 2005, found that patients undergoing breast cancer treatment and whose care was interrupted were more likely to die within 10 years than those who had not been exposed to the storm. She also found that if a disaster caused an interruption in regular healthcare service and posed barriers to treatment access for older adults, they were more likely to wind up being hospitalized.

One study by Yale researchers found long-term exposure to wildfire smoke, which is tied to conditions such as heart disease, diabetes and chronic kidney disease, contributed to more than 11,000 deaths per year between 2007 and 2020. Another study, from the University of California, Berkeley, found that each hurricane and tropical storm contributes to between 7,000 and 11,000 excess deaths. “Disasters aren’t just one-off events. They can have lasting impacts,” says Bell.