Hurricane Season With a Chronic Illness: A Medication and Infusion Plan for Gulf Coast Patients

Why does hurricane preparedness for chronic illness need its own plan?

Because a missed medication, a ruined biologic, or a delayed infusion can trigger a serious flare at the worst possible time. Chronic illness adds risks a standard kit does not cover: refrigerated drugs, immune-suppressing treatments that raise infection risk, steroid dependence, mobility limits, and the need for medical records when your usual doctor is unreachable.

General preparedness guidance from Ready.gov tells every household to plan to be on its own for several days, with at least a gallon of water per person per day and a supply of non-perishable food. People with autoimmune and inflammatory conditions need to layer a medical plan on top of that. Consider what a typical storm can do:

• Pharmacies and clinics may close before landfall and reopen slowly afterward.
• Extended power outages can last days, putting refrigerated medicines at risk.
• Flooded roads can make it impossible to reach an infusion center or lab.
• Evacuation may take you to another city where no one has your records.
• Stress, heat, poor sleep, and disrupted routines can all provoke flares on their own.

The good news is that most of this can be planned in an afternoon, well before a storm appears in the Gulf.

How much medication should I have on hand for hurricane season?

Aim to keep at least a two-week supply of every daily or weekly medication when a storm threatens, and refill as early as your insurance allows. During a declared disaster, Texas pharmacists may be able to dispense an emergency supply, and regulators often urge insurers to relax early-refill limits.

Start with a simple habit: refill each prescription as soon as you are eligible rather than waiting until you are down to the last few pills. When a storm enters the forecast cone, call your pharmacy and your insurance plan to ask about an early or extended refill. Some practical points:

• Ask about 90-day supplies for maintenance medicines, if your plan and your doctor agree it is appropriate.
• Specialty pharmacies need lead time. Biologics and other specialty drugs often ship by mail. Ask your specialty pharmacy about storm procedures, delivery timing, and whether you can reschedule a shipment so it does not arrive at an empty or flooded home.
• Know Texas emergency refill rules. Texas pharmacy law allows a pharmacist, during a disaster declared by the governor and when the Texas State Board of Pharmacy authorizes it, to dispense up to a 30-day supply of many prescription drugs without reaching your prescriber. Schedule II controlled substances are excluded.
• Watch for insurance bulletins. After Hurricane Beryl in 2024, the Texas Department of Insurance said it expected health plans to authorize payment for up to a 90-day supply of prescriptions regardless of when they were last filled. That was guidance for carriers, so confirm current rules with your plan.
• Medicare drug plans can help members in declared disaster areas find an in-network pharmacy, replace lost or damaged drugs, and in some cases order an extended supply.

Do not stockpile by skipping doses, splitting pills, or changing schedules on your own. Talk to your doctor before making any change.

How do I protect refrigerated biologics during a power outage?

Plan ahead with a cooler, frozen gel packs, and a thermometer, and know your product’s labeled room-temperature limits. The FDA advises checking storage instructions or contacting a pharmacist, doctor, or manufacturer if a medicine was not kept at its recommended temperature, and replacing temperature-damaged drugs as soon as possible.

Many rheumatology treatments, including injectable biologics for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and lupus, must be refrigerated. Before the season starts:

• Read your package insert. Many biologic pens and prefilled syringes allow a limited period at room temperature, but the time and temperature limits differ by product. Write yours on an index card and keep it with the medication.
• Build a cold kit. A hard-sided cooler, several frozen gel packs, and a small refrigerator thermometer let you keep medicines cool for a day or more. Wrap medicines in a towel so they never touch ice directly — most biologics must not freeze, and frozen medicine generally should not be used.
• Keep the fridge closed. During an outage, an unopened refrigerator holds its temperature longer. Move medicines to the cooler only if the outage drags on.
• Avoid heat. Do not leave medicines in a hot car or in direct sunlight while evacuating.
• Call when in doubt. If a biologic got too warm, froze, or sat out longer than its label allows, call your pharmacist or the manufacturer before using it.

The FDA also notes an important exception: if a temperature-sensitive medicine is life-sustaining and no replacement is readily available, it may be used until a new supply can be obtained. Insulin is the classic example; FDA guidance says insulin vials and cartridges can generally be kept at 59°F to 86°F for up to 28 days. Medicines that touched floodwater or contaminated water should be thrown away, even in sealed containers, unless they are life-saving and no replacement is available.

What if a hurricane disrupts my infusion or injection schedule?

Contact your infusion center and prescribing doctor as soon as a storm is forecast. Ask whether your infusion can be moved earlier, what the center’s closure and rescheduling procedures are, and what to do if you miss a dose. A short delay is often manageable, but your doctor should decide how to catch up.

Infused treatments for rheumatoid arthritis, lupus, vasculitis, and gout are usually given on a set schedule. When a storm threatens:

• Write down the date of your last infusion and when the next one is due.
• Ask your infusion center whether moving an appointment a few days earlier is possible.
• Save the infusion center’s phone number and any after-hours line in your phone.
• After the storm, call to confirm the center is open before driving there on damaged roads.

For self-injected medicines, the same principle applies. If a dose is missed during an evacuation, do not double up later without guidance. Methotrexate for arthritis, for example, is taken once a week, not daily, and confusion during stressful times can lead to dangerous dosing mistakes. Your rheumatologist can tell you how to resume safely. Learn more about these therapies on our rheumatoid arthritis treatment, lupus treatment, and psoriatic arthritis treatment pages.

What special risks do steroids and immune-suppressing drugs create after a storm?

People on long-term corticosteroids should never run out suddenly, because stopping abruptly can cause dangerous adrenal problems. People taking immunosuppressants face a higher infection risk from floodwater, wounds, and mold during cleanup. Ask your doctor in advance about a steroid sick-day plan and when to hold or continue medicines if you get sick.

A few precautions matter more for people with autoimmune disease:

• Steroids: If you take prednisone or another steroid daily, make sure you never run out. Ask your doctor whether you need a written plan for illness or injury.
• Floodwater: Avoid wading in floodwater, which can carry sewage and bacteria. Clean any cut promptly and watch for redness, warmth, or pus.
• Mold cleanup: If you are immunosuppressed, let others handle moldy drywall and debris when possible, or use protective equipment your doctor recommends.
• Vaccines: Ask whether your tetanus and other vaccines are up to date before the season.
• Heat: Losing air-conditioning after a storm is dangerous for anyone with chronic illness. Know where cooling centers are, drink fluids, and run generators only outdoors, far from windows, to avoid carbon monoxide poisoning.

What medical documents should I pack in a hurricane go-bag?

Pack a current medication list with drug names, strengths, and schedules; your diagnoses and allergies; recent lab results; insurance and pharmacy cards; and contact information for your doctors, specialty pharmacy, and infusion center. Keep paper copies in a waterproof bag and digital copies on your phone or in secure cloud storage.

If you evacuate to Dallas, San Antonio, or Austin and need care, a doctor who has never met you will need these details quickly. Ready.gov recommends keeping copies of insurance and identification documents electronically or in a waterproof, portable container. A good medical folder includes:

• A one-page summary: diagnoses, medications and schedules, allergies, and recent hospitalizations
• Most recent lab work, especially for people on methotrexate, biologics, or other drugs that require monitoring
• Insurance cards (front and back) and pharmacy benefit cards
• Names and phone numbers for your rheumatologist, primary care doctor, specialty pharmacy, and infusion center
• Medical device information and supplier contacts, if you use mobility aids or other equipment

Our checklist of what to bring to a rheumatology appointment doubles as a useful template for this folder.

What is the Texas STEAR registry, and should I sign up?

The State of Texas Emergency Assistance Registry (STEAR) is a free registry run with the Texas Division of Emergency Management that gives local emergency planners information about residents with disabilities, medical needs, or access and functional needs. Registering does not guarantee a specific service, but it helps communities plan.

According to the Texas Division of Emergency Management (TDEM), STEAR is intended for people with disabilities, people who are medically fragile, and people with access or functional needs — for example, those with limited mobility, communication barriers, a need for extra medical help during an emergency, or a need for transportation or personal care assistance. Key facts:

• It is free. You can register online at stear.texas.gov, by calling 2-1-1 (or 877-541-7905), or with a paper form.
• It does not guarantee help. Services vary by community; your local emergency management office can explain how the information is used.
• Renew every year. Registrations stay in the system for one year, so re-register annually, ideally before June 1.
• Keep it current. Contact 2-1-1 if you move or no longer need assistance.

If severe arthritis limits your mobility, or you depend on electricity for medical equipment, STEAR registration is worth the few minutes it takes.

How can I get prescriptions if my pharmacy is closed after a hurricane?

Call your pharmacy’s main line or check its app to find an open location, since many chains can transfer prescriptions between stores. Ask your insurance plan about in-network options and emergency refills, and keep pharmacy and insurance cards with you. If you cannot reach your prescriber, a pharmacist may be able to provide an emergency supply under Texas disaster rules.

After a major storm, some pharmacies reopen quickly while others stay closed for days. Steps that help:

• Keep prescription bottles or photos of the labels, which make transfers and emergency refills faster.
• Use your insurance plan’s member services line to find an open in-network pharmacy.
• If you go out of network, keep receipts; some plans reimburse part of the cost.
• Contact your doctor’s office once phone service is restored; offices often prioritize urgent refill requests after storms.

Questions about coverage? Our insurance page explains how the practice works with most major plans, and our contact page has office details.

Where can I get rheumatology care in West Houston, Katy, or Fulshear before and after a storm?

West Houston Arthritis and Rheumatology, led by double board-certified rheumatologist Dr. Syed Alam, MD, FACR, helps patients with arthritis, lupus, and other autoimmune conditions plan for long-term care, including treatment reviews before hurricane season. Patients come from West Houston, Katy, Fulshear, Cinco Ranch, Cypress, Richmond, Rosenberg, Sealy, and Sugar Land.

Dr. Alam is board-certified in internal medicine and rheumatology, completed his rheumatology fellowship at Temple University Hospital and his internal medicine residency at John H. Stroger, Jr. Hospital, is trained in musculoskeletal ultrasound, and has more than 10 years of rheumatology experience. The office is at 19002 Park Row Blvd, Suite 100, Houston, TX 77084, open Monday through Friday, 8:00 a.m. to 5:00 p.m. Call (832) 305-5226. The practice is accepting new patients, accepts most major insurance plans, and patients from elsewhere in Texas may request an appointment. New to the practice? See our new patients page or our guide on when to see a rheumatologist.

Key takeaways

• Hurricane preparedness for chronic illness means planning medications, refrigerated biologics, infusions, and records before June 1.
• Refill early, keep at least a two-week supply when a storm threatens, and ask about emergency and extended refills.
• Know your biologic’s room-temperature limits, keep a cold kit ready, and never let medicine freeze or touch floodwater.
• Register with the free Texas STEAR registry if you have medical or mobility needs, and renew every year.
• Never stop steroids abruptly or change doses on your own; ask your doctor for a storm and sick-day plan.

Frequently asked questions

Can I use my biologic if the power was out for a day?

It depends on the product and how warm it got. Many biologics allow a limited time at room temperature, but limits vary. Check your package insert and call your pharmacist or the manufacturer before using it.

Should I take my medicines with me if I evacuate?

Yes. Take every medication, your cold kit for refrigerated drugs, and your medical documents. Keep them with you rather than in checked luggage or a hot trunk.

Does STEAR registration mean someone will rescue me?

No. TDEM states that registering does not guarantee any specific service. It gives local planners information so they can better prepare. Always follow evacuation orders and have your own plan.

What if I miss a methotrexate or biologic dose because of a storm?

Do not double up or change your schedule on your own. Contact your rheumatologist once you can for instructions on how to resume safely.

Can a pharmacist refill my prescription without my doctor during a disaster?

Sometimes. Texas law allows emergency dispensing of up to a 30-day supply for many drugs during a governor-declared disaster when the Texas State Board of Pharmacy authorizes it. Schedule II controlled substances are excluded.

When should I start preparing?

Before June 1, when hurricane season begins. Update your plan again whenever a storm enters the Gulf forecast.

Your next step

Sources and further reading

1. Safe Drug Use After a Natural Disaster, U.S. Food and Drug Administration.
2. Information Regarding Insulin Storage and Switching Between Products in an Emergency, U.S. Food and Drug Administration.
3. State of Texas Emergency Assistance Registry (STEAR), Texas Division of Emergency Management.
4. Commissioner’s Bulletin B-0011-24: Hurricane Beryl Life, Accident, and Health Guidance, Texas Department of Insurance.
5. Getting Care in a Disaster or Emergency, Medicare.gov.
6. Hurricanes, Ready.gov.
7. People with Disabilities, Ready.gov.
8. Hurricane Preparedness, National Hurricane Center.