Health Insurance Plans
Effective, January 1, 2014, all new employees and their dependents are eligible to enroll in the MUSC Health Plan. Employees have the choice of seeing MUSC providers and paying lower out-of-pocket costs, including some preventive services at no cost to the patient. Employees may also schedule appointments with providers not affiliated with MUSC and receive benefits under the Standard State Health Plan. Learn more about this exciting new plan and how to schedule appointments with a MUSC primary care physician.
Health Plans Available to Existing Employees
The State Health Plans (SHP) are PPO plans in which there is a network of hospitals, doctors and service providers that agree to specific discounted fees. While you may use any provider for care, typically your costs are less when you receive services in-network. If you go to a provider who is not a member of the PPO network the plan generally pays a higher percentage of the services.
Both the Savings and Standard plans are administered through Blue Cross Blue Shield and have an annual deductible that must be met prior to the plan paying benefits. Once the annual deductible is met, SHP will pay a percentage of coverage. Members do not need a referral from a primary care physician.
BlueChoice is an HMO plan in which members must use only healthcare providers, including hospitals, within the HMO network. If you receive care outside of this network, the plan will not pay benefits unless the care was preauthorized or deemed an emergency.
Subscribers are required to designate a primary care physician (PCP) who will refer them to specialists for services they do not offer.
The Savings plan requires a subscriber to pay the full allowable charge for prescriptions. There is no copayment, but the costs are applied to your annual deductible. Prescription drug benefits are administered by Medco.
The Standard plan offers a "3-tier" prescription plan with copayments available for generic, higher cost brand names and highest cost brand names. Mail order is also available and prescription drug benefits are administered by Catamaran.
BlueChoice offers copayments for generic, preferred, non-preferred and specialty pharmaceuticals. Mail order is available for up to a 90 day supply.
Mental Health & Substance Abuse Benefits
Savings and Standard subscribers must contact Companion Benefit Alternatives (CBA) 1-800-868-1032 for pre-authorization and must visit in-network providers.
BlueChoice subscribers must contact Companion Benefit Alternatives (CBA) at 1-800-868-1032 for pre-authorization and must visit in-network providers.