Employees and their dependents are eligible to enroll in the MUSC Health Plan (PDF). 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.
The MUSC Health Plan is a PPO plan 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 receive services at an approved MUSC Health Plan provider, your out of pocket expenses will be less than if you visit an in-network or out-of-network provider.
Both the Savings and MUSC Health Plan are administered through BlueCross BlueShield and have an annual deductible for certain services that must be met prior to the plan paying benefits. Once the annual deductible is met, BlueCross BlueShield will pay a percentage of coverage. Members do not need a referral from a primary care physician.
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 MUSC Health Plan 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 ExpressScripts. MUSC retail pharmacies offer discounted copays for prescriptions.
Savings and Standard subscribers must contact Companion Benefit Alternatives (CBA) at 800-868-1032 for pre-authorization and must visit in-network providers.