The following updates have been made to Medical Plan benefits as a result of the COVID-19 crisis.
As allowed under the Consolidated Appropriations Act, 2022, no deductible will apply under the high deductible health plan (HDHP) for telemedicine services, including virtual office visits with network providers and Teladoc consultations, incurred from April 1, 2022, through December 31, 2023. If you’re enrolled in the HDHP medical option, the plan will pay 80 percent of allowable charges for covered telemedicine visits during this timeframe regardless of whether you have met your annual deductible for the year in which the charge was incurred. You are responsible for paying the remaining 20 percent (your coinsurance) of the cost. Any coinsurance amounts you pay for telemedicine services do not count toward your annual deductible.
All three medical options (PPO, EPO, and HDHP) will pay 100 percent of the cost — you pay no deductible, copay, or coinsurance — for COVID-19 testing (diagnostic and antibody testing ordered by your physician). If you're enrolled in Medicare Supplement, Medicare pays 100 percent of the cost for lab testing for COVID-19 when your doctor orders the test. The plan does not cover COVID-19 testing for employment purposes; for example, an employer screens all employees before they return to the workplace.
The Medical Plan will cover up to eight over-the-counter (OTC) home COVID-19 tests approved by the U.S. Food and Administration (FDA) in a 30-day period through December 31, 2023. Simply present your prescription drug ID card when buying an OTC home COVID-19 test at the pharmacy counter of a participating Express Scripts pharmacy and you won't be charged a copay. You can also use Express Scripts Pharmacy home delivery service to get your eight tests with no copay. Read more about this coverage, including certain limits that may apply.
The Medical Plan will cover COVID-19 vaccinations approved by the U.S. Food and Drug Administration (FDA) at no cost to members, including when two doses are required and approved booster shots. If getting the vaccine at a pharmacy, present your prescription ID card; at the hospital or doctor’s office show your medical ID card.
If you're enrolled in Medicare Supplement, Medicare pays 100 percent of the cost for FDA-approved vaccines.
For information about COVID-19 vaccines and to find a vaccine provider near you, visit the Centers for Disease Control (CDC) website.