Health Insurance Plans
There
are six medical insurance plans offered to MUSC employees:
- State Health Plan - Savings
- State Health Plan - Standard
- MUSC Options
- BlueChoice HealthPlan
- CIGNA
Mental Health Care is covered under the above Insurance Plans but
provided through specific providers.
Comparison Charts
When
comparing the available health plans, look at the services each
plan offers. Are there services that are limited or not covered
(exclusions)? Which doctors, hospitals and other providers participate
in the plan’s networks (i.e., does your doctor participate)?
Are the doctors accepting new patients? Do you need approval from
the plan or primary care physician before going to the hospital
or receiving specialty care? Finally, compare the costs. Consider
things such as: deductibles, co-payments., how much the plan will
pay once your deductible has been met, how much the plan will pay
if you use a non-participating provider, and the limits on how much
the plan will pay in a year or over a lifetime.
Check out our for an overview of each plan's main features.
Preferred Provider Organization (PPO)
The State Health Plans (SHP)
are administered through Blue Cross and Blue Shield and exists
in 2 options: Savings or Standard.
Both of these plans have an annual deductible that must be met
prior to receiving paid coverage. Once the annual deductible is
met, SHP will pay a percentage of coverage.
A PPO plan 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, after you first satisfy a deductible, the
plan generally pays a large percentage of the usual, customary
and reasonable cost for care and you pay the remaining percentage,
plus any costs not covered by the plan.
Traditional Health Maintenance Organization (HMO)
BlueChoice Healthplan and
CIGNA HMO are managed care plans.
You are required to choose a primary care physician (PCP) who
coordinates all aspects of your healthcare within its network.
You can select a different PCP for you and each covered family
member. (PCP identification number(s) will be required when enrolling
for this coverage, or a PCP will be selected for you.)
You receive all your care from HMO providers only, except in
emergencies or for pre-authorized care. To receive benefits, you
must receive a referral from your PCP before you see a specialist.
Co-payments are required for Physician visits and prescription
drugs.
HMO with Point of Service (POS) Option
MUSC Options is a plan that
allows you to selectively go to providers inside or outside of
its network. To receive the maximum level of benefits, care must
be obtained within the HMO network and be authorized by the HMO.
When you use out-of-network services, you are likely to have much
higher out-of-pocket expenses in the form of deductibles and co-payments.
You receive all your care from HMO providers only, except in
emergencies. You select a Primary Care Physician (PCP) to manage
your health care in-network. You can select a different PCP for
you and each covered family member. (PCP identification number(s)
will be required when enrolling for this coverage, or a PCP will
be selected for you.)
Mental Health Care
Mental Health Care is handled through specific
providers as follows:
- State Plans - Subscribers must contact APS
Healthcare Inc. at 800-221-8699. Visit their web site at www.apshealthcare.com
(password: statesc)
- BlueChoice HMO - Subscribers must contact
Companion Benefit Alternatives (CBA) at 1-800-868-1032 for pre-authorization
and visit in-network providers.
- MUSC Options - Subscribers must contact
Companion Benefits Alternatives (CBA) at 1-800-868-1032 for
pre-authorization and visit in-network providers.
- CIGNA - Subscribers must contact CIGNA Behavioral
Health at 1-800-926-2273 for pre-authorization and visit in-network
providers. Visit their web site at: apps.cignabehavioral.com
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