Benefits and COVID-19
The following updates have been made to the CMU Medical Plans in response to the COVID-19 emergency.
Testing is covered 100% for CMU employees and their dependents enrolled in CMU medical plans:
- Active employee medical plans
- Local 95 medical plan
- Medicare Advantage Plans (Retiree Medical)
- Coverage applies to the diagnostic testing of COVID-19 as well as antibody testing.
- There are currently no limits to the number of tests, however the testing is based on medical necessity (diagnosis or suspicion of exposure to COVID-19).
- It is recommended to consult with a physician prior to testing, but a prescription from a provider is not required at this time.
*subject to change due to updates to CMS guidelines
Telemedicine and Virtual Medical Provider Visits**
Due to COVID-19, carriers are waiving member co-payment/cost share for telemedicine, telephonic and virtual provider visits (i.e., any non-physical visit with your medical provider including primary physician, pediatrician, specialists, etc.):
- Visits do not need to be related to COVID-19 to have co-payments/cost share waived.
- Members should work with their existing provider to set up a visit via phone or virtual meeting service such as Zoom or FaceTime.
- $0 co-payment for all telemedicine/virtual visits until June 4, 2020
- Member co-payment/cost share waived on all telemedicine/ virtual visits with in-network providers until June 16, 2020
- UPMC Health Plan:
- Member co-payment/cost share waived for UPMC AnywhereCare (virtual urgent care visits) until June 15, 2020
- Member co-payment/cost share still apply to non-AnywhereCare visits (telephonic or virtual in-network provider visits)
**Dates subject to change/extension
For more information from the CMU medical plan carriers, please refer to the COVID-19 resources listed on the plan websites:
Prescription Drug Benefits
CMU has worked with CVS Caremark to ensure that subscribers to the CMU Prescription Plans have uninterrupted and appropriate access to the medications they need.
- Home delivery from CVS Pharmacy
- Charges waived on one- to two-day home delivery of prescription medications.
- Refill Restrictions
- “Too Soon” restrictions are waived allowing subscribers to refill most maintenance medications ahead of normal schedule.
- Prior Authorizations extended to Maintain Member Access
- To prevent gaps in therapy, many clinical prior authorization records — set to expire between March 23 and June 30 — have been extended for 90 days.
Flexible Spending Accounts
As the COVID-19 outbreak and its impact continues to evolve, we are taking steps to provide assistance to CMU faculty and staff members with their Spending Account Plans:
Health Care Flexible Spending Accounts (HCFSA)
- In response to the COVID-19 emergency, the federal government passed the CARES Act which allows changes to Health Care Flexible Spending Accounts (HCFSAs).
- As a result, the CMU HCFSA plan has been updated to make over-the-counter drugs and medicines eligible for reimbursement from HCFSAs without a prescription. In addition, menstrual products are now considered a qualified medical expense.
- These changes are effective for purchases made after December 31, 2019.
- You can submit claims by logging in to Benefit Coordinators Corporation (BCC)’s My SmartCare Portal or through their My SmartCare Mobile App. Instructions [pdf] for accessing these tools, along with the FSA Reimbursement Request [pdf], can be found at Flexible Spending Accounts on the Human Resources website.
Dependent Care Reimbursement Accounts (DCRA)
- Changes to DCRAs in the middle of the plan year resulting from the closure of childcare centers or the inability of home childcare providers to attend to children due to COVID-19 can be allowed.
- In the event that your dependent care expenses are affected by the above circumstances, you may contact the HR Service Center to request a change.
- In order to be eligible, you must provide documentation of the facts and circumstances of your situation to ensure that the change falls within the permitted guidelines.
Paid Time Off
- The Office of Human Resources has approved temporary exceptions to the university’s Paid Time Off Policy for PTO that normally would have rolled into a staff member’s bank of Reserve Sick Days from April 1–August 1, 2020. Impacted staff members must use the affected PTO by December 31, 2020.