Until the end of the mandate due to the public health emergency, faculty and staff members who participate in CMU's pharmacy benefit can receive up to eight COVID-19 at home test kits (one test per package) per 30 consecutive days.

Direct Coverage — Digital Point of Sale Process

CVS Caremark's digital point of sale tool allows plan participants to confirm availability of tests, place an order, and pick up their tests from a nearby store while processing the tests under their pharmacy benefit. To order test kits:

1. Visit the CVS website or use the CVS Pharmacy mobile application (click on “At-Home COVID-19 Tests.")
2. Select "Request at-home COVID-19 tests," then answer a few preliminary questions and enter your zip code. You will be directed to the closest CVS Pharmacy locations that have test inventory.
3. Select your test kits and enter your benefit details (BIN, PCN, Member ID).
4. You will receive a confirmation and within an hour of order confirmation, you can pick up your tests at the pharmacy. Orders not picked up within 72 hours will be canceled.

Reimbursement Process

Employees who participate in a CMU medical plan can opt to request reimbursement. A $2.50 processing fee associated with the reimbursement option will be billed to the plan and will not be incurred by the employee.

• Employees participating in the pharmacy benefit can purchase over the counter tests from any pharmacy or vendor and reimbursement through Caremark's online claims submission process, the Caremark mobile application (available for Apple and Android), or by submitting a paper claim form [pdf]. 
• Local 95 Union employees participating in the Aetna HMO plan can purchase over the counter tests from any pharmacy or vendor and request reimbursement through Aetna's online claims submission process or by submitting a paper claim form via CVS Caremark [pdf]. 

The following updates have been made to the CMU Medical Plans in response to the COVID-19 emergency.

COVID-19 Testing*

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)

Testing guidelines:

• 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).
• You must have a physician referral for testing. Most testing sites are also by appointment only.
• Please refer to the carrier links below for more information on COVID-19 testing and locations in your area.

*subject to change due to updates to CMS guidelines

Telemedicine and Virtual Medical Provider Visits

Effective January 1, 2022, member copayment is $5 for telephonic and virtual provider visits** (i.e., any non-physical visit with your medical provider including primary physician, pediatrician, specialists, etc.). Members should work with their existing provider to set up a visit via phone or virtual meeting service such as Zoom or FaceTime.

**Employees enrolled in the High Deductible Health Plan with Health Savings Account must pay 100% of medical and prescription costs out of pocket or with their HSA funds until they reach their deductible.

Medical Plan Carrier COVID-19 Resources:

• Aetna (L95 plan)
• Highmark
• UPMC Health Plan

Health Care Flexible Spending Accounts (HCFSA) Only

As a result of the CARES Act, which allows changes to HCFSAs, 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.

Health Care Flexible Spending Accounts (HCFSA) and Dependent Care Reimbursement Accounts (DCRA)

In addition, the following IRS changes due to COVID-19 have been implemented FOR THE 2022 PLAN YEAR ONLY:  

• To the extent that you have any unused contributions in your HCFSA/DCRA at the end of 2021, you can use the unused contributions for eligible expenses incurred in 2022. If you elected to enroll in the HCFSA/DCRA for 2022, the 2021 plan year balance will be used before your 2022 HCFSA/DCRA funds are used for reimbursement.
• The unused 2021 contributions are in addition to any 2022 elections that you make. For example, for an HCFSA, if you have $1,000 remaining from the year 2021, and you elect to contribute $2,850 for the 2022 plan year, you have a total of $3,850 to utilize during the 2022 plan year. For a DCRA, if you have $1,000 remaining from the year 2021, and you elect to contribute $5,000 for the 2022 plan year, you have a total of $6,000 to utilize during the 2022 plan year.
• The deadline to submit claims for eligible expenses for the 2021 plan year has also been extended. You now have until June 30, 2023 to submit claims using the 2021 plan year DCRA.