Health Insurance

MUSC Health Plan | State Savings Plan | Health Insurance Resources | Maternity Leave & Birth Information | Medicare | Mental Health & Substance Abuse | MUSC Health Virtual Care | Prescription Benefits | Tobacco Surcharge | Travel Insurance | Changing Benefits

Employees and their dependents are eligible to enroll in PEBA Health Plans. New employees have access to MUSC Health Plan, with the choice of seeing MUSC providers and paying lower out-of-pocket costs, or providers not affiliated with MUSC with benefits under the Standard State Health Plan. University employees must be in classified, faculty, postdoctoral scholar, research grant or resident positions and employed for at least 20 hours per week (.50 FTE) to be eligible for insurance benefits. MUSC Health employees are eligible for insurance benefits if they are employed for at least 30 hours per week or more (.75 FTE). Premiums are paid in the month for that month of coverage. Biweekly paid employees pay premiums on the first two paychecks of each month.

Both of these plans are administered through BlueCross BlueShield and have an annual deductible for certain services that must be met prior to the plan paying benefits. Members do not need a referral from a primary care physician.

MUSC Health Plan

The MUSC Health Plan is a Preferred Provider Organization (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.

State Savings Plan

The State Savings Plan is a high deductible health plan and is only available to grandfathered employees. This plan is not available to new hires.

Health Insurance Resources

MyHealthToolkit allows you review your eligibility for services, your claims and pretreatment cost estimates. 

For claims assistance, contact BlueCross at 800-868-2520. MUSC Health’s group number is 002036601 and dental group is 00S006601.

Visit the PEBA website for plan comparisons, a summary of the MUSC Health Plan benefits and coverage, monthly premium amounts and more. 

Maternity Leave and Birth Information

Please visit the FMLA portal and review the Maternity Leave and Birth Information Packet (PDF).

Medicare Information

Employees or dependents turning 65 should review the PEBA Medicare Handbook. Enrollment in Medicare is handled by the eligible employee or spouse directly with the Social Security Administration. Please visit the Medicare website for more information regarding enrolling. For additional information about PEBA insurance coverage in coordination with Medicare, please review our Medicare Checklist (PDF).

Mental Health and Substance Abuse Benefits 

Savings and Standard subscribers must contact Companion Benefit Alternatives (CBA) at 800-868-2520 or visit them online for pre-authorization and must visit in-network providers.

MUSC Employee Assistance Program (EAP) offers employees and their families free, short-term counseling on a range of topics. An operator is available 8:30 a.m. to 5:00 p.m. Sessions are by appointment only. Visit MUSC EAP online to schedule an appointment.

MUSC Health Virtual Care

MUSC Health Virtual Care is an easy way to be treated for common conditions through online non-video and video interview. Online visits are free to MUSC employees. More information can be found in the MUSC Virtual Care Flyer (PDF)

Prescription Benefits

The State 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 Express Scripts. 

The MUSC Health Plan offers a "3-tier" prescription plan with copayments available for generic, higher cost brand names, and highest cost brand names. MUSC retail pharmacies offer discounted copays for prescriptions. More information can be found on the PEBA website.

Tobacco Surcharge

The surcharge for subscribers who have certified they use tobacco or who have not certified at all is $40 per month for subscriber-only coverage or $60 per month for a subscriber with dependent coverage. The subscriber will pay one surcharge, regardless of the number of tobacco users covered under his or her insurance. This charge will be paid unless the subscriber certifies no one covered under their health insurance uses tobacco, and no one has used it during the past six months. To change your tobacco surcharge status, please complete the Certification of Tobacco Use form and send to benefits@musc.edu.

If a subscriber's physician provides a letter stating that it is unreasonably difficult due to a medical condition for the subscriber to stop using tobacco or it is medically inadvisable for the subscriber to attempt to stop using tobacco, they can avoid the tobacco surcharge by participating in an alternative program that is described in the Insurance Benefits Guide.

Travel Insurance

Employees enrolled in the MUSC Health Plan or the State Savings Plan can use PEBA health insurance when traveling outside the United States. Through BlueCross BlueShield Global Core, your State Health Plan identification card gives you access to doctors and hospitals in more than 200 countries and territories worldwide and to a broad range of medical services. 

Please call PEBA insurance at 1-888-260-9430 for an international credible coverage letter before you travel. The BlueCross BlueShield Global Core Service Center can help you find providers in the area where you are traveling. It can also provide other helpful information about health care overseas. You can also call toll-free at 800-810-2583 or collect at 804-673-1177, as toll-free numbers do not always work overseas.

Changing Benefits

For existing employees, enrollment periods occur every year from Oct. 1 through 31. All changes and any applicable premium changes are effective on January 1 of the following year.

When you experience one of the qualifying life events listed below, you may make changes within 30 days of the event. You do not have to wait for an Open Enrollment period:

  • Marriage
  • Separation or Divorce
  • Birth or Adoption
  • Death
  • Employment or insurance change of dependents (loss or gain of coverage)
  • Dependency change of children – children may be covered on health, dental, and/or vision insurance until age 26 and life insurance until age 19, or 25 if they are a full-time student.
  • Loss of other coverage
  • Gain of other coverage