Health Insurance Plans

Employees and their dependents are eligible to enroll in the MUSC Health Plan (PDF). Employees have the choice of seeing MUSC providers and paying lower out-of-pocket costs, including some preventive services at no cost to the patient. Employees may also schedule appointments with providers not affiliated with MUSC and receive benefits under the Standard State Health Plan.

Health Plans Available to Existing Employees

MUSC Health Plan

The MUSC Health Plan is a 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. If you receive services at an approved MUSC Health Plan provider, your out of pocket expenses will be less than if you visit an in-network or out-of-network provider.

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.

Both the Savings and MUSC Health Plan are administered through BlueCross BlueShield and have an annual deductible for certain services that must be met prior to the plan paying benefits. Once the annual deductible is met, BlueCross BlueShield will pay a percentage of coverage. Members do not need a referral from a primary care physician.

Health Insurance Resources

Insurance Eligibility

Employees in classified, faculty, postdoctoral scholar, research grant, and resident positions are eligible for insurance benefits if they are employed for at least 20 hours per week or more (.50 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.

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 & 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.

Review the SC PEBA webpage or their Insurance Benefits Guide for more information.

MUSC EAP offers employees and their families free, short term counseling on a range of topics. An operator is available 8:30am-5:00pm, sessions are by appointment only. Contact: Jeni Bowers-Palmer or call 843-792-2848. EAP is offering phone and telehealth counseling. You can also 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, interviews and video interview. Online care on your schedule by MUSC doctors and providers. Online visits are free to MUSC employees. No appointments, no wait time and accessible 24/7 for the whole family. If you are concerned about coronavirus (COVID-19) or experiencing respiratory or flulike symptoms such as fever and/or cough, MUSC recommends you speak to an online virtual care provider. Virtual COVID-19 screenings are free. Just use the code COVID19 when you log in. More information can be found in the MUSC Virtual Care Flyer (PDF).

MyHealth Toolkit

Find information on BCBS health and dental providers. Features include provider locator and information on free value-based benefits. MyHealthToolkit® allows you to review your eligibility for services, your claims and pretreatment cost estimates. For claims assistance, contact BlueCross at 800-868-2520. MUSC Health group number is 002036601 and dental group is 00S006601.

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.$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 insurance. He will pay this charge unless he certifies no one covered under his 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 the University Benefits Office via email to benefits@musc.edu.

Due to health care reform, beginning January 1, 2011, 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, he can avoid the tobacco surcharge by participating in an alternative program that is described in detail 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 of 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. Please visit the BCBS Global Core website. You must accept the terms and conditions and login with the first three letters of your BIN. Then you may Select a Provider Type. You also can choose a specialty, city, nation and distance from the city. 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.

Enrolling & Changing Benefits

New Employees

As a new hire you will select benefits and may make changes within 30 days of your hire date.

Existing Employees

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

Qualifying Life Events

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/Divorce
Birth/adoption/
Death
Employment/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 until age 19, or 25 if they are a full time student
Loss of other coverage
Gain of other coverage

Please email benefits@musc.edu if you have questions about enrolling or changing your benefits throughout the year.