COVID-19 coverage changes coming

The national public health emergency related to COVID-19 will end effective May 11, 2023.  This end will impact health plan coverage of COVID-related treatment.

• COVID-19 vaccines, including boosters, will be continue to be covered as preventive care at no cost to the member if received from an in-network provider (including pharmacies)
• COVID-19 testing, which has been covered at no cost, will be covered at regular plan cost shares (coinsurance amounts) both in network and out-of-network.
• Out-of-network reimbursement for testing claims will be paid at allowed amounts (amounts a network provider would accept).   Balance billing by an out-of-network provider may apply.
• Over-the-counter COVID-19 tests will no longer be covered by the plan. Health plan members will pay 100% of the cost of these tests.  They may, however, still be available at no cost from some governmental entities.
• The cost of FDA-approved treatments prescribed by a provider for COVID-19 will be covered in the same way as other regular health plan benefits (subject to a coinsurance).
• Paxlovid will be covered as a Tier 2 drug. All other antivirals will be Tier 3.  (This means employees who purchase these medications at a pharmacy other than a U Pharmacy will pay a higher coinsurance.)
• Prior authorization may be required for some treatments.

May is open enrollment

Annual open enrollment for academic campus and U Health academics employees will be held during the month of March.  On May 1^st, the OE web page will be updated with all information and UBenefits will be open for making your OE elections.

Health plan rates will be increasing and some plan changes will take effect July 1, 2023.  Detailed information will be available on the HR website