Medical benefits provide you and your family with financial protection and access to quality health care. All Benelect medical insurance plans comply with Health Care Reform requirements.
COVID OTC Test Coverage
Over-the-counter (OTC) COVID-19 test kits for personal use are covered by the University's health plans
Employees covered under the Supermed PPO and High Deductible Health plans can use their MedImpact ID to purchase test kits at MedImpact in-network pharmacies. Test kits must be purchased, like prescription medication, at the pharmacy counter to take advantage of the direct electronic adjudication process. Presenting your MedImpact ID card will enable you to receive kits at no cost. Some pharmacy chains are not set up yet for direct coverage using insurance; if that is case, you will need to request reimbursement. If you purchase a kit and pay at the register, use the MedImpact COVID Home Test Kit DMR form to receive reimbursement. Complete the demographic information on Part 1. In the Indicate Reason section, check “Pharmacy unable to process claim electronically” and on the line for “Describe Emergency” write “OTC Covid Test.” Attach the receipt for the COVID Test(s) and mail to the address on the first page of the form. Note that kits purchased at sites that are not part of the MedImpact network will be reimbursed at a maximum of $12 per kit.
Employees covered by Medical Mutual's HMO, CLE-Care, option are encouraged to call their local retail pharmacy to see if they have at-home COVID-19 tests available. After finding a pharmacy having kits available, simply take your Express Scripts ID card to a retail pharmacy that is in-network. Pick up the COVID-19 test and bring it to the pharmacy counter - not the regular checkout lane. Check out at the pharmacy counter showing the ID card and your at-home COVID-19 test should automatically ring up at no cost to you.
COVID-19 Vaccination Coverage
The COVID-19 vaccinations are covered by the University's health plans.
If you are receiving the vaccination in a medical setting, i.e., hospital or physician's office, the vaccination should process through your CWRU medical plan.
Vaccinations received at a pharmacy will be covered by MedImpact, the University's pharmacy benefits manager. At this time, the Federal government is covering the cost of the vaccinations. If you are told by a pharmacy that your MedImpact plan doesn't cover vaccinations, the pharmacy will still provide the vaccination at no cost to you.
Health Care Reform
In 2014, a bill was passed requiring all citizens to have health insurance. Health Care Reform enhances health insurance, and Case Western Reserve University's plans meet all of the requirements to comply with the regulations. Health insurance plans offered through the university:
- Offer Essential Health Benefits
- Provide preventive care services at no cost to you
- Provide a minimum level of coverage
- Have no lifetime dollar caps on coverage
- Can include dependents up to age 26
You can find information on preventive care services at healthcare.gov
If you can afford insurance but decide not to have coverage, you may pay a fine. In 2018, the fine was 2.5% of your yearly family income, up to a set maximum. The maximum penalty for 2018 was $695 per person or $2,085 per family; the penalty has been waived since 2019.
While the majority of people will get health insurance through work, there are options for those who don’t have employer-sponsored coverage. Individuals can go online to healthcare.gov to learn about the Individual Marketplace.
At the Marketplace, individuals can compare insurance plans and enroll in the plans that best meets their needs. Some individuals may be eligible for tax credits or subsidies to reduce premiums and out-of-pocket costs. The amounts depend on income and family size. These financial aids are only available when insurance is purchased through the Marketplace.
Case Western Reserve University is committed to making sure you understand the implications of Health Care Reform. If you have questions on how these changes may impact you or your family, please contact the HR Service Center at 216.368.6964 or AskHR@case.edu.