COVID-19: Important Health & Prescription Drug Coverage Information

BCBS:  Member Costs are Waived for COVID-19 Testing and Care

For both BU Health Plans – the BCBS PPO and the BU Health Savings Plan – co-pays, co-insurance, and deductibles will be waived for testing, counseling, vaccination (once available), and other COVID-19 care provided at doctors’ offices, emergency rooms, and urgent care centers for all covered members. Inpatient care is covered retroactive to March 6, 2020.

BCBS:  Dedicated Coronavirus Helpline (1-888-372-1970) and Resource Center

BCBS has introduced a new Helpline that is available to answer any questions from members about benefits, providers, and share other resources related to COVID-19.  Blue Cross Blue Shield has also established a regularly updated resource center that includes information about how to stay safe, a downloadable tip sheet, a video featuring one of their physicians, and an FAQ.

BCBS: Telehealth Available Starting Monday, March 16 – updated 6/1/2020

Effective Monday, March 16, telehealth will be covered under both BU Health Plans.  This allows covered members to receive care from licensed doctors and providers in the BCBS Well Connection network.  Learn more here.

  • Effective June 1, 2020, American Well’s national network of psychiatrists are available by appointment on Well Connection. This is in addition to the behavioral health therapists that are already accessible.

BCBS: BU Physical Therapy @ The Ryan Center via Telehealth

The Boston University Physical Therapy Center has transitioned to a fully online telehealth mode of care. Member costs are waived for BU Health Plan members.

BU Dental Plans: Benefit Enhancement – effective 6/1/2020

As of June 1, 2020, both BU Dental Health Plans allow routine cleanings, periodic exams, and fluoride treatment twice in a calendar year, without the need  for a 6-month wait period between appointments.

OptumRx: One-Time Access to Out-of Network Pharmacy – effective 4/13/2020

OptumRx will allow access to an out-of-network pharmacy upon pharmacy request when:

  • an out-of-network pharmacy has stock of a covered prescription medication that is in short supply at a network pharmacy,
  • an out-of-network pharmacy is in closer proximity than a network pharmacy to a member’s residence, as reported by the member, or
  • an out-of-network pharmacy has capability to mail/deliver to the member’s home that is not provided by a network pharmacy.

This access will remain in effect for 90 days from the date of implementation and re-evaluated for extension thereafter (2nd week of July).  Specialty networks are not included in this policy.

OptumRx:  Early Refill for Prescription Medications – updated 6/25/2020

OptumRx will allow covered members to receive one early refill per medication if those members have refills remaining on file at a participating retail or mail-order pharmacy. The refill obtained will stay consistent with the standard days’ supply previously filled by the member. OptumRx is extending this Refill Too Soon policy beyond the original expiration date of June 30th an additional 90 days until September 30th.

OptumRx:  Prior Authorization (PA) Extension Expires May 1- updated 4/21/2020

After rigorous review of regulatory guidance, available reporting and curated feedback from the field, OptumRx made the decision not to extend the prior authorization policy. This policy will expire next Friday, May 1, meaning any prior authorizations requiring renewal starting May 2, will follow the standard process. At this time, there are no plans to extend the policy past that date. OptumRx will continue to monitor activity and adjust as deemed appropriate.

OptumRx: Specialty Medications Extended Supply Distribution

During the COVID-19 outbreak, when a patient calls to refill their specialty medication, Optum Specialty Pharmacy will offer patients a one-time, 90-day supply of key chronic specialty medications. This policy will go into effect Monday,  March 23, 2020.

FSA Health Care:  Revised Reimbursement Rules for Over-the-Counter Drug Costs

Over-the counter drugs not prescribed by a physician can now be submitted for reimbursement on the FSA Health Care. This change takes effect for expenses incurred on or after January 1, 2020.

FSA Dependent Care: Childcare changes allow Life or Career Event

As the availability and need for childcare changes during the COVID-19 crisis, you may have an opportunity to change your current enrollment in this account through a Life or Career Event.

The following scenarios qualify as a Life or Career Event allowing you to request a change mid-year:

  • If childcare is closed or otherwise no longer available, you may reduce or discontinue contributions
  • When your childcare re-opens and becomes available again, you may re-enroll or recommence contributions
  • If you have a qualified dependent previously in school that is now in need of qualified childcare due to school closures, you may enroll in this account.  You may also reduce or discontinue contributions when the childcare is no longer necessary due to the re-opening of schools

Life or Career Events must be submitted within 30 days of the event and include supporting documentation. If you would like to request a change, please visit the BU Benefits Center and Select Manage my Benefits – Life or Career Events.