The university offers three types of medical coverage: a
Consumer Driven Health Plan (CDHP), a
Preferred Provider Organization (PPO) and a
Health Maintenance Organization (HMO). Each of these plans provides comprehensive medical and prescription drug coverage.
COVID-19 Test Coverage
OTC COVID-19 Test Coverage by HMO, PPO, and CDHP Plans
DePaul’s medical plan pharmacy benefits, which are provided through BCBSIL/Prime Therapeutics, cover FDA-authorized over-the-counter diagnostic tests for COVID-19. Per federal guidance, this coverage began Jan. 15, 2022, and is effective through the end of the federal public health emergency.
For employees enrolled in DePaul's HMO, PPO, or CDHP plan, you will be reimbursed up to $12 per test, up to 8 tests every 30 days per person. (For example, you can purchase 4 boxes that include 2 over-the-counter COVID-19 tests.) Tests must be FDA-authorized. If you aren’t sure if a test kit is FDA-authorized, ask your pharmacist for help.
You can go to a
Prime network pharmacy and purchase tests at the store’s pharmacy counter. The pharmacy should process the test through your pharmacy insurance at no cost to you. If you have to pay out of pocket for the test, you can file a claim to receive reimbursement for up to $12 per test. Click here for the
reimbursement request form and instructions.
COVID-19 Test Coverage through MDLIVE for PPO and CDHP Plans
Employees enrolled in DePaul's PPO or CDHP plan who obtain a virtual care visit through MDLIVE also have access to COVID-19 testing. If their MDLIVE provider deems that a test is medically appropriate upon completion of a virtual care visit, the MDLIVE provider will order a test. Find details here about COVID-19 testing through MDLIVE.
Get Your Annual Flu Shot and Wellness Check
How to Get Your Flu Shot
Here are the options on how employees who are enrolled in DePaul’s health plans can obtain a flu shot this year.
For PPO/CDHP DePaul plan members, flu shots can be obtained through:
- PPO providers will cover flu shots at 100%, no cost to the member out of pocket;
- CVS/Walgreens clinic and the claim will be processed like a medical visit, under wellness benefits at 100%, no cost to the member out of pocket;
- A pharmacy offering flu shots (for example, Mariano’s or Jewel-Osco) and the claim will process under the pharmacy benefit as a claim for a vaccine at 100%, no cost to the member out of pocket.
For HMO DePaul plan members, flu shots will need to be obtained from their PCP or medical group. The medical group manages all the care for members, so they are required to work with their PCP to determine where they can get their flu shot.
How to Get Your Annual Wellness Check
All DePaul health plan members are encouraged to make an appointment with their primary care physician for an annual wellness check.
Consumer Driven Health Plan (CDHP)
The Consumer Driven Health Plan (CDHP) combines a High Deductible Health Plan (HDHP) with a
Health Savings Account (HSA) that allows pre-tax contributions to be set aside in an interest-bearing account to cover eligible medical, dental and vision expenses, as well as future health care premiums, such as those required for COBRA and retiree medical. The HSA is partially funded by the university, with the option for employees to contribute additional pre-tax funds.
This plan includes a network of hospitals and physicians that have agreed to accept a scheduled, discounted rate for their services. Participants may choose to visit any health care provider included in the network without a referral, and charges will be paid up to 80 percent of the scheduled amount after satisfying the annual deductible. Wellness care is covered at 100 percent for adults and children.
When using providers who are out-of-network, charges are paid up to 60 percent after the annual out-of-network deductible is satisfied. Out-of-network charges are paid in accordance with the Medicare reimbursement rate for service. Charges above the Medicare rate are not covered.
For CDHP plan details, visit the Health Benefits page.
Preferred Provider Organization (PPO)
The PPO plan features a network of hospitals and physicians that have agreed to accept a scheduled, discounted rate for their services. Participants may choose to visit any health care provider included in the PPO network without a referral; charges will be paid at 80 percent of the scheduled amount after satisfying the annual deductible. Routine office visits are covered at 100 percent after a $30 co-pay for a primary care physician or a $50 co-pay for a specialist. Other procedures undertaken during the office visit may be subject to the deductible and co-insurance. Wellness care is covered at 100 percent for adults and children. When using providers who are not in the network, charges are paid at 60 percent after the annual out-of-network deductible is satisfied. Out-of-network charges are paid in accordance with the Medicare reimbursement rate for service. Charges above the Medicare rate are not covered.
For PPO plan details, visit the Health Benefits page.
Health Maintenance Organization (HMO)
The HMO plan provides a wide range of comprehensive health care services, including regular physicals and check-ups. Office visit co-pays are set at $30 for a primary care physician and $50 for a specialist. Most other services are covered at 100 percent. To receive coverage under the HMO, participants must use the doctors, hospitals and other health care providers within the HMO network, and must have their care coordinated by a primary care physician.
For HMO plan details, visit the Health Benefits page.
Pharmacy Benefits
The following provides information about pharmacy benefits.
Vendor Contact Information
BlueCross BlueShield of Illinois
BlueEdge CDHP Group #000130
PPO Group #P00055
Blue Cross Blue Shield of Illinois
P.O. Box 805107
Chicago, IL 60680-4112
(800) 458-6024
BlueCross BlueShield of Illinois HMO
Group #H55881
P.O. Box 805107
Chicago, IL 60680-4112
(800) 892-2803