What is a primary care physician and what is a specialist?
I understand that there is a 60-day waiting period for the employer contribution for medical insurance coverage for new faculty. Would there be a waiting period for my wife and stepchildren after the wedding?
If I'm a graduate student, do I have to enroll in the Graduate Student Health Plan to have health coverage?
Does the Graduate Student Health Plan's repatriation benefit meet the visa requirements for foreign nationals?
My doctor has prescribed a particular medicine for me, but my health plan says it’s not on the plan’s formulary. What does that mean?
If I'm an A&M Care plan participant, can I get prescriptions filled at my favorite pharmacy?
What happens if I use an out-of-network pharmacy?
Under the A&M Care plan, how do I determine whether to have my prescriptions filled at my local pharmacy or the mail-order pharmacy?
If Medicare is primary, do I have to use network doctors and hospitals?
If I have Medicare as my primary carrier, do I have to precertify with BlueCross BlueShield?
If my doctor submits evidence that I must have a drug not on the formulary list for medical reasons, can I get the nonformulary drug by paying the formulary copayment?
Under the A&M Care plans, how long will it take to get prescriptions filled through the mail-order program?
What is a formulary list?
How will I know if my prescription will be filled with a brand-name or a generic medication?
Under the A&M Care plans, I understand some medications may be limited or require prior authorization. Which drugs are these?
Why don’t retirees eligible for Medicare have to use network providers?
If I choose not to enroll in Medicare, will my benefits be paid the same way as an active employee’s are paid?
I turned 65 this year. Does that mean I should enroll in 65 PLUS?
If I buy a brand-name drug, do I just pay the formulary or nonformulary copayment?
Can I add or drop dependents from my health plan during the plan year?
- Employee’s marriage, divorce or death of employee’s spouse
- Birth, adoption or death of a dependent child
- Child becoming ineligible for coverage due to reaching age 25 or marrying (age 26 for health coverage)
- Change in employee’s, spouse’s or dependent child’s employment status that affects eligibility for coverage
- Change in employee’s, spouse’s or dependent child’s residence that affects eligibility for coverage
- Employee’s receipt of a qualified medical child support order or letter from the Attorney General ordering the employee to provide (or allowing the employee to drop) medical coverage for a child
- Changes made by a spouse or a dependent child during his/her employer’s annual enrollment period
- The employee, spouse or dependent child becoming eligible or ineligible for Medicare or Medicaid
- The employee/retiree or dependent child loses coverage under the State Medicaid or Child Health Plan or becomes eligible for premium assistance under the Medicaid or Child Health Plan.
- Significant employer-initiated or carrier-initiated changes in or cancellation of the employee’s, spouse’s or dependent child’s coverage
- Change in day care cost due to a change in provider, change in provider’s fees (if the provider is not a relative) or change in number of hours the child needs care (for Dependent Day Care Spending Accounts)
A court order against the spouse of an A&M System employee does not constitute a Change in Status. Also, a change in income, which may affect coverage affordability, does not constitute a Change in Status.