Each employee's needs are different — that's why Duke offers four different medical plans to meet the needs of you and your family:

• Duke Select HMO
• Duke Basic HMO
• Blue Care HMO
• Duke Options PPO

Each medical care plan covers both pharmacy and behavioral health benefits. Please refer to the Medical Plans Comparison Chart for details. All of our medical plans will cover pre-existing conditions for covered services.

Important Updates to Your Health Coverage

• At-home COVID-19 test kits are covered under your Express Scripts pharmacy benefit when an approved test kit is purchased. Express Scripts members may receive up to 8 FDA-approved tests every 30 days at no charge when these tests are purchased at a participating retail pharmacy or ordered through Express Scripts' mail order benefit. When you purchase approved test kits at a retail location, present your Express Scripts pharmacy ID card at the pharmacy counter in order to have the kits covered through insurance. If you purchased test kits on or after January 15, 2022, you may submit your itemized pharmacy receipt to Express Scripts by using the Pharmacy Claim Form and the kits will be processed for reimbursement. Contact Express Scripts at (800) 717-6575 for assistance in submitting claims or using the mail order feature. At-home test kits that were purchased using funds from your HealthEquity Health Care Reimbursement Account are ineligible for reimbursement.
• Individuals may also order FDA-approved at-home COVID-19 test kits through the site www.COVIDTESTS.gov and search for vaccine location sites by zip code here.
• Beginning April 1, Duke Select and Duke Basic members will receive a new digital ID card that contains additional information about plan deductibles and out-of-pocket information. These ID cards will be accessible through the member portal at www.aetna.com. Any members who have an enrollment change due to a qualifying life event, experience a name change, or request a new ID card after March 19, 2022 will receive a newly redesigned ID card.

Health Insurance Coverage for Virtual Visits

Effective through December 31, 2022, a virtual office visit with your regular healthcare provider is covered under your health plan, subject to your regular copay. This includes virtual office visits with your behavioral health provider.

Need to Find a Provider?

An online directory of participating medical providers for all medical plans is available here.

Enrolling/Making Changes

Employees have 30 days from the date of a qualifying life event or 30 days after their hire date to enroll or make changes to their health, dental, vision, and reimbursement accounts.

Remember:

Your child does not have to meet IRS definitions of a dependent to be eligible for coverage for medical, dental and vision benefits. Because of national health care reform, Duke offers coverage for children under age 26 for medical, dental and vision benefits regardless of their student status or their marital status. If your covered child lives outside your home, consider which plans offer coverage in that area.

Health Management Programs

Duke supports you and your family in practicing prevention through a broad range of health management programs that emphasize a proactive approach to improving health and preventing disease before it happens.

For Employees Who Travel Internationally on Duke Business

Duke provides supplemental health insurance at no additional cost for full-time, benefits-eligible employees traveling internationally for a period of time not to exceed six months on Duke business. You must have health insurance from Duke or another company in order to be eligible for this coverage.

This coverage, called Cigna Medical Benefits Abroad (MBA), offers eligible employees and their spouses or registered same-sex partners and dependents up to age 26 who are traveling with them, supplemental medical insurance coverage for unexpected injuries and illnesses while traveling abroad on Duke business. This coverage supplements Duke's regular health insurance plan or the employee's other health insurance coverage. The coverage also includes up to seven days of personal travel when taken in conjunction with a covered business trip.

For more information, including coverage limits and eligibility requirements, visit the Medical Benefits Abroad website.

Tobacco Use Surcharge (Fee)

Duke charges employees covered under a Duke medical insurance plan who smoke or use other forms of tobacco an extra $50 a month. The surcharge does not apply to dependents who use tobacco.

A "tobacco user" includes anyone who has used tobacco more than five times in the previous two months. Tobacco use includes smoking and use of snuff, e-cigarettes, or chewing tobacco. The use of a nicotine patch and nicotine gum not subject to the surcharge.

The monthly surcharge will be removed upon completion of a tobacco cessation program through LIVE FOR LIFE, Duke's employee wellness program. If you think you might be unable to complete the program, you may request to complete an alternative program or meet an alternative standard. Completion of an alternative activity may allow you to avoid the surcharge. Contact us at (919) 684-5600 and we will work with you (and, if you wish, with your doctor) to find the best method for achieving your best health.

Visit the Tobacco Cessation website for more information.