Skip to main content
  • Duke@Work
  • About HR
  • Managers
Home

Human Resources

Search form

  • Careers
    • Search/Apply for Jobs
    • Frequently Asked Questions
    • Duke Temporary Service (DTS)
    • About Duke
    • Job Descriptions
    • Affirmative Action & Nondiscrimination
  • Benefits
    • Medical, Dental, & Vision Benefits
    • Reimbursement Accounts
    • Employee Discounts
    • Retirement Plans
    • Time Away From Duke
    • Educational Benefits
    • Family-Friendly Benefits
    • Financial Security Benefits
    • Benefits Unique to Duke
    • Employee Appreciation
    • Benefits Enrollment
    • Summary Plan Descriptions & Required Notices
  • Health & Wellness
    • Get Moving Challenge
    • LIVE FOR LIFE
    • Health Assessments
    • Farmers Market
    • Mobile Farmers Market
    • Duke Fitness Club
    • Run/Walk Club
    • Exercise & Fitness
    • Mental Health & Stress
    • Webinars
    • Personal Assistance Service (PAS)
    • Health Coaching Programs
    • Nutrition Programs
    • Tobacco Cessation
    • DukeWELL
    • Employee Occupational Health & Wellness (EOHW)
    • Workers' Compensation
  • Compensation
    • Pay Statements
    • Pay Schedules & Forms
    • Pay Ranges & Job Classifications
    • Overtime Changes
  • Training
    • Learning Management System
    • Professional Development Course Offerings
    • Special Development Programs
    • Career Resource Center
    • Consulting & Organization Development
    • Location & Facilities
  • Policies
    • Recruitment, Hiring, & Transferring
    • Diversity & Institutional Equity
    • Workplace Expectations & Guidelines
    • Staff Development
    • Benefits
    • Pay Administration
    • Payroll
    • Time Away From Duke
    • Workplace Health & Safety
    • International
    • Definitions
  • Forms
    • Benefits Forms
    • Manager Forms

You are here

  • Home
  • Benefits
  • Medical, Dental, & Vision Benefits
  • Required Notices

Required Notices

  1. Designation of Primary Care Provider
  2. Newborns' and Mothers' Health Protection Act
  3. Mastectomy Benefits
  4. Loss of Medicaid or CHIP Eligibility

1. Designation of Primary Care Provider

You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact Duke Human Resources at 919- 684-5600. For children, you may designate a pediatrician as the primary care provider.

You do not need prior authorization from Duke Health Plans or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact Duke Human Resources at 919-684-5600.

2. Newborns’ and Mothers’ Health Protection Act

Under federal law, group health plans and health insurance issuers offering group health insurance coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your doctor, nurse midwife or physician assistant), after consultation with the mother, discharges the mother or newborn earlier.

Also, under federal law, group health plans and health insurance issuers may not set the level of benefits or out-of-pocket costs so that any later portion of the 48- hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay.

In addition, a plan or issuer may not, under federal law, require that a doctor or other health care provider obtain certification for prescribing a length of stay of up to 48 hours (or 96 hours). However, to use certain providers or facilities, or to reduce your out-of-pocket costs, you may be required to obtain certification.

3. Mastectomy Benefits

In accordance with the Women’s Health and Cancer Rights Act of 1998, the Duke Health Plans provide for the following services related to mastectomy surgery:

  • Reconstruction of the breast on which the mastectomy has been performed
  • Surgery and reconstruction of the nondiseased breast to produce a symmetrical appearance without regard to the lapse of time between the mastectomy and the reconstructive surgery
  • Prostheses and physical complications of all stages of the mastectomy, including lymphedemas.

The benefits described above are subject to the same co-payment or coinsurance and limitations as applied to other medical and surgical benefits provided by Duke Health Plans.

4. Medicaid and the Children’s Health Insurance Program (CHIP)

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of April 16, 2010. You should contact your State for further information on eligibility.

ALABAMA – Medicaid
Phone: 1-800-362-1504

ALASKA – Medicaid
Phone (Outside of Anchorage): 1-888-318-8890
Phone (Anchorage): 907-269-6529

ARIZONA – CHIP
Phone: 1-877-764-5437

ARKANSAS – CHIP
Phone: 1-888-474-8275

CALIFORNIA – Medicaid
Phone: 1-866-298-8443

COLORADO – Medicaid and CHIP
Medicaid Phone: 1-800-866-3513
CHIP
CHIP Phone: 303-866-3243

FLORIDA – Medicaid
Phone: 1-866-762-2237

GEORGIA – Medicaid
Click on Programs, then Medicaid
Phone: 1-800-869-1150

IDAHO – Medicaid and CHIP
Medicaid
Medicaid Phone: 1-800-926-2588
CHIP
CHIP Phone: 1-800-926-2588

INDIANA – Medicaid
Phone: 1-877-438-4479

IOWA – Medicaid
Phone: 1-888-346-9562

KANSAS – Medicaid
Phone: 800-766-9012

KENTUCKY – Medicaid
Phone: 1-800-635-2570

LOUISIANA – Medicaid
Phone: 1-888-342-6207

MAINE – Medicaid
Phone: 1-800-321-5557

MASSACHUSETTS – Medicaid and CHIP
Medicaid & CHIP Phone: 1-800-462-1120

MINNESOTA – Medicaid
Click on Health Care, then Medical Assistance
Phone: 800-657-3739

MISSOURI – Medicaid
Phone: 573-751-6944

MONTANA – Medicaid
Phone: 1-800-694-3084

NEBRASKA – Medicaid
Phone: 1-877-255-3092

NEVADA – Medicaid and CHIP
Medicaid
Phone: 1-800-992-0900;
CHIP
Phone: 1-877-543-7669

NEW HAMPSHIRE – Medicaid
Phone: 1-800-852-3345 x 5254

NEW JERSEY – Medicaid and CHIP
Medicaid
Medicaid Phone: 1-800-356-1561;
CHIP
CHIP Phone: 1-800-701-0710

NEW MEXICO – Medicaid and CHIP
Medicaid
Medicaid Phone: 1-888-997-2583;
CHIP
Click on Insure New Mexico
CHIP Phone: 1-888-997-2583

NEW YORK – Medicaid
Phone: 1-800-541-2831

NORTH CAROLINA – Medicaid
Phone: 919-855-4100

NORTH DAKOTA – Medicaid
Phone: 1-800-755-2604

OKLAHOMA – Medicaid
Phone: 1-888-365-3742

OREGON – Medicaid and CHIP
Phone: 1-877-314-5678

PENNSYLVANIA – Medicaid
Phone: 1-800-644-7730

RHODE ISLAND – Medicaid
Phone: 401-462-5300

SOUTH CAROLINA – Medicaid
Phone: 1-888-549-0820

TEXAS – Medicaid
Phone: 1-800-440-0493

UTAH – Medicaid
Phone: 1-866-435-7414

VERMONT– Medicaid
Phone: 1-800-250-8427

VIRGINIA – Medicaid and CHIP
Medicaid
Phone: 1-800-432-5924
CHIP
CHIP Phone: 1-866-873-2647

WASHINGTON – Medicaid
Phone: 1-877-543-7669

WEST VIRGINIA – Medicaid
Phone: 304-342-1604

WISCONSIN – Medicaid
Phone: 1-800-362-3002

WYOMING – Medicaid
Phone: 307-777-7531

To see if any more States have added a premium assistance program since April 16, 2010, or for more information on special enrollment rights, you can contact either the U.S. Department of Labor Employee Benefits Security Administration at www.dol.gov/ebsa (1-866-444-3272) or the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services at www.cms.hhs.gov (1-877-267-2323, ext. 61565).

Benefits

  • Medical, Dental, & Vision Benefits
    • Medical Insurance
      • Plan Comparison (2022)
      • Premiums (2022)
      • HMO Plans
      • PPO Plans
      • Medical Benefits Abroad
      • Retiree Health Insurance
        • Duke Plus
        • Early Retiree Health Plans
      • Health Management Programs
      • Infertility Benefits
      • Bariatric Surgery
      • 1095-C Tax Form
    • Dental Insurance
      • Plan Comparison (2022)
      • Premiums (2022)
    • Vision Insurance
      • Plan Chart (2022)
      • Premiums (2022)
      • How to Use the Plan
    • Pharmacy Benefits
      • Covered Drugs
      • Frequently Asked Questions
      • Retail Pharmacy Vaccinations
    • Behavioral Health and Substance Abuse Benefits
      • Providers
      • Treatment of Autism Spectrum Disorder
    • Enroll/Make Changes
    • Coverage & Eligibility
    • Find a Network Provider
    • Privacy Practices
    • Required Notices
  • Reimbursement Accounts
    • Your Personal Account
    • Health Care Account
      • How to File a Claim
      • How to Manage Your Account
      • Health Care Card
      • Eligible & Ineligible Expenses
      • Orthodontia
      • IRS Rules
      • Frequently Asked Questions
      • IIAS-Compliant Merchants
    • Dependent Care Account
      • How to File a Claim
      • What's Covered?
      • Managing Your Account
    • How the Plan Works
    • EZ Receipts Mobile App
    • Appeal a Denied Claim
    • When Participation Ends
    • Legal Information
    • Changes for 2020 and 2021 Reimbursement Accounts
  • Employee Discounts
    • Vendor Registration Form
    • Vendor Information
  • Retirement Plans
    • Enroll or Make Changes
      • Enroll in Your Duke Retirement Plan
      • Making Changes
      • Roth 403(b) Contributions
      • Vesting of Duke's Contribution
      • Transfer Funds
      • Request a Withdrawal or Loan
        • CARES Act Distributions and Loans
    • About Duke's Plans
      • Employees' Retirement Plan (Non-Exempt)
      • Faculty/Staff Retirement Plan (Non-Exempt)
      • Faculty/Staff Retirement Plan (Exempt)
        • Duke's Contribution
        • Service Requirement Waiver
        • Suspension of the Duke Contribution FAQ
        • Restoration of the Duke Contribution FAQ
        • Additional Duke Contribution FAQ
      • 457(b) Deferred Compensation Plan
    • Tiered Investment Choices
      • Target Date Funds
      • Your Default Investment Options
      • Self-Directed Brokerage Account (BrokerageLink®)
      • TIAA Traditional Annuity
    • Investment Carriers
    • Investment Performance
    • Retirement Planning Guide
    • Frequently Asked Questions
    • Recent Fund Changes
    • Retirement Appointment Request
  • Time Away From Duke
    • Holidays, Vacation & Sick Time (University)
      • Holiday Schedule (2022)
      • Additional Days Off (Dec. 1, 2020 - Feb. 28, 2021)
    • Paid Time Off (DUHS)
      • How it Works
      • Time & Attendance
      • Swipe & Go
      • Policies
      • Banks
      • Frequently Asked Questions
      • Glossary
    • Leaves of Absence
      • University - Employee FMLA
      • University - Family FMLA
      • Health System Employee/Family FMLA
      • Care for Injured Service Member (FMLA)
      • Qualifying Exigency (FMLA)
      • Leaves of Absence: Effects on Benefits
    • Paid Parental Leave
      • Paid Parental Leave Changes - August 3, 2020
    • Kiel Memorial Vacation/PTO Donation Program
      • Donations
      • Recipients
      • Important Timelines
      • Payment Process
      • Frequently Asked Questions
    • Other Work Absences
  • Educational Benefits
    • Employee Tuition Assistance
      • Eligibility
      • How to Apply
      • Reimbursement
      • Departmental/Manager Responsibility
      • Frequently Asked Questions
    • Children's Tuition Grant
      • How to Apply
      • Employee Eligibility
      • Child Eligibility
      • Online Application for Participating Schools
    • Undergraduate Admissions Workshops
  • Family-Friendly Benefits
    • Lactation Support Services
    • Duke Child Care Partnership
    • Duke Children's Campus
      • Part Time Childcare Procedures
      • Wait Pool Registration
    • The Little School at Duke
      • Wait Pool Registration
    • Choosing Child Care
    • Child Care Tuition Subsidy
    • Flexible Work Options
      • Flextime
      • Compressed Work Schedules
      • Job Sharing
      • Abbreviated Schedule or Part-Time Work
      • 10- and 9-Month Arrangements
      • How to Introduce
      • Guidelines for Success
      • Frequently Asked Questions
  • Financial Security Benefits
    • Financial Fitness Resources
    • Plan Comparison
    • Disability Benefits
      • Duke Disability
        • Eligibility
        • When Am I Covered?
        • Filing for Benefits
        • Amount of Coverage
        • Benefits While Disabled
        • Frequently Asked Questions
      • Voluntary Disability
        • Short Term Disability
        • Long Term Disability
        • Choosing Coverage
        • Enrollment
        • Cost
        • How to File a Claim
        • Frequently Asked Questions
      • Department Manager & Payroll Representative Info
    • Life Insurance
      • Basic Life Insurance
      • Supplemental Life Insurance
        • Supplemental Life Insurance Rate Table
      • Personal Accident Insurance
        • Eligibility
        • Coverage
        • Benefits
      • Business Travel Assistance
        • Stateside Travel
        • Travel/Accident Insurance
      • Insurance Certificate
      • Post-Retirement Group Term Life Insurance
      • Survivor Benefit
      • Universal Life Insurance
      • Plan Information
      • Your ERISA Rights
    • Long Term Care Insurance
    • Property Insurance
    • Duke Credit Union
  • Benefits Unique to Duke
  • Employee Appreciation
    • Presidential Award
    • Career Service Awards
  • Benefits Enrollment
    • Open Enrollment 2022
      • What You Need To Know
      • Medical Plan
        • Plans Comparison
        • Premiums
        • Preventive Care
      • Dental Plan
        • Plan Comparison
        • Premiums
      • Vision Care
        • Plan Chart
        • Premiums
      • Pharmacy Benefits
      • Behavioral Health and Substance Abuse Benefits
      • Health Care Reimbursement Account
      • Dependent Care Reimbursement Account
      • Supplemental Life Insurance Special Enrollment
    • Information for 4th Quarter (Oct - Dec) New Hires
    • Contact a Plan Provider
    • When Can I Enroll?
    • Life Events Information
      • Getting Married
      • Getting Divorced
      • New Child
      • Death in the Family
      • Leaving Duke
        • COBRA Continuation Insurance
        • Eligibility for Retiree Health
        • Severance Overview
    • Same Sex Spousal Equivalent Information
      • Reimbursement Accounts
    • Benefits Payroll Deduction Schedule
  • Summary Plan Descriptions & Required Notices
    • Summary Annual Report for the Welfare & Fringe Benefits Plan
    • Summary Annual Report for Faculty/Staff Retirement Plan
    • Summary Annual Report for the Retiree Health Plan
    • Summary of Material Modification

Human Resources

Duke Human Resources
705 Broad St. Box 90496
Durham, NC 27705
Phone: (919) 684-5600
Have questions?

Follow Us
  • Facebook
  • Twitter
  • Linkedin
  • Youtube
Duke University
  • Duke University
  • Working@Duke