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Medical, Prescription, Dental and Vision

Medical, Prescription, Dental and Vision

Medical Plans

Information on Medical Plans

View a summary comparison of the medical plan options here.

How much do the Health Plans cost?

Employee contributions for medical and dental coverage are deducted from the first two paychecks each month and go towards insurance costs for the following month. The cost of coverage is based on average hours worked per week. Employees working 30 or more hours per week have a lower cost than those working less than 30 hours per week. Average hours worked are monitored quarterly throughout the year, and premium tier levels may change for part-time employees, based on actual hours worked. View the cost of the health plans here.

Blue Cross of Idaho

Boise State offers three medical plan options for eligible faculty and staff, administered by Blue Cross of Idaho: Traditional, PPO, and High Deductible. The faculty or staff member may enroll themselves, spouse and children, up to age 26.

Each plan provides comprehensive medical and prescription drug coverage, with different levels of out of pocket expense and premium costs. Vision and Employee Assistance Plan benefits are included with medical plan enrollment. Deductibles and annual benefit maximums for all plans are applied on the fiscal year, effective July 1 through June 30.

Traditional Plan

This medical plan option features traditional insurance coverage, providing payment of 80% of the Allowable Charges for most covered expenses, after an annual deductible.  This plan does not require the use of In-Network providers, however use of Blue Cross participating providers may have lower out of pocket expenses.

PPO Plan 

The PPO provides for In-Network and Out-of-Network benefits for most commonly provided services. After paying an annual deductible, the plan generally pays eighty-five percent (85%) of most Allowable Charges provided by an In-Network provider. In-Network Physician Office Visits (office exam only) require a $20 copayment and are not subject to the annual deductible. Eligible Out-of-Network services are subject to a separate deductible and are generally reimbursed at seventy percent (70%) of most Allowable Charges.

The PPO plan does not require declaration of a primary care physician or referrals, any provider is acceptable. However, there are financial benefits when using providers who belong to the Blue Cross of Idaho PPO network. To locate participating providers, refer to the Blue Cross of Idaho Online Provider directory.

High Deductible Plan

The High Deductible Plan requires payment of an annual deductible but allows the use of any provider. After the deductible has been met the plan generally pays seventy percent (70%) of most Allowable Charges. Using providers who belong to the Blue Cross of Idaho network of participating providers may lower out of pocket expenses.

Prescription Drug Plan

Blue Cross of Idaho – Blue Cross of Idaho Rx

Prescription drug coverage is included when enrolled in any of the above mentioned medical plans. Coverage provides retail prescription drug benefits through participating pharmacies. PPO and Traditional Plans offer the same pharmacy benefits.  The High Deductible plan requires the deductible to be met before reimbursing at 70% of allowable charges.

Prescription drug benefits are managed by Blue Cross of Idaho’s pharmacy benefit manager, Blue Cross of Idaho Rx.

For network pharmacy listings and more, visit: Blue Cross of Idaho

Prescription Drugs 30 Day Supply

In-network pharmacies: Co-payments
  • Tier 1 – Generic: $10 copayment
  • Tier 2 – Preferred Brand: $30 copayment
  • Tier 3 – Non-preferred Brand: $60 copayment
  • Tier 4 – Specialty: $100 copayment

For clarification, if the member requests a brand name drug when a generic is available, the member is responsible for the difference between the price of the generic drug and the brand name drug, regardless of the formulary or non-formulary status. A drug formulary listing can be found at the Blue Cross website at Prescription Drug Formulary Search

IngenioRx Mail Order Pharmacy is Available

Getting your ongoing prescription medication is even easier with the IngenioRx Mail Order Pharmacy. Have your maintenance medications (medications you take regularly for a long-term or chronic condition) delivered directly to you, with no additional cost- and you’ll even save money as well as time.

  • You can get a 90-day supply of your maintenance medication for 2 copays.
  • Temperature-sensitive items are shipped with ice packs in coolers and/or express delivery.

Get started by logging into your Blue Cross of Idaho member portal – select Prescription Drugs – Benefits and Coverage – Access Your Pharmacy Benefits Now.

Non-Network Pharmacies

$25 co-payment plus 20% of balance

Dental Plan

Blue Cross Dental

Boise State employees enrolled in one of the State’s medical plans will receive automatic dental coverage through Blue Cross of Idaho Dental. Additional coverage for eligible family members must be elected. NOTE: Dental coverage is available onlyto those enrolled in a State employee medical plan.

How much do the Dental Health Plans Cost?

Employee contributions for medical and dental coverage are deducted from each of the first two paychecks each month, to pay for insurance for the following month. Cost of coverage is based on average hours worked per week; those working 30 or more hours per week have a lower cost than those working less than 30 hours per week. Average hours worked are monitored quarterly throughout the year, and premium tier levels may change for part-time employees, based on actual hours worked.

View the cost of the health plans here.

How does the Blue Cross Dental Plan Work?

With this plan you can use any provider you want — but you may save money when you use providers who belong to the Blue Cross of Idaho network of participating dental providers.

Blue Cross of Idaho Dental BenefitsBCI Out-of-NetworkBCI In-Network
Deductible (Per Person)$50 for non-preventative$50 for non-preventative
Preventive & Diagnostic:
Exams and cleanings, x-rays (twice a year)
100%100%
Basic: Fillings70%80%
Basic: Root Canals, Extractions, Periodontics50%80%
Major Services:
Crowns, Crown Build-ups, Bridges, Dentures
50%50%
Annual Maximum Benefit:$1500$1500
Waiting Period for Major Services:12 Months12 Months
Child Orthodontic Services:50%50%
Orthodontic Lifetime Max:$1000$1000
Waiting Period for Orthodontic Services:12 Months12 Months

*All preventative services will be covered at 100%. Deductible for non-preventative services is $50.00

To locate participating providers, refer to the Blue Cross of Idaho participating provider directory located at Blue Cross of Idaho.

Declining Dependent Dental

Employees can decline dental coverage for their dependents at any time by selecting  -Self Only- in the Dental Enrollment section of the medical/dental enrollment form. Once declined, dependent dental coverage may only be added at the next annual open enrollment period.

Vision Plan

Vision Service Plan (VSP)

State of Idaho Vision Plan (pdf)

Find a VSP doctor

Your coverage with a VSP in-network provider

VSP® Choice Plan – Adults and dependents 19 years of age and older

Benefit Description Copay
WellVision® Exam Focuses on your eyes and overall wellness
Every 12 months
$20
Prescription Glasses $20
Frame $130 allowance for a wide selection of frames
$150 allowance for featured frame brands
20% savings on the amount over your allowance
$70 Walmart/Sam’s Club/Costco® frame allowance
Every 24 months
Included in Prescription Glasses
Lenses Single vision, lined bifocal and lined trifocal lenses
Impact-resistant lenses for dependent children
Every 12 months
Included in Prescription Glasses
Lens Enhancements Standard progressive lenses
Premium progressive lenses
Custom progressive lenses
Average savings of 20-25% on other lens enhancements
Every 12 months
$0
$95-$105
$150-$175
Contacts
(instead of glasses)
$130 allowance for contacts; copay does not apply
Contact lens exam (fitting and evaluation) Every 12 months
Up to $60
Out-of- Network Benefits Call Member Services for out-of-network details at 800-877-7195.
Extra Savings Get the most out of your benefits and greater savings with a VSP network doctor. Visit vsp.com/offers for information on additional savings and exclusive member extras available to VSP members.

Your coverage with a VSP in-network provider

VSP Elements Plan – Dependents younger than 19 years of age

Benefit Description Copay
WellVision® Exam Comprehensive WellVision Exam covered in full
Every 12 months
$0
Prescription Glasses $0
Frame Covered-in-full frames from the Otis & Piper Eyewear CollectionTM
Available only through a VSP doctor.
Not available at retail locations.

Every 12 months
Included in Prescription Glasses
Lenses Impact-resistant plastic or glass lenses covered in full.
Single vision, lined bifocal, lined trifocal, or lenticular lenses covered in full.
Every 12 months
Included in Prescription Glasses
Lens Enhancements The following lens enhancements are covered in full:
  • Scratch-resistant coating

  • Ultraviolet coating

Every 12 months
Additional lens enhancements, covered after copay, save members an average 20 – 25%
Contacts (instead of glasses) Contact lens exam (fitting and evaluation):
  • Standard and premium fits are covered in full

Materials:
Prescription contact lenses covered with a minimum three-month supply for any of the following modalities:
  • Standard (one pair annually)
  • Monthly (six-month supply)
  • Bi-weekly (three-month supply)
  • Dailies (three-month supply)
  • Contact lenses are in lieu of frame and lenses

Every 12 months
$0
Out-of- Network Benefits No retail or out-of-network benefit available.
Extra Savings Get the most out of your benefits and greater savings with a VSP network doctor. Visit vsp.com/offers for information on additional savings and exclusive member extras available to VSP members.

Participating Vision Providers

Eligible members are not required to use In-Network providers, however, using a provider who belongs to the State VSP plan network may result in lower expenses.  Most benefits are paid based on Allowable Charges, meaning the provider will accept plan benefits plus your share (any deductible, coinsurance or co-payments) of the costs as payment in full.

Non-participating Providers may charge more than the plan’s Allowable Charges, leaving the insurance member responsible for any amounts exceeding the Allowable charges plus any deductible and coinsurance amounts. An exception may be made non-participating provider is used for an emergency or because a non-participating provider is the only source of services.

To find Participating Vision Providers, please contact Vision Service Plan, 1-800-877-7195 or go online http://www.vsp.com Go to “Members” and select “Find a VSP Doctor.” A login will be required.

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