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MSU Human Resources >> Benefits >> Healthcare >> MSU Non-Medicare Health Plan with Prescription Drug Coverage


MSU Non-medicare plan with

prescription drug coverage

Who is Eligible

Eligible Population Health Plan Administered by    Network  
MSU retirees eligible for Medicare (age 65+)  MSU Medicare Advantage Plan   Humana Humana
MSU retirees not yet eligible for Medicare (age 64 and under) MSU Non-Medicare Plan  Personify Health Aetna
MSU retiree dependents eligible for Medicare MSU Medicare Advantage Plan Humana Humana 
MSU retiree dependents not yet eligible for Medicare MSU Non-Medicare Plan Personify Health Aetna

MSU employees not actively working due to

workers' compensation, long-term disability or other reasons that are eligible for Medicare and their associated dependents   

MSU Medicare Advantage Plan Humana Humana
MSU active employees with End Stage Renal Disease (ESRD) who have been enrolled in Medicare for longer than 30 months MSU Medicare Advantage Plan Humana Humana

 

Medical Coverage:

The MSU Non-Medicare Plan is administered by Personify Health and utilizes the Aetna provider network for medical and RxBenefits partnering with CVS Caremark for prescription drug coverage for the 2025 plan year.

The plan covers in-network preventative services at 100%.  The majority of the in-network diagnostic services are covered at 100% of the approved amount after either the required co-pay or annual deductible of $100 for single and $200 for family for the 2025 plan year.  Select in-network services are covered at 50%-90% of the approved amount after the required in-network annual deductible, however, not all services are subject to the deductible.  Participants should refer to the type of service for benefit details.  The annual out-of-pocket maximum for the 2025 plan year, which consists of applicable deductible and co-insurance, is $3,000 for single and $6,000 for family, per calendar year.

The plan also covers out-of-network services.  Preventive and diagnostic services are covered at 90% of the approved amount after the required out-of-network annual deductible of $500 for single and $1,000 for family for the 2025 plan year.  Select out-of-network services are covered at 50% of the approved amount after the required out-of-network annual deductible.  Participants should refer to the type of service for benefit details.  Participants may be responsible for the amount that exceeds the approved amount in addition to their deductible or co-insurance.  The annual out-of-network, out-of-pocket maximum for the 2025 plan year, which consists of applicable co-insurance only, is $3,000 for single and $6,000 for family, per calendar year, for medical services.

  • You will have access to Aetna's large network of physicians.
  • You are not required to have a referral to see any provider.

Prescription Drug Coverage:

Prescription drug coverage is included in this plan. The table below shows co-pay rates for various types of prescription drugs.

Prescription Plan Co-Pays for the MSU Non-Medicare Plan
# Drug Tier 30-Day Supply Co-Pay at Retail 90-Day Supply Co-Pay at Retail 90-Day Supply Co-Pay at Mail Order or MSU Pharmacy
1. Generic Medications3 $10 $30 $20
2. Preferred Brand-Name Medications $30 $90 $60
3. Non-Preferred Brand-Name Medications $60 $180 $120
4. Specialty Drugs $75 N/A4 N/A4
Annual Out-of-Pocket Co-Pay Maximum: $1,000 / Individual AND $2,000 / Family
3Some generics may be on higher tiers.
4Specialty medications limited to a 30-day supply.

Performance Drug List - Standard Control for Clients with Advanced Control Specialty Formulary

Additional Information and Resources

Visit the Personify Health website for plan information.

Enrollment Materials

In addition, eligible participants will receive an Enrollment Kit from Personify Health with further details and instructions.

Frequently Asked Questions (FAQs)

View a list of FAQs here.

Contact Information

If you have questions regarding eligibility and enrollment, please contact the HR Solutions Center at 517-353-4434, 800-353-4434 or emailSolutionsCenter@hr.msu.edu.

If you have questions about plan coverage, please contact Personify Health at 800-273-2509, option #2.

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