Health Insurance

COVID laboratory testing – Deductible & Coinsurance Apply 

As announced in Penn State Today, the U.S. Department of Health and Human Services (HHS) ended the public health emergency on May 11. Starting on June 1, 2023, any COVID-related testing is no longer covered at 100% and are subject to deductible and coinsurance under the Penn State medical plans. 
As a result of the end of the emergency declaration, several health insurance coverage and cost-share waivers have changed including:

• COVID-19 vaccines will remain covered through both of the Highmark Blue Shield plans at $0 cost share, when provided by an in-network provider as a preventive service. 
• Over-the-counter COVID-19 testing will be an eligible expense through a FSA or HSA, or an employee can pay out of pocket.  
• The federal government is providing four free at-home COVID-19 tests for every U.S. household through COVID.gov/tests. 

The services listed below will continue to be covered under the Penn State Highmark Blue Shield health care plans’ standard cost share amounts (copayments, deductibles, and coinsurance where applicable):    

• COVID-19 diagnostic and antibody testing 
• Related services to diagnose COVID-19 — office visit (in-person or telehealth), emergency room or urgent care
• Prescription antiviral treatment

Please discuss with your physician the financial impact of any COVID-19 testing that may be prescribed – certain tests can cost ~$1,500 or more, which will apply to your 2024 deductible that begins January 1, 2024.

Benefits-eligible employees can contact the Penn State Highmark concierge customer service team at 844-945-5509 with further questions. 

Health Plans

Penn State Health Plans are administered by Highmark. There are two health plan options for eligible employees to choose from; the Lion Traditional and the Lion Advantage HSA plans. 

Employees should visit our frequently asked questions for more details regarding this partnership.

The Highmark Concierge Team can be reached directly at 844-945-5509. If you are a current Penn State medical plan member, you may access your specific plan information via the Highmark microsite for Penn State. If you are not a current Penn State medical plan member, you may visit the main Highmark website for more information.

Lion Advantage HSA | Lion Traditional

Regular full-time faculty and staff members are eligible to enroll in Penn State’s Health Care Plan. For information about spouse and dependent children eligibility, please see Dependent Eligibility.

Part-time faculty and staff members can become eligible for medical coverage under the Affordable Care Act (ACA) regulations. There is a small group of part-time employee grandfathered under a former policy, for which additional details regarding this plan can be found within the health care premium comparison below. The same dependent eligibility outlined for full-time faculty and staff also applies for part-time faculty and staff.

Postdoctoral appointees: As per postdoctoral eligibility, the per-pay contribution rates follow the same salary-based premium schedule as for faculty and staff. For additional information regarding the benefits available to postdoctoral appointees, please contact or visit the Office of Postdoctoral Affairs. Please note that if you are a Postdoctoral Fellow, or a J1 Visa holder, you are only eligible for the Lion Traditional plan.

Postdoctoral SCHOLARS are ELIGIBLE for the Health Care and Dependent Care Flexible Spending Account (FSA). Postdoctoral FELLOWS are NOT ELIGIBLE for either Flexible Spending Account (FSA). When any Postdoctoral appointment is changing to a full-time Faculty, Staff, or Technical Service position, you will become newly eligible for an FSA. In order to enroll in an FSA after changing from a Postdoctoral appointment to a full-time Faculty, Staff, or Technical Service position, please submit a Workday benefit change request to "Change Flexible Spending" in addition to submitting your Job Change benefit elections.

If you or your dependents are no longer eligible for the health plans, information will be mailed from Lifetime Benefit Solutions regarding continuing coverage under COBRA. Additional information regarding COBRA benefits can be found on our COBRA website.

Becoming Medicare eligible (turning age 65) as an active employee or your spouse is becoming Medicare eligible:

As an active employee, your Penn State medical plan is considered primary for you and your eligible dependents; so as an active employee with Penn State group health coverage, there is no need to sign up for Medicare Parts A or B.

Part A is provided at no cost, so you can either enroll or decline Part A, but only if you are not currently enrolled or want to be enrolled in the future in the Lion Advantage HSA plan. Employees cannot be enrolled in Medicare Parts A or B, AND have pre-tax contributions to a Health Savings Account (HSA). Therefore, since Penn State automatically makes a pre-tax contribution annually to Lion Advantage HSA plan members' HSA, the employee cannot be enrolled in Medicare. Please note, your spouse could have Medicare, as this rule only applies to you, the employee.

Since there is a premium associated with Part B and it is secondary coverage, it may not make financial sense to pay for Part B. Please contact your local Social Security Office with any questions regarding Part B. Employees need to make the determination if it makes fiscal sense to enroll in Medicare as a secondary insurance.

Upon leaving employment/retirement, if you and/or your spouse are 65 plus, you will want to visit your local Social Security office three months prior to sign up for Medicare upon retirement.

Please be aware that if you are enrolled in the Lion Advantage HSA  plan, you must decline Parts A and B. Per IRS regulations, you, the employee, cannot be enrolled in Medicare Part A or B and be contributing to a Health Savings Account, which is automatically included with the Lion Advantage HSA plan; however you CAN insure your Medicare eligible dependent under the Lion Advantage HSA plan. It is important to note, upon turning 65, you are automatically enrolled in Part A if you are receiving Social Security benefits.

Dually-Employed at Penn State

Faculty/Staff or Postdoc: If you and your spouse are both employed at Penn State and are currently covered under one spouse’s medical plan, your coverage election must be made by the higher-paid spouse. It is important to note that while you may remain covered under one medical plan of the higher-paid spouse, you do have the option to move to separate plans if you wish.

Technical Service Employees: This applies if BOTH spouses are Technical Service employees; does not apply if the spouse is faculty or staff. It is important to note that while you may remain covered under one medical care plan of the higher-paid spouse, you do have the option to move to separate plan if you wish.

For reference, here are the possible combinations for employees choosing to be covered under one medical plan based on the above changes:

• Faculty/Staff/Postdoc + Faculty/Staff/Postdoc = Must be covered under the spouse with the higher salary
• Technical Service Employee + Technical Service Employee = Must be covered under the spouse with the higher salary
• Technical Service Employee + Faculty/Staff/Postdoc = Employees can choose which spouse will carry the policy

If you experience the following qualifying event changes:

1. Spouse becomes a new employee at Penn State and is the higher-paid spouse.
2. You and your spouse are both Penn State employees and a change of position for one of you changes the higher-paid spouse to the one not carrying coverage.

In either of these instances, you will NOT be required to change coverage to the higher-paid spouse mid-year. During the next annual benefits open enrollment period, you will need to make the appropriate changes for the higher-paid spouse to carry coverage if choosing to maintain coverage under only one spouse.