Medical Coverage

Medical Coverage

East Alabama Health has a self-insured group health insurance program that is administered by Blue Cross and Blue Shield of Alabama.  Below is a brief description of the health insurance benefits.

Eligibility and Enrollment

• Health insurance is available to employees who are in a full-time, part-time or flex work status.  
• For benefits purposes, flex is treated as a full-time employee.
• New hires have 30 days from their date of hire to enroll in health coverage.
• To make changes outside of Open Enrollment, there must be a qualifying life event and the change is made within 30 days of the event.  
• Participation in the health plan is optional.

Medical Plan Costs

East Alabama Health covers a portion of your biweekly premium each pay period.  Below are the biweekly rates for insurance.  The rates shown assume all Gaps In Care are complete and is the lowest rate possible.

New Updates to 2024 Health Plan

• Now offering a High Deductible Health Plan (HDHP). Please see your benefits booklet for the matrix. 

2024 Medical Matrix

Gaps In Care

East Alabama Health offers a Gaps in Care program to encourage you to take charge of your health. Subscribers and spouses who are covered through the BCBS EAMC, EAMC Lanier or Healthlinks health insurance plan, are required to complete the below Gaps in Care program to receive the health insurance incentive.

• Preventive office visit with primary care physician
• Labs required for gaps in care
  • Lipids (cholesterol)<
  • HgbA1C (all participants)
  • Glucose (fasting or non-fasting)
• Mammogram for women age 50 and older as of 87/31/2024 for gap closure
• Colonoscopy for men or women age 50 and older as of 7/31/2024 for gap closure

Children (even those ages 18-26) are not required to complete Gaps in Care; only employees and spouses need to complete Gaps in Care for the lowest insurance premium. The Gaps in Care deadline will be in July 2024.

Important: Lab tests will only be covered 100% if they are processed by a Tier 1 laboratory provider, facility or at a Tier 1 provider’s office. Please note if labs tests are processed through Lab Corp, Quest, etc. they will not be covered at 100% and could fall under Tier 2 or Tier 3 coverage. Please contact the HR department with specific questions about lab tests coverage. 

Lark - Free Health Coaching

BCBS Alabama has teamed up with Lark to offer Lark's Diabetes Prevention, Diabetes Care, and Hypertension programs for eligible members who have an official diagnosis, to help them get healthy and stay healthy. Through the Lark app, there is coaching available 24/7 as well as other services integrated with the programs. All programs also include a free wireless scale. All of this is provided to you at no additional cost! Enroll online by visiting enroll.lark.com/bcbsalabama.

Mental Wellness

New Directions in conjunction with Blue Cross and Blue Shield of Alabama is the mental wellness provider for East Alabama Health.  Mental wellness claims are processed through the health plan and as long as the provider is a BCBS provider then each visit will process through the medical plan and you will be responsible for the specialist co-pay.  Mental wellness benefits can help with things such as:

• Marital or family issues
• Stress – related issues
• Emotional problems

Substance Abuse

For substance abuse, please call the Blue Cross and Blue Shield customer service number on the back of your insurance card for assistance in facilitating access to a New Directions representative.  All substance abuse and residential treatment facilities are subject to the EAH tiered network of providers and also requires prior authorization through New Directions.  For more information, call Blue Cross and Blue Shield at 1-866-888-6934.

Baby Yourself

Baby Yourself is the free maternity program provided by Blue Cross and Blue Shield of Alabama.  Baby Yourself includes:

• A personal nurse to answer questions during and after pregnancy
• Gifts and educational resources
• Information of breastfeeding
• A free app to track your pregnancy<

Enrolling in Baby Yourself in your 1st trimester will make your inpatient facility deductible $300.  If you are not a participant of Baby Yourself, the inpatient facility deductible is $600 for maternity admissions.

Continuation of Coverage

Continuation of your group health benefits as provided by the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 is available for employees, spouses, and dependents after certain qualifying events occur. Additional information including cost and application for applying for coverage is here.

Family Medical Leave Act

Employees approved for leave under the Family Medical Leave Act (FMLA) will be permitted to continue their group health insurance coverage with no change.  It is your responsibility to keep your premium payments up to date when out on leave.