The PURA Benefits Committee has renewed the PURcare and Medicare Advantage PPO Health Insurance Plans with United Healthcare for 2012 and has negotiated very low, competitive premium increases.
PURcare, the Purdue-sponsored Medicare Supplement health plan participated in by over 2,000 Purdue retirees, will continue for 2012 with effectively the same medical, vision and prescription drug benefits as in 2011, with an overall premium increase of only 4.5 percent. The PPO Plan will have the same benefits and copays as in 2011 except for a small increase in total out-of-pocket costs, resulting in a premium increase of about 6 percent. Our per-member average health care claims have been increasing at an average of 10.5 percent per year for the past three years.
Through the expertise of Hewitt Consulting, paid for by Purdue University; the desire of United Healthcare to continue to serve our members; and the hard work of the Benefits Committee; our premium increases were maintained at very competitive rates as compared with other plans. Sponsored plans across the nation are seeing premium increases of 9 to 15 percent. The 4.5 percent negotiated for PURcare members and the 6 percent increase for PPO members are among the lowest increases for 2012.
PURcare for 2012
* The PURcare medical plan including vision care (United Healthcare Senior Supplement) will continue with a premium of $199.47 per member per month. The Benefits Committee dropped two benefits, private duty nursing and caregiver services, that were not being utilized by our members, in an effort to keep premiums down. As in the past, members who want to continue with the PURcare plan do not need to re-enroll and will be enrolled automatically.
* The PURcare Prescription Drug coverage (Part D) continues with open formulary, no step therapy and no "donut hole" for a rate of $75.05 per month per member. Prescription drug costs will remain at 50 percent local and 45 percent mail order. True out-of-pocket maximum costs will be $4,700, which represents the Medicare-determined amount for the Standard Medicare Part D catastrophic threshold. Once this threshold is reached, prescription drugs are covered at 100 percent for the remainder of the year.
* Annual deductible for hospital/medical treatments will continue to be $300. After this level is reached, all Medicare-approved costs, including hospitalization, outpatient services, skilled nursing facility, home health care, and other benefits, will be covered at 100 percent for the remainder of the year, plus up to $150 per year for Vision care.
* PURcare members must continue to be enrolled in both the medical and prescription drug plans to be eligible to participate in this plan. An exception is made for members with VA benefits for prescription coverage.
Veteran Affairs eligible members
Great news for VA prescription drug qualified members. For 2012, the PURcare medical-only premium will be the same as all members of the PURcare plan. This is a major savings for our VA participants. Monthly premiums will be $199.47.
Medicare Advantage PPO Plan
The Purdue-sponsored Medicare Advantage plan, UnitedHealthcare Group Medicare Advantage (PPO), was also renewed for 2012. The plan features a lower monthly premium, but higher out-of-pocket costs for Medicare-covered services. For 2012, monthly premiums will be $184.12 with no change in covered benefits or co-pays from 2011. To keep the premium increase as low as possible, the negotiated annual maximum outof- pocket cost will increase from $2,800 to $3,000.
New health insurance consultant hired for PURA by Purdue
In consultation with PURA, Purdue hired a new consultant to assist the Benefits Committee in benefits negotiations and in obtaining information needed to renew the insurance coverage. Hewitt and Associates in Chicago was hired and helped greatly with the process.
Purdue Human Resources support continues
PURA members also continue to receive outstanding support from Purdue Human Resources, and we thank them. We specifically rely on secretarial help from Michele Salla. Our full time support person for health insurance is Kate LaMar. Contact Kate with questions at klamar@purdue.edu or 765-494-1694.
Special notes from the Benefits Committee on frequently asked questions
* Medicare does not cover medical costs when you travel outside the U.S., but PURcare does. Please read information on this coverage in materials that you will receive from United Healthcare.
* While Medicare pays for many Home Health Care services, PURcare coverage provides an additional $5,000 per year for coverage of doctor-prescribed services. Read the UHC material for more information or contact Kate LaMar in Purdue Human Resources at klamar@purdue.edu or 765-494-1694.
* Medicare's wellness review process has changed. Make sure you read the new information from Medicare to know how it works. Even though you are eligible to have this review once every year, it is not considered to be an annual physical exam.
* Screening for cervical and vaginal cancers including Pap tests and pelvic exams are covered by Medicare Part B once every 24 months. Bone density tests are also covered by Medicare Part B once every 24 months, and mammograms are covered once every 12 months. PSA blood tests and digital rectal exams are covered by Medicare Part B once every 12 months. In each case, participants should make sure their doctors code the test correctly.
