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Benefits/Health Insurance

PURA Benefits Committee

PURA Benefits Committee Purpose and Contact Information

Purdue Human Resources Support/Contact Information for Retiree Health/Benefits Questions

Purdue University Retiree's Association Helpful Contact Information

PURA Health Information

PURA Health Insurance Plans Renewed for 2023

New PURcare and Medicare Advantage PPO Enrollment Eligibility Policy, Effective Fall 2019

RIPEA Group Health Insurance Plans

Guidelines Utilized by the PURA Benefits Committee to Select Health Insurance Plans

Paying Your Insurance Premiums

PURA Health Insurance PAST DUE PREMIUMS and TERMINATION POLICY
effective September 1, 2015; revised May 2021

PURCare Benefit Plan Vision Coverage 

Renew Active Fitness Program

Insurance Coverage for the Shingles Shot 

Emergency Room Services

Insurance Assistance to Official Retirees Under Age 65 Available

Official Purdue University Retiree Benefits

List of Benefits Available to Purdue University Retirees

Who may use Purdue Center for Healthy Living Services

Parking Via License Plate Recognition Available to Retirees

Purdue Aphasia Research Laboratory and BrainBuilders Program

Purdue Retiree Airport Parking Benefits

Purdue Global Education Benefit Available to Official Retirees

Learn how to Retire Smart

Helpful Medicare/Supplement Coverage Information

Federal Hospital Pricing Requirement

Prescription Drugs Administered While in the Hospital

Hospital Inpatient Admission or Observation - Does it Make a Difference?

Helpful End of Life Planning Information

Recap & Slides from Nov. 2018 PURA “Planning for Your Future” Seminar 

Planning and Managing End of Life Issues: Open Letter to Retirees

What to Do When a Loved One Passes Away-A Survivor's Checklist

Organizing My Affairs    Document     Instructions

PURA Benefits Committee

Benefits Committee Purpose and Contact Information

The Benefits Committee monitors the medical plans for retirees, evaluates changes, and investigates alternatives where advantages may be gained.

A key part of the execution of this committee's responsibilities is through the support provided by the Purdue University Human Resource Services department that handles the communication, gathers additional vital data, and provides a focal point for problem resolution.

The committee also strives to keep retirees aware of additional University benefits and privileges and promotes program improvements where possible.

Questions concerning the PURA health care plan should be sent to Larry Pherson, Chair, at lpherson3744@gmail.com

Purdue retirees and spouses are eligible for membership to this or any other PURA committee. Due to the Benefits Committee's responsibilities, priorities and processes and the time involved in researching and resolving complex issues affecting retirees, this committee has elected to have no term limits for its members. Anyone interested in joining this or any other committee should contact the committee chair.

Last updated: March 2022

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Purdue Human Resources Support

PURA members continue to receive outstanding support from Purdue Human Resources. Our support person for health insurance is Kate LaMar. Please email or phone Kate with questions at klamar@purdue.edu or 765-494-1694.

Any questions related to PURA activities, or to update your contact information (mailing address, email address) please email pura@purdue.edu.

Last Update:  March 2022

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PURA Health Information

PURA Health Insurance Plans Renewed for 2023

The Benefits Committee of the Purdue University Retirees Association (PURA) has renewed the PURcare and Medicare Advantage PPO group health insurance plans with UnitedHealthcare (UHC) for 2023.  As in the past, the objective was to maintain the best medical and drug insurance plans, at the lowest premium possible, while preserving your ability to see the Medicare provider of your choice.

Your committee is announcing the following monthly premiums for 2023:

PURcare (UHC Senior Supplement plus Part D prescription plan).             $290.97/member

UHC Group Medicare Advantage PPO (including Part D prescription plan). $172.91/member

The 2023 monthly PURcare premium has increased $10.20 /month. The Committee is disappointed by the 3.6% increase, but in light of current economic conditions, we believe that we have met the objective of obtaining the lowest premium possible while maintaining the outstanding medical and drug insurance plan.

Historically, the PURcare premium (per member per month) has been:

Plan Year

2018

2019

2020

2021

2022

Monthly Premium

$282.73

$265.39

$281.80

$281.43

$280.77

For PURcare members with prescription coverage from the Veteran’s Administration, the 2023 supplement-only monthly premium will be $185.43/member, an increase of $7.13.

The 2023 monthly premium for the Group Medicare Advantage PPO Plan does not increase and will remain $172.91/member. There will be no change to Hospital and Medical co-pays or the Annual Out-of-Pocket Maximum for the Medicare Advantage PPO Plan.

There is one significant change in the benefits provided by both plans for 2023.  Effective January 1, 2023, Renew Active will replace SilverSneakers as the fitness program available through PURcare Senior Supplement and Group Medicare Advantage PPO plans. Renew Active is a comprehensive Medicare fitness program that will be available through your plan at no additional cost to you. The Renew Active benefit will provide:  

  • Free gym membership
  • Access to a nationwide network of gyms and fitness locations, the largest of all Medicare fitness programs (including the West Lafayette Wellness Center)
  • Annual personalized fitness plan
  • Allows you to bring a friend or family member to the gym to assist in your workout, at no additional cost
  • Access to thousands of on demand workout videos and livestreaming fitness classes

The Committee is and will continue to be working with UnitedHealthcare to make the transition from SilverSneakers to Renew Active as seamless and transparent as possible for you. Be watching for future communications from both PURA and UnitedHealthcare regarding the transition to Renew Active.  
The PURA Benefits Committee’s goal for the future is to continue to provide outstanding group health insurance plans while maintaining stability in monthly premiums. PURA members continue to receive outstanding support from Purdue Human Resources. PURA’s plans support a portion of the costs of these staff. 

If you are currently enrolled in either of the plans, PURcare or Group Medicare Advantage PPO, and you do not want to make a change, no action is required. Your coverage will automatically continue for 2023. Re-enrollment is not required!

If you elect to terminate your PURA group coverage for a non-PURA plan, you will not be permitted to rejoin later.

Please contact Kate LaMar with questions about plan details or enrollment at klamar@purdue.edu or (765) 494-1694.

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New PURcare and Medicare Advantage PPO Enrollment Eligibility Policy, Effective Fall 2019


By PURA Benefits Committee

In fall 2019, the PURA Benefits Committee enacted a new enrollment eligibility policy for PURcare and Medicare Advantage PPO, the two health plans for eligible Purdue University retirees. This new policy went into effect in September 2019.

Previously, Purdue retirees 65 years old or older had to decide at their date of retirement if they wished to join one of the two health plans offered by the University.  If this coverage was waived, the retiree was not eligible for Purdue-sponsored retiree health care coverage in the future.  With this new policy, the Benefits Committee has extended the timeline for retirees to decide if they want to join or waive PURA coverage.

Now, Purdue retirees 65 years old or older when retiring now have a one-time option to join a PURA retiree group plan during the first or second Medicare Open Enrollment period after their date of retirement when starting Medicare at age 65. For example, a university employee who retires in October of a given year has that same year and the following year's Medicare Open Enrhollment annual periods (October 15 to December 7) to enroll in one of the PURA health plans. An employee with a retirement date in December through November will be eligible to enroll during the Medicare Open Enrollment periods (October 15 to December 7) in the following two consecutive years.

There are no additional requirements to this new enrollment policy. However once a retiree waives coverage after his/her two post-retirement Medicare enrollment periods, that individual will not be eligible for Purdue-sponsored retiree health care coverage in the future.

The PURA Benefits Committee continues to be committed to offering comprehensive and affordable medical plans for university retirees. The additional time and flexibility this new enrollment policy provides will assist university employees as they transition to retirement.

Last Updated:  March 2022

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RIPEA Group Health Insurance Plans

The Retired Indiana Public Employees Association (RIPEA) sponsors group health insurance plans for its members covered by Medicare.  There is an annual membership fee, currently $18, to join RIPEA.

If you are PERF eligible, and feel that PURCare and PURA Medicare Advantage plans do not meet your needs, you may want to consider the healthcare plans offered by RIPEA.

There are two options for Medicare Supplement plans, as well as Medicare Advantage plans. The plans are provided by Anthem Insurance Company. 

Visit the website www.ripea.org or call 1-800-345-9214.

Last updated March 2022

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Guidelines Utilized by the PURA Benefits Committee to Select Health Insurance Plans 

Medicare Senior Supplement Plan (PURcare):

  • Any Senior Supplement plan and provider of the insurance should be able to serve our PURA members wherever they live.
  • The plan should give complete freedom for the member to select any doctor or provider of health services that accept Medicare patients.
  • The plan should cover medical and prescription drugs.
  • Any prescription drug plan should cover any legal drug prescribed by a doctor and approved by Medicare.
  • The insurance company should have a good reputation for service in the industry.
  • The plan should cover emergency healthcare services while the member is traveling outside the United States.
  • The plan should have a market competitive premium with the lowest possible annual deductible rate and with no or very low co-pays or other out-of-pocket costs to the member.
  • The plan should be comprehensive with marketing advantages over off the shelf plans provided by the insurance company.

Medicare Advantage or Preferred Provider Organization Plan

  • The Plan and provider of the insurance should be able to serve our PURA members wherever they live in the State of Indiana.
  • The plan should cover medical and prescription drugs.
  • The insurance company should have a good reputation for service in the industry.
  • The plan should have a market competitive premium with competitive co-pays and other out-of-pocket costs to the member.

Last Updated:  March 2022

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Paying Your Insurance Premiums

Members of PURA Health Insurance plans may pay their premiums for the entire year, pay by the month or use automatic monthly bank debits for the premium payments, known as Electronic Funds Transfer (EFT). EFT is highly recommended as a reliable and convenient way to make your premium payments. A member can change their method of payment anytime throughout the year. A large number of our members use this method and have experienced no problems. If you are interested in making a change in your payment method, contact Kate LaMar at 765-494-1694.

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PURA Health Insurance PAST DUE PREMIUMS and TERMINATION POLICY Effective September 1, 2015; Revised May 2021

The Purdue University Retirees Association (PURA) Benefits Committee and Purdue University Human Resources desire to have in place a member eligibility for enrollment and continuation in any Health Insurance Plan offered by PURA and a termination policy to govern members with past due health insurance premiums. 

The Benefits Committee of PURA approved the following member eligibility statement for participation in and renewal of one of the PURA United Healthcare insurance plans, effective September 1, 2015.  The Benefits Committee has asked the insurance provider United Healthcare to administer the billing process to individual members and to collect the premiums for all plans.

Eligibility and Enrollment

All official retirees of Purdue University (55 years of age with 10 or more years of service), a spouse who is Medicare eligible and their Medicare eligible dependents under the age of 26 may enroll in Health Insurance options offers by PURA in partnership with Purdue University.

All individuals desiring health insurance through one of the PURA plans must individually enroll in the selected plan through the designated staff of Purdue Human Resources.  A designated representative of the Purdue Human Resources Department will enroll members using the eligibility criteria for new and continuing members approved by the PURA Benefits Committee.

All members of any PURA sponsored health insurance program plan must pay their premiums on the schedule set forth by United Healthcare (UHC).  UHC sends invoices and collects premiums for enrolled members.  Failure to pay the health plan premiums will result in plan and benefit coverage cancellation as set forth below and as stated in the plan policy documents.

Involuntary Termination Policy

All members of any plan must pay their premiums to UHC on a schedule determined by UHC.  Failure to pay premiums will result in the member receiving a past due invoice.  The designated representative of the Purdue Human Resources Department will receive a report each month with names of members who have failed in paying their premiums for 60 or 90 days (equivalent of two or three months of total premium due) so that confirmation can be given to UHC for termination of specified member’s health insurance coverage in accordance with the involuntary termination policy stated below.  No member will have their health insurance plan involuntarily terminated in regards to delinquent premium payments without the specific approval of Purdue/PURA.

Members who disagree with UHC on any past due premiums by reason of payments made and not recorded or other reasons for disagreement of payment due shall have an appeal process to resolve such disagreements.  This appeal will be made to the address provided in your UHC Senior Supplement Certificate of Coverage or your UHC Medicare Rx Evidence of Coverage.

Failure to pay premiums will result in the forfeiture of eligibility and termination from the plan.  No action will be taken to terminate coverage during the first 60 days of delinquency (grace period).

The PURA Benefits Committee has established the following policy that will determine involuntary termination of the policy and benefits for any individual member:

  • UHC reports to PURA/Purdue names of members who are 60 or 90 days delinquent in premium payments each month. The Purdue Human Resources Department will contact members who have past due premiums of 60 or more days to work out a plan for each member, if they desire to continue health insurance through PURA.
  • PURA/Purdue reviews list for termination and confirms to UHC that termination of members who are 90 days delinquent is appropriate under PURA policy.
  • Members who are 90 days (equivalent of three months of total premiums due) delinquent in payments will be involuntarily terminated from the selected plan by Purdue/PURA.
  • No action will be taken to terminate coverage during the first 60 days of delinquency (grace period). At the end of 90 days with past due premiums, if the member has not responded to the past due invoice from UHC by making a full payment of all delinquent premiums, a letter will be sent by UHC at the request of PURA indicating that the member’s coverage will be terminated due to no longer meeting the eligibility requirements for Purdue’s employer sponsored coverage through PURA.  This letter will be sent at least 21 days prior to the effective termination date to provide the member opportunity to purchase another plan so that they will not have any gap in coverage.
  • Claims with a date of service after the specified termination date will not be considered for payment by UHC. Any claims with a valid date of service provided prior to the termination date will be adjudicated and paid according to the plan benefits by UHC.

Voluntary Termination

Voluntary termination will result from death of the member, member ineligibility due to moving outside of the United States or by cancellation of the policy at the end of the calendar year.  Voluntary termination does not remove the member’s obligation to pay premiums until the time of termination.

Having these guidelines and policies in place will allow UHC to properly administer the plan and to ensure the administration of the plans complies with Center for Medicare and Medicare Services (CMS) requirements.

Last updated March 2022      

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Renew Active Fitness Program

 

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Insurance Coverage for the Shingles Shot 

Shingles vaccinations are covered under the PURcare and PURA Medicare Advantage Medicare Supplement Plans as drugs at a Tier 2 (Preferred Brand) copay. Therefore, the Shingles vaccine copay is at the 50% coinsurance level with the $45.00 maximum copay allowed under the plan. In addition, United Healthcare will reimburse up to $20.00 for the administrative fee associated with the administration of the medication.

There are two Shingles vaccines available. Zostavax is a one-time injection. A newer vaccine, called Shingrix, is a two-step injection, typically administered two to six months apart. The applicable fees, as outlined above, apply. For Shingrix, the fees are applied to each injection.

Pharmacies offer the Shingles vaccine.  Contact or visit a pharmacy of your choice for more information and to make an appointment. 

Last Updated:  March 2022

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Emergency Room Services

Several media outlets reported that United Healthcare intended, effective July 1, 2021, to withhold payment for emergency room services not determined to be emergencies. Hospitals, medical care providers and many social service organizations made their concerns known to United Healthcare.

Since United Healthcare is the insurance provider for PURA’s PURCare and Medicare Advantage plans, PURA likewise was concerned when we learned United Healthcare's intentions. The Benefits Committee contacted United Healthcare to make them aware of our concerns.

We are pleased to report United Healthcare's decision to delay implementation of their new Emergency Room policy, at least, until the end of the COVID pandemic. United Healthcare also confirmed that the proposed practice will not be applicable to PURA's PURCare and Medicare Supplement Plans.

Utilization data provided to us by United Healthcare shows that PURA members covered by PURCare have over the years been careful to use the Emergency Room for emergency situations. We hope that will continue, as it has a positive impact on our premiums. Likewise, if you are facing a health situation of an emergency nature, do not delay getting to the Emergency Room for treatment.

Last Updated:  March 2022

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Insurance Assistance to Official Retirees Under Age 65 Available

Purdue University, in partnership with the Purdue University Retirees Association and the Henriott Group, Inc., has arranged assistance for official Purdue retirees under the age of 65 and not yet eligible for Medicare, to help you understand your health insurance options in retirement.

The Health Insurance Marketplace (also known as the Exchange), created as part of the Affordable Care Act, offers health insurance options to ensure everyone in the United States has access to affordable health care.

It is likely that some number of Purdue retirees would be eligible for a premium tax credit (also known as a subsidy) to assist with the cost of healthcare through the Marketplace.  There are several plans available and it can be difficult to find a well-matched plan. That’s where Henriott comes in.  They are knowledgeable and experienced in helping you shop for a plan that best suits your needs.

Purdue University and PURA are pleased to be able to offer this assistance, and we encourage you to review your options.

Last Updated:  March 2022

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Official Purdue University Retiree Benefits

Who May Use Purdue Center for Healthy Living Services

Purdue’s Center for Healthy Living (CHL) is located in the Purdue West Shopping Center at 1400 W. State St. The center serves benefits-eligible employees, retirees and their dependents covered on the Purdue CDHP (Consumer-Driven Health Plan) medical plans: Premier CDHP, Standard CDHP or Limited CDHP. Retirees must be covered by one of these three medical plans to be eligible to use the center.

Retirees 65 and over with United Healthcare (PURcare and Medicare Advantage PPO) are not eligible to use the services of the CHL.  The CHL providers do not see any Medicare patients.  However, PURcare and PURA's Medicare Advantage PPO patients may use the CHL lab for blood work and other testing provided at the CHL, as this is billed by LabCorp through your insurance.  The CHL lab services are also available to retirees from the Regional Campuses, although they would need to travel to West Lafayette.

For more information about the center, including services, costs and hours, visit www.purdue.edu/healthyliving. For questions, call the center at 765-494-0111 or contact Purdue Human Resources at 765-494-2222.

ATTENTION FUTURE PURDUE RETIREES!

Are you concerned about Medical and Prescription Drug Insurance after you retire?

As you plan for your retirement the decision you make on Supplemental Medical and Prescription Drug health insurance will be one of your most important decisions.  There are lots of choices and if you are healthy now you may be tempted to buy the cheapest available plan.  However, we suggest that you consider that as you grow older your medical and drug needs will most likely increase—maybe exponentially.  The old adage of “pay me now or pay me later” applies here. Find out more about the Purdue retiree's group insurance plan, PURcare, here.

Last Updated:  March 2022

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Parking Via License Plate Recognition Available to Retirees

The December 2017 PURA News announced that Purdue University (West Lafayette Campus) Parking Facilities was about to initiate implementation of its new License Plate Recognition (LPR) software. You may recall that the LPR system allows Parking Facilities to enforce parking using the vehicle’s license plate rather than a physical permit displayed in the window. The system allows parking enforcement officers to utilize a scanner that reads license plates as they patrol to determine if a vehicle parked in that space has been properly registered with Purdue Parking facilities for on-campus parking.

What does this mean for Purdue University retirees? THERE IS NO IMPACT FOR CURRENT PURDUE UNIVERSITY RETIREES!

You received a Gold Purdue University parking permit during August 2017. This permit allows the privilege of parking on campus through July 31, 2022. Purdue retirees whose retirement dates were before January 15, 2018, will, if they wish, continue to receive physical parking permits after August 31, 2022.
Retirees, upon acceptance of a post-retirement appointment, will register their vehicles using the LPR system.  There is no intent to require current retirees to convert to the LPR system, but retirees may do so if they wish.


1. To complete the registration, you will need to have the following information available:
a) License Plate Number and Type

b) Registration Expiration Month and Year

c) Vehicle Make, Model, Year and Color

Reminder: you may register more than one vehicle, but no more than one vehicle may be parked on campus at any time.

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Purdue Aphasia Research Laboratory and BrainBuilders Program

Purdue Aphasia Research Laboratory

Stroke is the second leading cause of mortality worldwide, and the major cause of long-term disability in adults. In Indiana, being firmly situated in the 'Stroke Belt', there is a higher incidence of stroke than in the rest of the nation (according to the Kentucky Indiana Stroke Association).

One of the persisting disabilities of stroke patients is the loss of communication abilities (aphasia), affecting all modalities of communication including one's ability to speak, to comprehend, to read, and/or to write. Research evidence shows that persons with aphasia continue to improve their communication skills with continued participation in communication-based activities and interactions—even years post-stroke—significantly improving their quality of life.

The Purdue Aphasia Research Laboratory is working to better understand how persons with aphasia process information during listening and speaking, and to identify factors and conditions that maximize re-learning of language. Persons who have had a stroke resulting in aphasia are invited to participate in our research.

Participation in the Laboratory’s research is free of charge and a comprehensive language evaluation is completed prior to participating. If interested, please contact them by email at aphasia@purdue.edu, on their website, https://www.purdue.edu/hhs/slhs/aphasia/, or by phone at 765-496-0216.

BrainBuilders Program

Individuals struggling with memory loss can learn how to maximize thinking, memory and language skills though Purdue’s BrainBuilders program.  Housed in the College of Health and Human Sciences’ Department of Speech, Language and Hearing Sciences, the program utilizes graduate students from the No. 3 ranked speech-language pathology program in the nation to facilitate individual and group cognitive exercises and engage clients in creative activities centered on a weekly theme.  The group is designed to give thinking skills a workout and to provide cognitive and social stimulation with a therapeutic emphasis.

The program accepts Medicare, Aetna and Anthem insurance.  Patients must complete an assessment prior to starting in the program to determine eligibility.

Those who are interested in joining the program or learning more should contact Michelle Gutmann at mgutmann@purdue.edu or 765-494-3809.

Last updated March 2022

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Purdue Retiree Airport Parking Benefit

There are currently two services offered for Purdue employees at the Indianapolis International Airport:  ParkIND Proximity Card and Fast Park & Relax.  Using a Purdue email account, these same services also are available to Purdue retirees.

ParkIND Proximity Card

Indianapolis International Airport has provided a Purdue-specific rate of $14 per day for parking on the fifth floor of the Airport Terminal Parking Garage, which is lower than the daily public rate for garage parking. 

To be eligible for this rate for business (for current faculty and staff) or personal travel, travelers must sign up for a free ParkIND Proximity Card using their Purdue University, Purdue University Fort Wayne or Purdue University Northwest email address: https://parkindplus.ind.com/fpp/createacct.aspx

Once the membership is activated, travelers can log-in to their ParkIND Plus Account https://parkindplus.ind.com/fpp/signin.aspx at any time to update their profile, add or change credit/debit cards, check point balances, print detailed receipts or redeem points for free parking.

The Proximity Card must be presented at the time of parking to be eligible for Purdue’s discounted daily rate. 

Questions may be directed to Purdue Travel at 765-494-7354 or purduetravel@purdue.edu.

Fast Park & Relax

Fast Park & Relax offers a less expensive parking option for business and leisure travel and provides many additional perks compared to traditional airport parking lots.  Some of these perks include:

  • Guaranteed parking is available in well-lit, fenced areas with security monitoring;
  • Continual shuttle service runs 24 hours a day;
  • Users are picked up and dropped off directly at their vehicle;
  • Shuttle drivers load and unload luggage;
  • Emergency vehicle services are provided at no additional charges for lockouts, dead batteries and flat tires;
  • A rewards system is available

The Indianapolis International Airport is one of 14 Fast Park & Relax nationwide locations.

To enroll in the Fast Park & Relax rewards program and to view options and features, use Purdue’s partner link and promo code and enter your Purdue email address to get started.

Last updated March 2022

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Purdue Global Education Benefit Available to Official Retirees

Purdue University offers an educational tuition benefit available to official retirees through the Purdue University Global (PG) online university.

Official retirees from any Purdue system campus can take advantage of the tuition benefit to pursue certificates, associate, bachelors and master’s degrees tuition free. Purdue Global offers more than 100 degree and non-degree programs to choose from.

Spouses and dependents of official retirees as defined in Policy VI.A.1: Status and Privileges of Retired Faculty and Staff, Surviving Spouses and Surviving Children are provided the opportunity to pursue a degree online from Purdue Global and receive a partial fee remission.

Before beginning the enrollment process, there are few things to know and do:

  1. Review the PG Education Benefits Guidelines, the PG Education Benefit Manual, and FAQs here, which provides more details about the PG Education Benefit, program requirements, and specific tuition discounts by program.

  2. Next, complete the Intake Form located here. Be sure to fill in the program of study and desired start date you are interested in – which will allow the appropriate admissions advisor to reach out and reduce potential delays in form processing.

  3. Email your completed Intake Form to edbenefits@purdueglobal.edu

  4. Once a completed intake form is submitted, an admissions advisor will call to help complete the admissions process. Due to the volume of interest and individualized attention, the advisor’s response may take up to six business days.

Purdue University Global Resources:

To view Purdue Global programs offered, visit the Purdue Global website. For program of study assistance, call 844-787-3834.

Policy VI.A.1: Status and Privileges of Retired Faculty and Staff, Surviving Spouses and Surviving Children is located here.

For questions regarding the PG Education Benefit, visit the Purdue Global Education Remission Benefit website here or email the Bursar at remissions@purdue.edu 

Last updated March 2022

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Helpful Medicare/Supplement Coverage Information

Federal Hospital Pricing Requirement

By PURA Benefits Committee
January 2019

As of January 1, 2019, all hospitals must post online all the costs for the goods and services they provide. It is a requirement of the Affordable Care Act and is part of an effort to bring greater transparency to health care. Hospitals provide the prices they have set for their procedures, services, drugs and supplies on spreadsheets called chargemaster lists.

Finding the chargemaster information on a hospital’s website takes diligence. Typing in the hospital’s name along with keywords “billing” or “chargemaster” might produce a link. If lists are located, the numbers can be misleading and will not help patients figure out their true costs. Most consumers will not be paying the chargemaster prices.

Hospital officials and health care professionals are warning that the chargemaster lists will be of limited use to people with insurance coverage, because the listed prices do not represent consumers’ out-of-pocket responsibility. In addition, the lists contain a hodgepodge of numbers, abbreviations, technical medical terms and codes that may be difficult to decipher. Different hospitals may not display the same items the same way.

Due to the complexity and opaque nature of hospital pricing, the chargemaster lists are unlikely to provide clarity and usefulness to the average person. There are other sources that may be of greater assistance in helping consumers evaluate hospital costs:

1) FAIR Health makes available resources that help consumers understand their health benefits, plan their costs and make the most of their medical and dental coverage. www.fairhealthconsumer.org 

2) Health Care Bluebook Fair Price is the reasonable amount one should pay for a medical service. It is calculated from a nationwide database of medical payment data and customized to an individual’s geographic area. www.healthcarebluebook.com 

3) Indiana Hospital Association has a website which calculates the overall cost of a procedure and allows users to compare hospital charges and quality ratings. www.mycareINsight.org 

When using the above tools, keep in mind they do not take a person’s insurance into account. However, these sources provide helpful resources for estimating health care costs.

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Prescription Drugs Administered While in the Hospital

In the event that an individual on the PURcare plan (Senior Supplement + Part D) is admitted to the hospital as an inpatient, Medicare Part A will pay for all drugs that are received, including self-administered drugs.  “Self-administered drugs” are drugs prescribed by a doctor prior to entering the hospital that you would normally take on your own.   The only responsibility of the plan participant will be that of their typical cost share for the inpatient hospital stay. 

A retiree enrolled in the Group Medicare Advantage plan who is admitted as an inpatient will pay only their Hospital per-day copayment; self-administered drugs will be covered.

When a member of the PURcare plan is kept in the hospital on an observation basis, payments for the medical services would be covered under Medicare Part B, which does not cover self-administered drugs under any circumstance.

Under observation, the plan member in PURcare or the Medicare Advantage plan will be billed for self-administered drugs and will be expected to pay the hospital. The member must file a claim for reimbursement under their Part D prescription drug plan.  The Part D plan will reimburse the member on an out-of-network basis which will put all the prescription drugs in a Tier 3 level cost share or copay. The plan will only reimburse the cost of the drug up to an amount that is comparable to a contracted rate; any difference between the charged amount and the reimbursed amount will be the responsibility of the plan member.

Contact the UnitedHealthcare Customer Service number on the back of your Part D or Medicare Advantage ID card to ask for the “Direct Member Reimbursement Form” for prescription reimbursement.  If you have questions or problems, please contact Kate LaMar, Human Resources, at klamar@purdue.edu or (765) 494-1694.

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Hospital Inpatient admission or Observation - Does it Make a Difference?

Yes!  The inpatient or observation status of the patient affects Medicare and supplement insurance payments to the hospital, to skilled nursing or rehabilitation facilities, and for prescription drugs.  Administrative personnel at Lafayette area hospitals, St. Elizabeth East Hospital and IU-Arnett Hospital, responsible for compliance with Medicare rules provided the following information. A hospital’s failure to comply with Medicare rules can result in the hospital not being reimbursed for services and possible fines.

Inpatient admitted status is covered by Medicare Part A.  Observation status is covered by Medicare Part B.  Currently the hospital is reimbursed $4400 a day for Part A inpatient admission and $400 a day for observation.  Insurance coverage with PURcare and other Medicare supplement plans and different Medicare Advantage plans varies depending on the plan. 

Important information for you or an advocate to remember when you or a loved one is hospitalized:

  • You should select an advocate before you enter the hospital to speak for you and ask questions in case you cannot.
  • The admitting physician determines whether the patient is admitted as an “inpatient” or admitted “for observation”.
  • Observation—the admitting physician believes the problem can be resolved in less than a 2 midnights stay.  If not resolved in 2 midnights, the status may be changed to inpatient.  However, this does not happen automatically. 
  • Inpatient Admission—the admitting physician believes 3 or more midnights and specialized treatment or care is needed.
  • A patient is not necessarily told whether he/she is admitted as an inpatient or under observation.  The patient or the advocate must ask.
  • The physician’s decision on inpatient admission or observation status is reviewed by a case management team to insure that Medicare rules are met.  If more information is needed, a hospitalist or a specialist’s opinion may be sought.  Medicare rules state that observation status cannot be appealed.  However, one hospital administrator suggested talking to the case management nurse if there are questions about the patient’s observation status.
  • After outpatient surgery certain conditions may warrant further outpatient observation.  Depending of care needed, the patient or advocate must ask whether the status is observation or inpatient admission.
  • There is no Medicare coverage for prescription costs when in observation status.  The prescription bill must be paid by the patient.  The patient can then file a claim with his/her Part D prescription plan for reimbursement.  The claim may or may not be paid depending on the insurance policy.
  • A patient must have inpatient admission status over 3 midnights to be eligible for Medicare to cover a skilled nursing or rehabilitation facility stay.  Medicare covers up to 100 days in a skilled nursing facility when meeting Medicare requirements. 
    •  PURcare Senior Supplement coverages continue for day 101 and beyond, if the patient continues to meet Medicare requirements.
    • Medicare Advantage plans do not have a 3 midnight inpatient requirement to be eligible for a skilled nursing or rehabilitation facility.  Coverage is provided up to 100 days if the patient continues to meet Medicare requirements.

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Helpful End of Life Planning Information

Recap & Slides from Nov. 2018 PURA “Planning for Your Future” Seminar 

Organized by PURA’s Program Committee, the “Planning for Your Future” seminar, held on November 26, attracted more than 140 Purdue retirees and retirees-to-be for an informative afternoon.

Included was important advice about financial and health care issues, senior living options, and more, featuring local experts sharing their expertise on issues which all senior citizens face as they age, including these, and more.

  • Medical & legal powers of attorney, wills and trusts and related tax implications.
  • The impact of the new tax law on income and other taxes, possible adjustments to financial planning; the benefits of planned giving and/or donating stocks to charities.
  • Having enough income to live comfortably.
  • Services that can be provided by home healthcare agencies to help seniors remain in their homes permanently.
  • Costs of the various care options, and how they impact seniors’ estates.

Evaluations from those in attendance were overwhelmingly positive and generated discussion about repeating this content in future years. With our ever-changing economy, new medical research, the rising cost of prescription drugs and other issues, there certainly will be new information to share. With seminars such as this, the Purposeful Living in Retirement program in the spring, and programs at PURA’s monthly luncheon meetings, we’ll do our best to keep everyone up-to-date.

If you were unable to attend, slides from the seminar may be downloaded here.

For more information for Purdue retirees visit

Purdue University's Human Resources' Benefit webpage.

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