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 2026

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 2026. This year the Committee’s priority was to maintain the best possible medical and drug plans at the lowest premium possible.

Your committee is announcing the following monthly premiums for 2026:

PURcare (UHC Senior Supplement plus Part D prescription plan) $366.87/member

UHC Group Medicare Advantage PPO (including Part D prescription plan) $190.45/member

PURcare for 2026
The 2026 PURcare premium has increased $10.93 /month. The Committee is pleased that the increase has been limited to 3%. In order to minimize the premium increase, it is necessary to increase the deductibles in this plan for the first time in 20 years. By taking this action, we have met the objective of maintaining the custom benefits of the plan with the lowest possible premium increase. Members in this plan can use any Medicare provider or facility in the country.

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

Plan Year	2021	2022	2023	2024	2025
Monthly Premium	$281.43	$280.77	$290.97	$298.39	$355.94

For PURcare members with prescription coverage from the Veterans Administration, the 2026 supplement-only premium will be $225.98/member/month.

Group Medicare Advantage PPO for 2026
Another Committee priority was to enhance the affordability of the PPO Plan. To achieve that priority the 2026 plan deductibles and out-of-pocket maximum will be adjusted for the first time in ten years.

The 2026 Group Medicare Advantage PPO Plan will have a premium decrease of $51.49/member/month. The premium for 2026 will be $190.45/member/month. Members in this plan can use any Medicare provider in the country that will accept this insurance plan.

Your Benefits Committee has, as we have in past years, placed a high priority on protecting PURA members’ life assets at the expense of higher monthly premiums. The 2026 plans do continue to provide protection from catastrophic medical and drug expenses. With the changes to the deductibles and out-of-pocket maximum, the Committee expects both plans will continue to be attractive to new retirees and competitive options for the future.

An open forum has been scheduled on Monday, November 3, 2025, immediately following the PURA Monthly Meeting. The forum should begin at approximately 11:30am. The PURA Monthly Meeting is held at the VFW, 2660 Duncan Rd, Lafayette IN. If you wish to attend virtually, you may do so by connecting to the Zoom link provided in emails from PURA , or request the Zoom link by emailing pura@purdue.edu.

Important! 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 2026. Re-enrollment is not required!

Adjustments to these plans can be found here.

If you elect to terminate your PURA insurance for non-PURA insurance, you will not be eligible to return to the group plans in the future.

PURA members continue to receive outstanding support from Purdue Human Resources and for that we are most thankful. PURA’s plans support a portion of the costs of these staff.

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

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PURA Health Insurance Plans Renewed for 2025

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 2025. This year the Committee’s job was to negotiate the best possible premium, given the Part D Drug Plan enhancements from the Inflation Reduction Act of 2022. The improved 2025 Part D benefits include replacing the Donut Hole with a $2000 maximum out-of-pocket. Please see more about 2025 Medicare Part D changes on the included Additional Information page.

Your committee is announcing the following monthly premiums for 2025:

PURcare (UHC Senior Supplement plus Part D prescription plan) $355.94/member

UHC Group Medicare Advantage PPO (including Part D prescription plan) $241.94/member

The 2025 PURcare premium has increased $57.55 /month. The Committee is extremely disappointed by the 19.2% increase, but believe we have met the objective of maintaining the custom benefits of the plan with the lowest possible premium increase.

The 2025 PURcare Senior Supplement annual deductible of $300 has not increased, and the Part D prescription plan, unlike many plans on the individual market, continues to have no deductible.

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

Plan Year	2020	2021	2022	2023	2024
Monthly Premium	$281.80	$281.43	$280.77	$290.97	$298.39

For PURcare members with prescription coverage from the Veterans Administration, the 2025 supplement-only premium will be $219.88/member/month, an increase of $27.03.

The 2025 Group Medicare Advantage PPO Plan will have an increase of $69.03/member. The premium for 2025 will be $241.94/member/month. There is no increase to the Hospital and Medical Co-pays, and the Annual Out-of-Pocket Maximum is unchanged at $3,400. Members in this plan can use any Medicare provider in the country that will accept this insurance plan. The plan continues to feature no deductible for either Hospital/Medical services or prescription purchases. 2025 Medicare Part D changes are on the Additional Information page.

Your Benefits Committee has, as we have in past years, placed a high priority on protecting PURA members’ life assets at the expense of higher monthly premiums. The 2025 plan does not change co-pays or deductibles, and drug costs may be significantly reduced for those members with high-cost drugs. The result of keeping these out-of-pocket costs low is a higher premium. We understand that the announced increase is surprising. If you wish to do some market comparisons remember to compare, in addition to premiums, the Deductibles, Co-pays and Out-of-Pocket maximum.

If you elect to terminate your PURA insurance for non-PURA insurance, you will not be eligible to return to the group plans in the future.

An open forum has been scheduled immediately following the November 4, 2024, Monthly PURA Meeting. We expect that the forum will begin at approximately 11:30am. The Monthly PURA meeting is held at the VFW, 2660 Duncan Rd, Lafayette IN. If you wish to attend virtually, you may do so by connecting to the Zoom link provided in emails from PURA. You can request the Zoom link by emailing pura@purdue.edu.

Important! 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 2025. Re-enrollment is not required!

PURA members continue to receive outstanding support from Purdue Human Resources, and for that, we are most thankful. PURA’s plans support a portion of the costs of these staff.

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

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PURA Health Insurance Eligibility, Continuation and Termination Policies

The Purdue University Retirees Association (PURA) Benefits Committee and Purdue University Human Resources have the following policies in place for the group health insurance plans offered by PURA.

Eligibility

Retiree health insurance options are offered by PURA in partnership with Purdue University. Official retirees of Purdue University (55 years of age with 10 or more years of service) can continue to be covered in a plan that is appropriate for their age and Medicare status.

Purdue retirees hired before January 2021 who retire prior to age 65, and their eligible dependents and spouses, can participate in the Purdue University active employee health care plan or Marketplace plans through Henriott Group, Inc. until they reach the age of 65 and/or are eligible for Medicare.

Purdue retirees 65 years or older can join a PURA retiree group plan to go with Medicare.

A new or newly eligible retiree/spouse will be eligible to enroll in a PURA group plan –

At the time they retire or lose other employer/retiree group coverage
If retired before age 65, when they become eligible for Medicare
Or in the first or second Medicare Annual Enrollment Period (October 15 to December 7) after the retirement or eligibility date.

Once a retiree waives coverage after the two post-retirement Medicare enrollment periods, they will not be eligible for Purdue sponsored retiree health care coverage in the future.

Official retirees and/or eligible dependents must individually enroll in the selected plan through Purdue Human Resources designated staff. A designated representative of the Purdue Human Resources Department will enroll members using the eligibility criteria approved by the PURA Benefits Committee.

Continuation

All members of any PURA sponsored health insurance program plan must pay their premiums on schedule set forth by UnitedHealthcare (UHC). UHC sends invoices and collects premiums for enrolled members. Failure to pay a monthly premium will result in the member receiving a past due invoice. Continued failure to pay premiums will result in the forfeiture of eligibility and termination from the plan. (See Termination details below.) No action will be taken to terminate coverage during the first 60 days of delinquency (grace period).

Members who disagree with UHC on any past due premiums by reason of payments made and not recorded or other reasons for disagreement can appeal to UnitedHealthcare (UHC) through the Customer Service contact for their plan.

Members who are currently enrolled in either of PURA’s two health plans do not need to re-enroll each year unless they choose to make a change or to stop participating. Coverage will automatically continue for the next year. If in the future the PURA Benefits Committee selects new plans, members will be given ample time to learn about the plans and will be provided with enrollment instructions.

It is permissible to switch between the Purdue plan options each year during the Annual Enrollment Period by contacting the Purdue Human Resources designated staff. There is also the option to waive coverage. However, healthy people cannot opt out of Purdue retiree group plans and then opt in when they develop health problems. That would be unfair to those who have been enrolled in the program from the beginning.

Termination

Failure to pay health plan premiums will result in plan and benefit coverage cancellation as set forth below in the termination plan policy.

A. Involuntary Termination Policy

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.

B. 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.

These guidelines and policies allow UHC to properly administer the plan and to ensure the administration of the plans complies with Center for Medicare and Medicaid Services (CMS) requirements.

Last Updated: May 9, 2025

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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 large number of our members use this method and have experienced no problems. A member can change their method of payment anytime throughout the year. If you are interested in making a change in your payment method, contact Kate LaMar at 765-494-1694.

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Renew Active Fitness Program

Effective January 1, 2023, Renew Active will replace Silver Sneakers as the fitness program available through the PURCare Senior Supplement and Group Medicare Advantage PPO plans.

Renew Active is a comprehensive Medicare fitness program for body and mind. It is available with the PURA United Healthcare Senior Supplement and Group Medicare Advantage PPO plans at no additional cost. Members may work out where they want, whether at a gym or fitness location or from home. Renew Active includes:

A free gym membership
Access to a nationwide network of gyms and fitness locations
An annual personalized fitness plan
Access to thousands of on-demand workout videos and live stream fitness classes
Option of bringing a family member, friend or caretaker to the gym at no additional cost to assist with the workout
Access to home fitness kits for those members living more than 15 miles from a partnering gym and/or are physically unable to access a partnering gym location

Renew Active also provides access to an online brain health program from AARP, “Staying Sharp”, with exclusive content for Renew Active members including:

Brain health assessment
Interactive brain challenges
Guide to music and brain health videos, fun games and more

Renew Active members have the opportunity to connect and engage with other health-minded members through:

Social activities at local health and wellness classes and events
Step challenges with the Fitbit Community for Renew Active; no Fitbit devise is needed. Joining the community also provides access to Fitbit Premium.

Identifying Renew Active Fitness Sites

With Renew Active members can belong to multiple participating fitness locations simultaneously across all 50 United States. Members will need to present their confirmation code to each participating fitness location they visit. The participating fitness location will then enroll the member in the program, providing access to a standard membership at no additional cost.

There are three easy ways to find out if a gym or fitness facility participates in the Renew Active Program:

Ask the staff at the gym or fitness facility;
Visit com to search for participating facilities by the facilities’ zip code;
Call the United Healthcare customer service number on the back side of the UHC membership ID card. The numbers to call are:
PURCare/Senior Supplement: 1-800-851-3802; Monday through Friday 8 am -8 pm
United Healthcare Group Medicare Advantage (PPO): 1-800-457-8506; Monday through Friday 8 am – 8 pm

Activating Renew Active Membership

Every Renew Active eligible member is provided a unique confirmation code that is used to access the member’s gym membership, create an account on AARP Staying Sharp, join the Fitbit Community for Renew Active and gain access to Fitbit Premium (no Fitbit device is required). The Renew Active Confirmation Code which starts with a letter followed by nine numeric digits may be obtained in any one of the following ways as of January 1, 2023:

Take the UHC issued PURCare/Senior Supplement or PURA Group Medicare Advantage PPO Membership Card to a participating facility. Facility staff, using the member ID from the back of the card, will enroll the member in Renew Active. This mirrors the Silver Sneakers process flow of today. If a member uses other fitness facilities, perhaps when traveling, activating the process for that facility uses the same process.
Call the customer service number that appears on the back of the UHC PURCare/Senior Supplement or PURA Group Advantage PPO member ID card and request the confirmation code. Make a note of the code and then provide it to the staff at the gym.
Sign into UHC.com. Click on Health and Wellness in the upper right-hand corner. Select Renew Active. Make a note of the Confirmation Code to provide to the staff at the gym.
Refer to the Renew Active welcome letter from UHC (mailed to all current 2022 members in early 2023) in which the Confirmation Code is included. Provide the code to the staff at the gym.

Nominating a Fitness Facility to the Renew Active Network

If a gym or fitness facility is not part of the Renew Active network (this situation should not occur frequently), and a member is happy with that gym/facility and would rather not have to change to another, there are ways to bring that facility into the network. To nominate a facility to Renew Active, a member can do one of the following:

Members can log into their member account at UHC.com and then go under Health and Wellness to find Renew Active. Complete an online nomination form, or obtain a Renew Active referral flyer to print and present to the manager of any non-participating fitness location. The flyer provides a brief overview of the program and the next steps for the location to join Renew Active.
The member may contact United Healthcare customer service at the number on the back of the UHC PURCare/Senior Supplement or Group Medicare Advantage PPO Membership ID card. This is a quick and easy way to nominate a facility for the Renew Active network.

Participating Renew Active Fitness Centers in the Lafayette/West Lafayette area:

H. Ismail Center
ATI Physical Therapy
Faith East Community Center
Faith West Community Center
France A. Cordova Rec Sports Center
Lafayette Family YMCA
Live Well Fitness & Rehab Center at Westminster Village
New Energy Wellness Aster Place
Northend Community Center
Orangetheory Fitness
Parkwest Fitness
Planet Fitness
Pure Barre
Vasa Fitness
West Lafayette Wellness Center
YMCA Downtown Center

Note:

Renew Active is accepted at all Planet Fitness, Vasa Fitness and YMCA centers in any state.

December 2022

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Inflation Reduction Act of 2022

The Inflation Reduction Act of 2022 (IRA) is a United States federal law which aims to curb inflation by reducing the Federal deficit, lowering prescription drug prices and investing into domestic energy production while promoting clean energy. In order to comply with the provisions of IRA, United Healthcare (UHC) has provided the following update regarding insulin and vaccine coverage for PURA members enrolled in a plan with Part D prescription Drug coverage. Both PURCare (UHC Senior Supplement plus Part D prescription plan and the PURA/UHC Group Medicare Advantage PPO including Part D prescription plan) are impacted.

Effective January 1, 2023 for Insulin:

The IRA implements copay caps for insulin. The caps set the maximum cost-share per month supply at $35.00/$75.00/ $105.00 for a 1-month/2-month/3-month supply .
The caps are agnostic to preferred, non-preferred or non-formulary status (when covered by the plan).
The caps apply to both retail and mail order purchases.
In order to comply with IRA, UHC is implementing the IRA caps to ensure that members pay the lesser of their standard cost-share or the IRA cost-share.
PURA insureds should expect that their cost-share for insulin purchases will either be reduced or remain the same as pre-IRA.

Effective January 1,2023 for Vaccines:

IRA reduces cost and improves coverage for adult vaccine coverage under Medicare Part D, effective January 1, 2023. The following is a list of $0 copay vaccines under IRA:

Hepatitis A

Hepatitis B

Human Papillomavirus (HPV)

Japanese encephalitis

Measles-mumps-Rubella (Combinations)

Meningococcal bacteria (Combinations)

Poliovirus

Rabies

Respiratory Syncytial Virus (RSV)

Rotavirus

Shingles

Tetanus-Diphtheria-Pertussis (Select combinations)

Tick-borne encephalitis

Tuberculosis

Typhoid fever

Varicella

Yellow fever

Reminder, vaccinations for influenza, COVID and pneumonia are covered under Medicare Part B.

The IRA provides the means for impacting prescription drug prices in 2024 and beyond. Further information regarding the IRA’s impact on PURA insureds will be provided as it becomes available.

Last Updated: May 2025

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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

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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Helpful Medicare/Supplement Coverage Information

Federal Hospital Pricing Requirement

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) The Indiana All-Payer Claims Database (APCD) is a healthcare claims database overseen by the Indiana Department of Insurance. The APCD allows consumers to compare healthcare price and quality in Indiana. www.apcd.idoi.in.gov

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.

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End Of Life Issues: Planning Cornerstones

Planning for the end of life is a smart thing to do. It is actually the greatest gift we can give to our loved ones! We can do this by organizing our affairs, expressing our wishes, and providing instructions for handling end-of-life matters. The following planning tools have been developed for PURA members to use as aids in making this gift to your survivors.

Organizing My Affairs – a tool to assist you in gathering information that the person(s) responsible for managing your estate will need. You are encouraged to download and print this document from the PURA Website along with the associated instructions, then complete the materials, and keep them updated, in a safe place, and share and discuss them with those responsible for managing your affairs.
Steps to complete the “Organizing My Affairs” document – Go here and look for the heading End Of Life Issues where you will find a series of related documents.
What To Do When a Loved One Passes Away –– A detailed Survivors Check list to supplement “Organizing My Affairs.” It is focused on providing guidance to the survivors(s) and giving prudent assistance in answering these questions; What should I be doing? When should I be doing it? Etc.
Some Final Personal-Finance Advice from Jonathan Clements– An enlightening article by Jonathan Clements, founder of HumbleDollar.com and a former personal-finance columnist for The Wall Street Journal. He can be reached at reports@wsj.com. This article stimulates the thought process of keeping documents updated, addressing digital assets, assigning individual property, leaving good notes, striving for conflict-avoidance, and the importance of sharing your thoughts with your loved ones.
Four Questions Retired Couples Should Ask Themselves About Their Finances TODAY! – Among older couples, one spouse often oversees the family resources. If the financial steward dies or becomes mentally incapacitated, the surviving spouse is too often left in a state of financial confusion. This document focuses on “Do We Talk Enough About Our Money?” Are both partners on the same page about investment risk? Is there a back up plan if the financial steward dies first or develops dementia? Are good financial records being kept? Source: The Wall Street Journal.
What Happens to your digital life when you die? – A guide developed by co.uk as a useful tool with pointers on what one can do in advance to protect your phone, tablet, computer, or other electronic devise to make sure precious photos, passwords, online accounts, Facebook friends or other social media are preserved per your intent.

April 2025.

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Four Questions Retired Couples Should Ask Themselves About Their Finances TODAY!

Among older couples, one spouse often oversees the family finances. The other does not worry so much about it.

Until it is too late.

If the financial steward dies or becomes mentally incapacitated, the surviving spouse is too often left in a state of financial confusion. In particular, wives stand a good chance of being thrust into the role during widowhood, because average life expectancy for women in the U.S. is nearly six years longer than it is for men.

Advisers encourage couples to share their financial information and responsibilities for that very reason. Getting there, however, can require some hard work—and open discussion.

In our case, we have been married for almost 52 years. Michael retired well before Joann, leaving ample time for him to focus on our finances and apply investment knowledge gained as a journalist covering financial markets for Dow Jones Newswires. Though Joann is also a veteran business writer and former career columnist for The Wall Street Journal, she found taking personal investment risks stressful and was puzzled by some of the ways Michael managed their assets.

We have successfully worked through a lot of our financial issues as a couple, learning along the way what conversations are the most productive. To that end, we offer four questions we think couples should ask themselves to avoid the survivor trap that so often plagues couples when the financial steward must be replaced.

1. Do we talk enough about our money?

Marital partners frequently carve out distinct roles.

Joann long paid household bills and balanced our checkbook. But she delegated oversight of her 401(k) to Michael and rarely questioned our financial adviser during meetings. She admits it was because she feared her limited investment knowledge would make her sound stupid.

Investment reports can seem daunting, says Justin Flach, managing director of wealth strategy in the San Diego office of U.S. Bank’s Ascent Private Capital Management division. Before discussing specific investment strategies, a couple can start by talking about shared financial goals, Flach suggests. Goals might include setting aside money for overseas travel, gifting funds to family members or donating to favorite charities.

After jointly developing a financial plan, review it together at least yearly. Heather Osborn, the Nashville-based director of wealth planning at Baird, proposes a deeper dive at least every five years—or immediately after a life-changing event such as selling a business or retiring.

We often discuss our financial goals, which have shifted a little. We now have three grandchildren with “529” education-savings plans that regularly receive our contributions. We have also decided to spend more on international trips sooner rather than later.

2. Are both partners on the same page about investment risk?

It can be a problem if spouses have different levels of tolerance for investment risk. Eric Kirste, a principal wealth manager at Savvy Advisors in New York, says he has seen divorces result from conflicts caused by different investment philosophies.

David Salsburg, founding partner at Gresham Partners in Chicago, says one spouse should not accept more investment risk than he or she is comfortable with just to go along with a partner. One way to satisfy both spouses, he says, is to set aside enough assets in a conservative bond portfolio to meet their income needs while putting the remaining portion into higher-growth, and thus riskier, investments.

A spouse who lacks financial expertise needed for riskier moves could gain confidence by opening a brokerage account in his or her own name and buying shares of a few companies, mutual funds, or exchange-traded funds, says Blair duQuesnay, a senior adviser at Ritholtz Wealth Management in New York.

Joann long kept silent about her lower risk tolerance. But in late 2023, she asked Michael to trim the stocks in her retirement account because she worried that year’s big market gain might presage market pain. She now says our frank discussions about our attitudes toward risk have helped her better grasp the role that investment risk plays in pursuing our strategic goals.

3. Is there a backup plan if the financial steward dies first or develops dementia?

If Michael couldn’t continue overseeing our assets, Joann hopes our son, who is an attorney, would help guide her decisions. But when we raised this idea with our son, he expressed concern that this kind of advisory role might unfairly exclude his sister.

Experts point to other possible downsides of enlisting a family member’s assistance. For instance, this relative must be prepared to perform time-consuming tasks. The person also must be trusted by other future beneficiaries of an estate, says Flach of Ascent Private Capital.

Our plan now is to have our son assist Joann, supported by a financial adviser, whose neutral presence offers assurance that both siblings are being treated fairly.

To develop a good advisory relationship, both spouses should be involved in choosing and working with that professional, experts say.

4. Are good financial records being kept?

In our household, we recently reorganized financial files, adding investment account information and maturity dates for bonds. But we keep discovering information gaps. When Joann wanted details of our water-utility account, we realized that Michael had stored its password in an unusual location.

Anyone who needed to quickly take over our financial affairs could face similar problems. For example, this person would have to know how to get access to password-protected financial websites, possibly by using our cellphones for two-step verification.

Salsburg of Gresham Partners recommends creating a “just in case” binder, placing it in a safe location and informing family members about how to access it. The binder should list owned assets, how they are titled and names and phone numbers of important contacts such as advisers and account administrators. Also useful would be a list of major regular expenses, including utility bills, mortgage payments and property taxes, as well as how those were being paid, Salsburg says.

If one spouse has been paying all the bills, set aside time as a couple to go through records such as credit card and bank statements to capture all items and passwords. Pulling this information together can be tedious, but it is then much easier to maintain and update.

There is a critical detail about credit cards both parties should know about: When the primary account-holder for a card dies, that card cannot be used for any further transactions—even if the surviving spouse is designated as an authorized user. Someone who ignores that prohibition could be held liable for fraud. The surviving partner must have a new card issued in their own name.

April 9, 2024 – The Wall Street Journal.

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Some Final Personal-Finance Advice from Jonathan Clements

No one likes to think about their own demise, but planning can make life after your death significantly easier for heirs.

Here are five ways to help heirs avoid extra time, money, stress, and acrimony after you pass:

Keep documents updated

Having a will or living trust is essential—but it is not enough. The proper documents need to be updated periodically, especially as life circumstances change.

Amber Hughes, a lawyer in the Phoenix office of law firm Dickinson Wright, offers the example of a mother who belatedly drafted new estate-planning documents but died before signing them. The old will had named as heirs stepchildren she had not spoken to in 20 years, and her sons are spending tens of thousands of dollars to have the unsigned will enforced by a judge.

Related

Many people also fail to update beneficiaries for life insurance, retirement accounts and bank or investment accounts. These assets pass according to the beneficiary designation, if there is one, regardless of what the will or living trust says, says Laura Zwicker, chair of the private client services group at law firm Greenberg Glusker Fields Claman & Machtinger in Los Angeles.

A client’s brother had an IRA valued at several million dollars. When he died, the IRA funds went to a woman he had not dated for at least 10 years instead of to his brother’s daughters, even though they were named as beneficiaries in his trust. The heir indicated on the IRA was the former girlfriend, and that was the one that counted. “Imagine their surprise, but there’s nothing we can do about it,” Zwicker says.

Address digital assets

Many people have digital assets, including email and online photos, that could be lost to heirs if proper provisions are not put in place. For instance, a writer who stores plays or novels on a Google drive but does not set up a Google inactive-account profile, may make it harder or impossible for heirs to gain access to these works. Terms might differ, so having appropriate documentation on file with each provider is important.

Cryptocurrency and nonfungible tokens can also easily be lost if their owners don’t provide heirs a way to access these assets. So, people should make sure beneficiaries know how to access an account’s private keys—the secret numbers used to access cryptocurrency—as well as the kind of wallet and crypto type. One caveat: Those private keys and other sensitive information should not be included in a will because it becomes public through the probate process and that puts the assets at risk.

Assign personal property in advance

Many people assume that heirs will figure out on their own how to divide personal property, but that can lead to fights.

Hughes offers the example of three sisters who fought over their mother’s collection of hundreds of porcelain dolls. They had to hire a professional mediator to draw straws until all of the dolls were distributed. Had the mother made a personal-property list before she died, significant aggravation and hostility might have been avoided. The list can be handwritten and up-to-date and should be kept with estate-planned documents. The document should also include where items can be found.

Leave good notes

Estate- planning experts advise that people set aside a folder with important information for the heirs, such as names, numbers, and locations of accounts, as well as names and contact information for attorneys, accountants, and financial advisers. This is especially important since bills are often paid online, eliminating once-helpful paper statements. Also let heirs know where to find your estate-planning documents. “If you can’t find the will and you don’t know who the trust and estate attorney is, that’s a horrible situation,” says Seth Slotkin at law firm Akin Gump Strauss Hauer & Feld in New York.

One word of caution: Try not to leave unnecessary documents for your heirs, because it is overwhelming, Slotkin says. How long to keep certain documents depends on their nature, but generally speaking, purging unnecessary documents will save your heirs time and money, he says.

Strive for conflict-avoidance

Parents sometimes create conflict by choosing one child over another to serve as executor, trustee, or both, says Neil Solarz, shareholder at Weinstock Manion in Los Angeles.

Sometimes it may be appropriate. But in most instances, Solarz recommends naming a relative or friend to avoid potential sibling-rivalry issues. If there is no one else available, people might consider hiring a trust company or a private professional fiduciary—vetted and licensed individuals who are licensed to act as trustees or executors.

SHARE YOUR THOUGHTS

What is the most important step you have taken to make your estate simpler for your heirs? Join the conversation below.

People who have specific reasons for dividing assets or roles unevenly should prepare a letter that explains their thought process, which can help mitigate the potential for future conflicts, Slotkin says. For example, clarify that you named your daughter as executor because she lives locally, but that you want all of your children to work together to settle the estate, he says. Or, if you are leaving the younger of three children $100,000 more than the others, explain why. This extra step can mean the difference between harmony and acrimony among your heirs, he says.

“The thing that’s most likely to cause the estate process to dissolve into something horrible is acrimony among the children,” Slotkin says. “If you want to make things easy for your kids, if there’s anything that could be misinterpreted, explain it to them so they’re not fighting about it.”

November 3, 2024 – The Wall Street Journal.

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