Vaccines for Children: List By Age, Benefits, Safety
What's Preventive Healthcare Insurance And What's Covered Under These Plans?
Preventive health insurance is exactly what it sounds like: a plan that covers care received in order to prevent the onset of illness.
Historically, most plans have covered preventive care at varying levels. After the passing of the Affordable Care Act, all plans are now required to cover preventive doctor's visits and exams at zero cost to the consumer.
Insurance companies are mandated by law to provide this level of benefit for any service that's determined to be preventive, such as your annual physical exam. Be sure to check your benefits summary, though.
Many plans, such as PPO plans, provide 100 percent coverage for preventive care, but require you to use an in-network provider.
Keep reading to learn more about what's covered under preventive healthcare benefits.
Preventive care can be categorized into three buckets:
Each category has its own list of preventive services. In an ACA-compliant plan, the following services must be covered at 100 percent. Be aware that fee schedules may change if you're enrolled in a grandfathered or grandmothered plan, as those plans aren't subject to the same ACA requirements.
Preventive care for adultsAn adult is anyone over the age of 18.
Screenings
Medications
Immunizations
Immunization doses, recommended ages, and recommended populations vary, so check with your insurance provider to understand your coverage for the following immunizations.
Counseling
Preventative care for women falls into two buckets, care for all women, and care for women who are pregnant or may become pregnant.
Preventive care for childrenA child is anyone under the age of 18.
Screenings
Medications
Immunizations
Immunization doses, recommended ages, and recommended populations vary, so check with your provider before your child receives one of the following vaccines to determine your coverage:
Additional services covered
Another preventive service that most insurance companies cover are wellness programs. Many consumers either don't utilize or aren't aware of this benefit.
Wellness programs are designed to improve and promote health and fitness. They're usually offered through an employer or employer-sponsored plan, but insurers also offer them directly to individual enrollees.
These programs often offer incentives and rewards to participants for achieving specific milestones toward a healthier lifestyle. For example, the carrier may offer you a $50 gift card for losing 5-10 pounds, exercising more during the week, or undergoing biometric screening.
Preventive services must be offered to you and your dependents free of charge as long as you're receiving care within your plan's network of health providers and facilities.
Preventive services are covered at this level of benefit regardless of the plan type or insurance carrier as long as your plan is ACA compliant. If you're currently enrolled in a grandfathered or grandmothered plan through a group policy, you may be subject to copays or coinsurance.
It's always a good idea to consult your broker, HR person, or insurance provider if you're unsure if a specific service is covered. For more information as well as updates to the list of covered preventive services, visit Healthcare.Gov.
Best Dental Insurance Companies With No Waiting Periods
After reviewing some of the best dental insurance providers, we found that Anthem Blue Cross Blue Shield (BCBS) is the best dental insurance company with no waiting periods. Anthem has the best overall cost-to-value score, the highest annual maximum coverage, and the best coverage for major dental services, both in-network and out-of-network. To find the best dental insurance with no waiting period, we researched 10 insurers in two Texas and California ZIP codes that provide dental insurance with no waiting periods for preventive care (such as exams and cleanings), basic care (like fillings and extractions), and major care (including crowns, implants, and braces). We made our picks based on 11 criteria, including plan costs, coverage percentages, and customer satisfaction.Choosing The Right Medical Plan
Evaluating the best option for you and your family PPO Plan to Go Away in 2021Every year, it is part of our process to evaluate our benefit plans to ensure we're balancing quality and affordability. During our analysis this past year, we concluded that the Purdue Health Plan (PPO) is no longer a sustainable or cost-effective option — for you or Purdue. This plan is costing employees and the university more money with no real overall advantage. (You can read more on that in a white paper that summarizes research on Purdue's plans.) For that reason, the PPO plan will not be available in 2021; however, in order to help ease the transition as individuals switch plans in 2021, we are looking at a HDHP replacement that has a similar plan design and cost structure as the PPO. In the meantime, for 2020, the PPO will only be an option for those currently enrolled in it. New enrollees are not eligible.
How Medical Plan Costs CompareThe premiums for the PPO plan are significantly higher than the two HSA plans. Additionally, Purdue's claims data shows that even though the deductible is higher with the HSA plans — which translates into higher out-of-pocket expenses during the year when services are needed — when you factor in upfront premium and Purdue's HSA contributions ($325 – employee only / $650 – employee plus), employees are actually spending LESS with the HSA plans. The Healthy Boiler Program wellness incentive also offers employees the opportunity to double those HSA contributions and earn an additional $325 (employee only) or $650 (employee plus).
See our full medical plan cost analysis here.
Now or Later?While current PPO members may select the PPO for 2020, you may consider transitioning now to a different plan. After all, the HSA plans offer the same provider network and free preventive care as the PPO plan. Even more, by choosing a health plan with a lower premium, you have an opportunity to put the money you save on premiums into an HSA to pay for medical services. If services aren't needed, the tax-free money in an HSA can accumulate and over time can become an important part of your retirement savings. Between contributions Purdue will make on your behalf and adding your savings from premiums, you can gain the best value with your healthcare dollars.
FSA vs HSA
If you've used an FSA on the PPO plan, the HSA works in a similar fashion; however, unused HSA dollars roll over year after year and are not subject to the FSA use-it-or-lose-it provision. In other words, the HSA funds are yours to use on healthcare expenses – you never lose the funds.
One-on-One Assistance AvailableHave questions about your 2020 benefit elections? You can schedule a one-on-one meeting with a Benefits representative to learn more about your options and address any questions you may have before you have to make enrollment decisions. Registration is now open and available via the Resources web page. Use your Purdue ID and BoilerKey to access registration in Successfactors. Please be sure to include a description of what you want to discuss. This helps the Benefits representative prepare for the meeting.
More Resources Available OnlineWe understand that selecting a medical plan for you and your family is a big decision. Our "Choosing the Right Medical Plan" video outlines some of the things you should consider when picking a plan. Plus, it takes you through a few scenarios — with single and family coverage, and if you tend to need regular medical care or just occasional care.
This year, we are adding a new tool to help you as you estimate your expenses for 2020 under each of the medical plans available to you. The tool is called Core Analytics, and you will have direct access to it when you go to enroll within Benefitfocus. Within the tool, you can estimate costs by looking at national averages of people with similar demographics. You can also personalize the data by entering what you think your healthcare needs will be in the coming year, and the tool will show you results of your estimated costs between the plans. Finally, the tool also allows you to evaluate your options by looking at your own claims' costs over the last year. Whichever way you choose, Core Analytics will show your estimated costs, so you can compare the plans.
View our Resource Page
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