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Health Insurance Changes in 2013

Co-Payment Reduction for Kaiser HMO Primary Care Office Visits: Co-payments for primary care office visits will decrease to $15 under the Kaiser HMO plan. All other HMO plan co-payments are unchanged.

Preventive Services: Preventive care services under the health plans will expand in 2013 to include eight new prevention-related health care services for women: well-woman visits; screening for gestational diabetes; contraceptives; human papilloma virus testing; screening and counseling for sexually transmitted infections and human immune-deficiency virus; breast feeding support, supplies and counseling; and screening and counseling for interpersonal and domestic violence. Preventive care services are covered at 100% by the plan and are available to participants at no out-of-pocket cost.

Tobacco Cessation Support: To aide efforts towards eliminating tobacco from your life and improving your health, beginning January 1 over-the-counter nicotine replacement products – such as patches and gums – and tobacco cessation support medications will be available at no out-of-pocket cost to participants in the CVS Caremark prescription drug insurance plan; a prescription is required to qualify for this enhanced benefit. No prior authorization is required. An annual limit of two cycles (12 weeks per cycle) for any combination of brand or generic nicotine replacement products or medications applies. Additional cessation support resources are offered at reduced or no cost:

  • MMO SuperWell QuitLine - Telephone coaching service for MMO subscribers. Up to 5 coaching sessions and 4 weeks of NRT included at no cost. Call 866-845-7702.
  • Kaiser – Telephone coaching, NRT and other resources for Kaiser subscribers. Prescription drug copayments apply.
  • Kp.org/Listen – Online guided imagery podcast. Free resource available to anyone.
  • Anthem – Online cessation programming through SelfHelpWorks. 40% discount for Anthem subscribers.
  • EASE@Work – Individual counseling with an addictions specialist or hypnotherapist. Up to 3 individual therapy sessions at no cost. Available to CWRU employees and spouses/equivalents.

Health Care FSA Contributions Limited to $2,500: A provision of the Patient Protection and Affordable Care Act limits health care flexible spending account contributions to $2,500 beginning in 2013.

New IRS Limits for Health Savings Account Contributions: In 2013 the annual IRS limits on Health Savings Account contributions are increasing to:

  • Employee only HDHP coverage - $3,250
  • Family HDHP coverage - $6,450

Individuals age 55 and older may be eligible to contribute up to an additional $1,000. The IRS defines “family” coverage as qualifying HDHP insurance that covers an employee and at least one dependent.