Changes in Expenses Covered by Healthcare Plans

Alpharetta, GA October 16, 2003: Despite the popularity and health benefits of diet programs and smoking cessation
programs few healthcare plans cover such expenses, according to a recent survey conducted by Culpepper and Associates of companies in the high-tech industry.

One of the most notable changes from last year's study is the increase in coverage for fertility treatments. Last year no healthcare plans covered fertility treatments; this year almost half of all plans cover this expense.

Emergency care and prescriptions are the only two healthcare expenses covered by all plans. Nearly all the plans cover other basic healthcare expenses such as annual physicals, maternity care, and x-rays.

Despite the increasing popularity of diet programs and laser eye surgery, few plans cover these expenses. A few respondents did note that they offer coverage for such expenses under supplemental plans.

Expenses Covered by Type of Plan:
Nearly all PPO plans cover the most common healthcare expenses such as prescriptions and emergency care. However, very few plans cover smoking cessation programs, diet programs, laser eye surgery, or experimental treatments.

Coverage under POS plans is nearly identical to coverage provided under PPO plans. The main difference being POS plans require employees to first select a primary care physician and then obtain referrals for specialized care.

Coverage under HMO plans is similar to the coverage provided under PPO and POS plans. The main distinction under HMO plans is the lack of coverage provided for out-of-network care.

In all cases, POS and PPO plans are more likely to cover expenses if the healthcare is provided by an in-network or preferred provider. Coverage across POS, PPO, and HMO plans is quite similar.

Expenses Covered by Company Size:
POS plans display the greatest disparity, with large company plans providing more comprehensive coverage than small company POS plans. Chiropractic care is more likely covered under large company healthcare plans regardless of the type of plan offered.




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