PEBB Increases Cost Sharing to Plug Budget Hole
- The board added a $500 co-pay for certain specialty services such as hip replacement, knee replacement and bariatric surgery.
- It imposed a $100 co-pay for emergency room visits where the patient is not admitted to the hospital was approved.
- The board placed a limit on alternative care visits such as chiropractic, acupuncture and naturopathy, limiting them to 60 covered visits or $1,000.
- Member cost sharing for dental crowns was increased from 25 percent to 50 percent.
- The board also voted to end a rural subsidy to 18 counties that paid out-of-network providers as if they were in the statewide plan network regardless of whether they comply with the plan’s quality requirements. Beginning April 1, those providers will be subject to out-of-network charges.