Purdue Medical Plan Tobacco-User Additional Premium: Questions and Answers
Basic Information
$1,250 per employee and covered spouse, per plan year. (2025)
$1,500 per employee and covered spouse, per plan year (2026)
Studies show that a tobacco user's annual medical costs are on average $1,700 higher than the costs of a non-tobacco user. The additional premium amount was set per year, per person to recover a portion of these additional costs.
According to the Centers for Disease Control and Prevention, men and women who smoke have more lifetime medical expenses and are absent from work more days each year than those who do not smoke. In addition, smoking increases costly complications of pregnancy, such as pre-term delivery and low birth-weight infants.
The state has identified the following statistics about what tobacco costs Indiana each year:
- For every pack of cigarettes sold in Indiana, Hoosiers spend $7.57 in health care costs related to smoking.
- Indiana residents' state and federal tax burden from smoking-caused expenditures is $566 per household.
Annual smoking-related economic costs (including smoking-attributable medical expenditures and smoking-attributable neonatal medical expenditures) total $3,391 per smoker.
According to the National Institute on Drug Abuse:
- Smoking harms nearly every organ in the body. It's been linked to cataracts and pneumonia, and it accounts for about one-third of all cancer deaths. The overall rates of death from cancer are twice as high among smokers as among nonsmokers.
- Smoking has been linked to about 90 percent of all cases of lung cancer and is associated with many other cancers and lung diseases. It's also been well documented that smoking substantially increases the risk of heart disease, including stroke, heart attack, vascular disease and aneurysms.
- All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The amount of nicotine absorbed from smokeless tobacco is 3-4 times greater than that delivered by a cigarette, and while nicotine is absorbed more slowly from smokeless tobacco, more nicotine per dose is absorbed and stays in the bloodstream longer.
- Chewing tobacco and snuff contain 28 carcinogens (cancer-causing agents). Smokeless tobacco increases the risk for cancer of the oral cavity, which can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth. Other effects include oral leukoplakia (white mouth lesions that can become cancerous), gum disease, and gum recession (when the gum pulls away from the teeth).
Avoiding/Waiving the Additional Premium
2025 Additional Premium ($1,250)
2026 Additional Premium ($1,500)
For non-tobacco users:
To avoid the additional premium, you must certify during your benefits enrollment and subsequent annual open enrollment that you have not used tobacco in the 12 months immediately prior to completing your enrollment.
For tobacco users:
To waive the additional premium, you have the following options:
Complete an approved tobacco cessation program
You may begin a tobacco cessation program at any time, but it must conclude after January 1 of each year in order to apply toward your premiums that year. Submit your certificate of completion to HR by March 31 of each year to retroactively reduce your impacted premiums for that entire plan year (a refund will apply, if applicable). Certificates received after March 31 will reduce your premiums going forward only
Become tobacco-free for 12 months
If you do not want to complete a tobacco cessation program (e.g., you have already quit), you may submit Tobacco User Certification Form at the point where you have not used tobacco in the last 12 months. Submit the form by March 31 each year to retroactively reduce your impacted premiums for that entire plan year (a refund will apply, if applicable). Certificates received after March 31 will reduce your premiums going forward only. Note: You do not have to enter a recipient to email at the bottom of the form; it will automatically be routed to Human Resources.
Medical Alternative: If you are unable to participate in a traditional program due to a medical condition, contact Human Resources to develop an alternative way to qualify for waiver of the tobacco-user additional premium.