Preventive Health Assistance (Pha): Coverage And Limitations

01. Point System. The PHA benefit uses a point system to track points earned and used by a participant. Each point equals one (1) dollar. (7-1-26) a. Maximum Benefit Points. (7-1-26) i. The maximum number of points for a Behavioral PHA is two hundred (200) each benefit year. (7-1-26) ii. The maximum number of points for the Wellness PHA benefit is one hundred twenty (120) each benefit year. (7-1-26) b. Points expire at the end of the participant's benefit year. (7-1-26) c. Points cannot be transferred to, or combined with, points in another participant's PHA benefit. (7-1-26) 02. Weight Management Program. Each program must provide weight management services with at least one (1) of the following: (7-1-26) a. Physical fitness; (7-1-26) b. Balanced diet; or (7-1-26) c. Personal health education. (7-1-26) 03. Premiums. Wellness PHA benefit points are only used to offset a participant's premiums to maintain eligibility under IDAPA 16.03.01, if applicable. Only ten (10) points may be applied per month. (7-1-26)