Aetna Student Health Insurance IUSD Mandatory Plan Student Health Insurance Coordinators April 13, 2015
IUSD Mandatory Plan
April 13, 2015
What you need to know about IUSD Mandatory Student Insurance • • • • • • • •
Student Enrollment and Waiver Coverage of Dependents Summary of Benefits Prescription Coverage Traveling Abroad Optional Dental Coverage Optional Health Discounts Aetna Navigator
IUSD Mandatory Plan
April 13, 2015
Enrollment and Waiver Process Enrollment
Waiver
•
•
Students can provide proof of comparable coverage. A waiver must be filed online at Aetna Student Health by the waiver deadline (September 1)
•
Requirements:
Students are automatically enrolled in the student insurance plan each semester and the cost of the student premium is billed through the bursar.
Student Price Annual
$2,800
Fall
$1,400
Spring
$1,400
•Emergency Coverage Internationally. •Inpatient and Outpatient Behavioral Health within the IUSM and IUSD area. •$5,000 for Prescription Coverage. •$1,000,000 Maximum Benefit per Lifetime per Condition.
IUSD Mandatory Plan
April 13, 2015
Coverage of Dependents • If you are covered by the Indiana University Mandatory Student Insurance Plan, you may also enroll your spouse/same sex domestic partner (residing with the insured student) and dependent children under age 26. Dependent Enrollment Deadline • Fall: September 1, 2011 • Spring: February 28, 2012 Per Semester Cost • Spouse $2,290 • Child(ren) $1,217
IUSD Mandatory Plan
April 13, 2015
Summary of Benefits Annual Deductible
$350 per Person
$700 per Family
Annual Out-of-Pocket Limit
$5,000 per Person
$10,000 per Family
Expenses
Preferred
Non-Preferred
IUPUI Health Services
100% after a $10 copay
Preventative Services
Covered at 100% with no cost sharing.
Office Visit
100% after a $20 copay
70%
Hospital Room and Board
90%
70%
Emergency Room
100% after a $50 copay
Diagnostic X-Ray Services
90%
70%
100%
70%
Ambulance Expenses
Maximum of $1,500 per trip for air transport; maximum of $150 for ground transport.
IUSD Mandatory Plan
April 13, 2015
Benefit Examples • Maternity •
Covered Medical Expenses for pregnancy, childbirth, and complications of pregnancy are payable on the same basis as any other sickness.
• Mental Health (Outpatient) • •
Preferred Care: 100% of the Negotiated Charge. Non-Preferred Care: 70% of the Reasonable Charge.
• Physical Therapy • •
Preferred Care: 90% of the Negotiated Charge. Non-Preferred Care: 70% of the Reasonable Charge.
IUSD Mandatory Plan
April 13, 2015
Prescription Coverage Prescription Drug Expenses
Preferred $100 Annual Deductible then:
Generic
$10 Copay
Preferred Brand
$30 Copay
Non-Preferred Brand
$50 Copay
Need to contact Aetna Pharmacy Management? Call 1-800-AETNA-RX (1-800-238-6279)
Non-Preferred
50%
IUSD Mandatory Plan
Please note that Mail Order Pharmacy will be an option for the 2011/2012 plan year.
April 13, 2015
IUSD Mandatory Plan
April 13, 2015
Traveling Abroad On Call International Coverage anywhere – At school, home or traveling.
Travel Assistance • 24/7 Emergency Travel Arrangements • Translation Assistance • Emergency Travel Funds Assistance • Lost Travel Documents Assistance • Assistance with Replacement of Credit Card/Travelers Checks If you require medical assistance and are more than 100 miles from home call: Within the United States: • 866-525-1956 Outside the United States: • 603-328-1956
24/7 Worldwide Medical Information & Assistance • Pre-Trip Plans • Medical Monitoring • Medical/Dental/Pharmacy Referral • Hospital Deposit Arrangements • Prescription Drug Replacement Assistance • Dispatch of Physician • Unlimited Emergency Medical Evacuation • Unlimited Medical Repatriation • Visit by Family Member/Friend during hospitalization • $2,500 Emergency Return Home in the event of death or life threatening illness of a parent or sibling
IUSD Mandatory Plan
April 13, 2015
Optional Dental Coverage Dental Premiums Student
Spouse/Same Sex Domestic Partner
Children
Annual
$260
$312
$466
Fall
$130
$156
$233
Spring/Summer
$130
$156
$233
Aetna Dental is an optional plan and students must enroll online. Students are not enrolled automatically like they are for medical. With Aetna Dental PPO, participating dentists have agreed to provide services at a negotiated rate for covered services, so you generally pay less out of pocket.
IUSD Mandatory Plan
April 13, 2015
Optional Dental Coverage Summary of Benefits Participating Provider
Non-Participating Provider
Individual Annual Deductible
$25
$25
Family Annual Deductible
$75
$75
Annual Benefit Maximum
$500
$500
Office Visit Copay Routine Cleaning/Exam (No Deductible) Basic/Major Services
None Two Routine cleanings/exams per policy year at 100% (Non-Participating Provider is subject to a R&C limit) 50% of Covered Charges (Non-Participating Provider is subject to a R&C limit)
IUSD Mandatory Plan
April 13, 2015
Optional Health Discounts Accessible in Aetna Navigator
As a member of the Plan, you can also take advantage of the following services, discounts, and programs. These are not underwritten by Aetna and are not insurance. Please note that these programs are subject to change. Aetna Fitness℠ Discount Program • Access to preferred rates on gym memberships and discounts on at-home weight loss programs, home fitness options and one-on-one health coaching services through GlobalFit™. Aetna Vision℠ Discount Program • Access to discounts on vision exams, lenses and frames when a member utilizes a provider participating in the EyeMed Select Network. Aetna Weight Management℠ Discount program • Access to discounts on eDiets® diet plans and products, Jenny Craig® weight loss programs and products, and Nutrisystem® weight loss meal plans.
IUSD Mandatory Plan
April 13, 2015
Aetna Navigator Aetna Navigator®. is your members-only website. It's secure, so your information is protected. View your personalized claims and health information. You can do it all right here — 24 hours a day, 7 days a week. • By logging into Aetna Navigator®. you can: • Review who is covered under your plan. • Request, view and print member ID cards. • View Claim Explanation of Benefits. (Sample EOB) • Access Health Discounts & Resources. • Look up costs and other health related information before you seek care and to better plan your expenses. • Research the price of a brand name drug and learn if there are generic alternatives. • Find health care professionals and facilities that participate in your plan. • Send an e-mail to Customer Service. • View the latest health information, news, and more!
IUSD Mandatory Plan
April 13, 2015
Contact Information Information about this plan and a copy of this presentation can be found at: http://www.hr.iu.edu/benefits/students.html
Tonya McCray and Laura Sargent • Email:
[email protected] • Phone: 812-855-4650 Appointments can be made to speak with us at anytime during the year. Please contact us at the information above to make your appointment.
