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Health Insurance What is health insurance?  Health insurance provides protection against the risk of financial loss resulting from an insured person’s.

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Presentation on theme: "Health Insurance What is health insurance?  Health insurance provides protection against the risk of financial loss resulting from an insured person’s."— Presentation transcript:

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2 Health Insurance What is health insurance?  Health insurance provides protection against the risk of financial loss resulting from an insured person’s sickness, accidental injury or disability. Are you required to have it?  Yes, immigration and university regulations require F & J visa holders to have sufficient coverage.

3 Health Insurance Why is health insurance important?  The United States offers superior health care, but it’s the most expensive in the world. Should an accident or illness occur and you’re not covered the financial burden can be overwhelming.  Health insurance protects you from these high costs and ensures the best care by providing coverage for specific health care services.

4 EMU’s Student Health Insurance  Policy Coverage  Injury and Sickness Policy  Health benefits coverage up to $100,000 per Injury or Sickness  Surgery is covered as long as it is a result of an accident or illness  Does not include dental and vision coverage unless care is related to an accident or illness.

5 EMU’s Student Health Insurance Primary Care Provider  Clinicians at University Health Services (Snow Health Center) are your primary provider(s)  Medical appointments, lab work, prescriptions  You must come to our facility if you are within 50miles.  If a referral is desired you must get this from a clinician at University Health Services before seeing a specialist.  In-Network Providers  United Health Care: Snow Health Center  Cofinity Network (in Michigan): St. Joseph Mercy Hospital (Ypsilanti, Livingston and Saline)  Private Healthcare Systems (PHCS) if you are outside of the state. https://www.uhcsr.com/

6 EMU’s Student Health Insurance In-Network Costs  You pay a $100 deductible, plus 20% of the total bill  The maximum out-of-pocket coinsurance you would pay is $2,500 (per policy year).  United Healthcare will pay everything else up to $100,000 (per injury or sickness). Out-of-Network Costs  You pay a $100 deductible, plus 30% of the total bill  The maximum out-of-pocket coinsurance you would pay is $10,000 (per policy year).  United Healthcare will pay the remaining bill up to a maximum benefit of $100,000 (per injury or sickness).

7 EMU’s Student Health Insurance Urgent Care  A facility dedicated to the delivery of medical care outside of a hospital emergency department  Primarily used to treat patients who have an injury or illness that requires immediate care but is not serious enough to warrant a visit to an emergency room Emergency Room  Part of the hospital providing rapid treatment to victims of sudden illness or trauma.

8 EMU’s Student Health Insurance Referrals  You must obtain a referral from UHS before seeking outside care.  Expenses incurred for medical treatment rendered outside of Snow Health Center for which no prior approval or referral is obtained are excluded from coverage.  A SHC referral for outside care is not necessary only under the following conditions (though you must follow-up with SHC):  Medical emergency  You must return to SHC for follow-up  When Snow Health Center is closed  Weekends, during break or vacation periods  Medical care is obtained at a clinic or office that is more than 50 miles from campus  Maternity; or  Mental Illness Treatment

9 EMU’s Student Health Insurance Receiving care at Snow We do the paperwork! Receiving care outside of Snow Doctor Visit and Lab work $10 co-pay You pay $100 deductible Insurance covers a percentage of the remaining balance; 80% if you were seen in network or 70% if you were seen out of network Prescriptions $10 – $20 co-pay *Most generic forms of birth control are covered at no cost. You pay full price and send in for reimbursement. Reimbursement is 50%, for a maximum of $100 Mental Health $10 co-pay (first visit is $15) You submit for reimbursement To receive care outside of Snow a referral is required prior to the visit unless it is an emergency.

10 EMU’s Student Health Insurance Preventative Care  When performed at Snow Health Center, the policy will provide Preventative Care for FREE  General Wellness Exam: physical exam and various screening or lab test depending on age, family history and health history.  Women’s Gynecological Exam: breast and pelvic exam, pap test, some STI testing

11 Scenario #1:  It is Wednesday morning and you wake up still not feeling better. You have had a sore throat and cough for two days that just won’t seem to go away.  What do you do?

12 Being Seen at the Snow Health Center  Appointments are preferred, but Walk-Ins are welcome.  Typically can get an appointment the same day or within 24hrs.  Types of Services we provide include:  Coughs and colds to sprained ankles and mole removals  Allergy shots, immunizations, flu shots  Women’s health care

13 Visiting a Doctor  Ask your doctor questions and listen for clear answers.  Know what prescriptions you are taking, when to take them and what not to mix with them.  Make certain that you understand your doctor’s responses. Take notes, if necessary.  Keep a log or diary of symptoms, concerns or unusual problems that occur.

14 Ease of Access  Accept various forms of payment including:  Billing to student’s tuition account for actively enrolled students  Cash, personal checks or credit cards

15 Scenario #2:  It is a Saturday afternoon and you decided to take a bike ride. While out having a good time you hit a bump on the path and fall off your bike. You land on your ankle and can tell its broken.  What do you do?

16 EMU’s Student Health Insurance Is it an Emergency?  In a life-threatening emergency, seek immediate attention by calling 911 or going to the Emergency Room at your nearest hospital.  Some examples include: Choking Not breathing Suspected poisoning or overdose Severe injuries, such as suspected broken bones, head injuries or heavy bleeding Seizures or convulsions Numbness or paralysis of an arm, leg or one side of the body A sudden, severe headache, especially if there is neck pain or a change in consciousness. Domestic violence or rape A change in mental ability, such as not knowing where you are or being unable to recognize familiar people

17 Scenario #3:  It is the weekend and the health center is closed. You have a fever and have been vomiting for several hours.  What do you do?

18 EMU’s Student Health Insurance  Call our Hotline to speak with a Registered Nurse 24 hours a day, 7 days a  They will discuss options  They cannot speak to what is or is not covered under the policy.  If it is a non-emergency and we are closed, but you feel you need to be seen it is best to go to an Urgent Care Facility.

19 Important Contact Information:  Student Insurance Office:  University Health Services (UHS):  Nurse Hotline:  United Health Care:  UHS:  United Health Care:  Cofinity: https://www.cofinity.net/cofinity/Index.aspxhttps://www.cofinity.net/cofinity/Index.aspx  PHCS:

20 EMU’s Student Health Insurance Billing for Student Insurance:  When registering for Winter semester a charge of $930 was automatically placed on your bill. This covers the Winter and Summer semesters.  If you are graduating at the end of the Winter semester and you no longer wish to have coverage you will need to bring your I-20 or DS-2019 to the Student Insurance. We will remover the Summer charge of $465.

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