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IUSD Mandatory Plan Aetna Student Health Insurance Student Health Insurance Coordinators April 30, 2015.

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Presentation on theme: "IUSD Mandatory Plan Aetna Student Health Insurance Student Health Insurance Coordinators April 30, 2015."— Presentation transcript:

1 IUSD Mandatory Plan Aetna Student Health Insurance Student Health Insurance Coordinators April 30, 2015

2 IUSD Mandatory Plan 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

3 Enrollment and Waiver Process Enrollment Students are automatically enrolled in the student insurance plan each semester and the cost of the student premium is billed through the bursar. Waiver Students can provide proof of comparable coverage. A waiver must be filed online at Aetna Student Health by the waiver deadline (September 1)Aetna Student Health Requirements: 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. April 30, 2015IUSD Mandatory Plan Student Price Annual$2,800 Fall$1,400 Spring$1,400

4 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 April 30, 2015IUSD Mandatory Plan

5 Summary of Benefits Annual Deductible$350 per Person$700 per Family Annual Out-of-Pocket Limit$5,000 per Person$10,000 per Family ExpensesPreferredNon-Preferred IUPUI Health Services100% after a $10 copay Preventative ServicesCovered at 100% with no cost sharing. Office Visit100% after a $20 copay70% Hospital Room and Board90%70% Emergency Room100% after a $50 copay Diagnostic X-Ray Services90%70% Ambulance Expenses 100%70% Maximum of $1,500 per trip for air transport; maximum of $150 for ground transport. April 30, 2015IUSD Mandatory Plan

6 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. April 30, 2015IUSD Mandatory Plan

7 Prescription Coverage Prescription Drug Expenses Preferred $100 Annual Deductible then: Non-Preferred Generic$10 Copay 50% Preferred Brand$30 Copay Non-Preferred Brand$50 Copay April 30, 2015IUSD Mandatory Plan Need to contact Aetna Pharmacy Management? Call AETNA-RX ( )

8 April 30, 2015IUSD Mandatory Plan Please note that Mail Order Pharmacy will be an option for the 2011/2012 plan year.

9 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: Outside the United States: /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 April 30, 2015IUSD Mandatory Plan

10 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 April 30, 2015IUSD Mandatory Plan 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.

11 Optional Dental Coverage Summary of Benefits Participating Provider Non-Participating Provider Individual Annual Deductible $25 Family Annual Deductible$75 Annual Benefit Maximum$500 Office Visit CopayNone Routine Cleaning/Exam (No Deductible) Two Routine cleanings/exams per policy year at 100% (Non-Participating Provider is subject to a R&C limit) Basic/Major Services 50% of Covered Charges (Non-Participating Provider is subject to a R&C limit) April 30, 2015IUSD Mandatory Plan

12 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. April 30, 2015IUSD Mandatory Plan

13 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:Aetna Navigator®. Review who is covered under your plan. Request, view and print member ID cards. View Claim Explanation of Benefits. (Sample EOB)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 to Customer Service. View the latest health information, news, and more! April 30, 2015IUSD Mandatory Plan

14 Contact Information Information about this plan and a copy of this presentation can be found at: Tonya McCray and Laura Sargent Phone: Appointments can be made to speak with us at anytime during the year. Please contact us at the information above to make your appointment. April 30, 2015IUSD Mandatory Plan


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