Presentation on theme: "PRESENTATION: MANDATORY HEALTH INSURANCE FOR INTERNATIONAL F-1, F-2, AND J-1 STUDENTS STUDENTS."— Presentation transcript:
PRESENTATION: MANDATORY HEALTH INSURANCE FOR INTERNATIONAL F-1, F-2, AND J-1 STUDENTS STUDENTS
WHY MUST I HAVE A HEALTH INSURANCE PLAN? UNITED STATES FEDERAL LAW REQUIRES YOU HAVE INSURANCE WHILE YOU ARE UNDER OUR SPONSORSHIP. HEALTH INSURANCE IS ABSOLUTELY NECESSARY IN THE U.S., ESPECIALLY ON LONG ISLAND, SINCE MEDICAL COSTS ARE VERY HGH. YOU MAY HAVE ANOTHER PLAN, BUT OURS IS MANDATORY WHILE YOU ARE A STUDENT HERE.
WHAT IS INSURANCE ? IT IS A CONTRACT YOU AND A COMPANY MAKE, WHICH ASSURES THEY WILL PAY FOR CERTAIN MEDICAL EXPENSES YOU MAY HAVE. THEY TAKE THE RISK—YOU DON’T ! THE CONTRACT STATES WHAT THE INSURANCE COMPANY WILLPAY FOR YOU. HEALTH INSURANCE IS PURCHASED WHILE YOU ARE HEALTHY. JUST AS CAR INSURANCE IS ALWAYS PURCHASED BEFORE YOU HAVE THE ACCIDENT! ACCIDENT!
OK, SO HOW MUCH AM I PAYING AND WHAT DO I GET? THE COST OF THE SPRING 2011 INSURANCE IS $636, INCLUDING MEDEX. THIS WILL BE POSTED TO YOUR SOLAR ACCOUNT AS SOON AS YOU REGISTER FOR CLASSES. THIS INSURANCE PLAN WILL PROVIDE HEALTH INSURANCE BENEFITS FOR YOU, JANUARY 15, 2011 THROUGH AUGUST 14, ALL OF YOUR NECESSARY MEDICAL BILLS WILL BE PAID AT 100% BY HTH.
MANDATORY HEALTH INSURANCE What are the benefits? ALL ILLNESSES AND ACCIDENTS ARE COVERED: 1. MEDICALLY NECESSARY INPATIENT HOSPITAL CARE IS PAID BY HTH, INCLUDING FEES FOR ROOM AND BOARD, DIAGNOSTIC TESTING, SURGERY, MEDICINE, AND MORE. 2. MEDICALLY NECESSARY OUTPATIENT CARE IS PAID BY HTH INCLUDING: –DOCTOR VISITS –EMERGENCY ROOM –DIAGNOSTIC TESTS –X RAYS, SONOGRAMS, ETC. –HIGH COST PROCEDURES –SURGERY –MENTAL HEALTH COUNSELING –MEDICINES, –AND MORE
THE MANDATORY PLAN DOES NOT PAY FOR DENTAL PROBLEMS LIKE X-RAYS, FILLINGS, EXTRACTIONS, ETC. IT ALSO DOES NOT PAY FOR VISION (EYE) EXAMS, EYEGLASSES, OR CONTACT LENSES HOWEVER, YOU MAY VOLUNTARILY ENROLL IN A DISCOUNT PLAN FOR VISION EXAMS, EYEGLASSES AND CONTACT LENSES, AND A SEPARATE DENTAL DISCOUNT PLAN. GO TO : Enter STONY BROOK, and look for DISCOUNT PLANS You may enroll on-line. YOU DIDN’T MENTION DENTAL WORK OR EYE EXAMS
SPRING INSURANCE COVERAGE ENDS AUGUST 14 Although your academic work ends in MAY, we are required to keep you enrolled in the international health insurance plan through the middle of August. if you leave the U.S. briefly (such as visiting your home country or anywhere else during the winter, spring or summer breaks), you will remain on our health insurance plan.
WHAT IF I AM A TA, GA OR RA ? REMEMBER that FIRST you will be automatically billed for the Mandatory Health Insurance as soon as you register for classes EACH SEMESTER! If you enroll in either the TA, GA, or RA insurance plan, we will remove the charges for the mandatory insurance plan in March. HOWEVER, because you may not have an assistantship all the time you are here, you may remain on the mandatory health insurance plan during certain semesters. Please listen to the entire orientation!
WHAT IF I HAVE A SPOUSE WHO IS A TA or GA or RA at Stony Brook and I have health INSURANCE THROUGH him or her? 1.You must enroll as a dependent on either the TA, GA, or RA insurance plan at the health insurance office. 2.You must also apply at the same office for a waiver of the mandatory insurance plan by February 14, and submit the proofs we specify on the instruction form. We will waive your mandatory insurance only once during a semester. 3.if your spouse loses the TA, GA, or RA insurance, then you and your spouse will both be billed for the mandatory plan.
HOW DO I ADD DEPENDENTS TO MY MANDATORY INSURANCE PLAN ? TO INSURE DEPENDENTS YOU MUST : GET AN APPLICATION FROM THE HEALTH INSURANCE OFFICE. COMPLETE THE FORM, AND SEND IT TO THE INSURANCE COMPANY WITH YOUR CHECK OR MONEY ORDER. YOU MUST ENROLL YOUR DEPENDENT WITHIN 30 DAYS OF HIS/HER ARRIVAL IN THE U.S., OR WITHIN 30 DAYS OF YOUR MARRIAGE, OR THE BIRTH OF A CHILD, OR WITHIN 30 DAYS OF THE TERMINATION OF OTHER INSURANCE.
USING YOUR INSURANCE PLAN WISELY THE STUDENT HEALTH SERVICE (INFIRMARY) SHOULD ALWAYS BE YOUR FIRST STOP WHEN YOU ARE SICK OR HAVE AN INJURY. IT IS ON THE WEST CAMPUS ACROSS FROM THE ‘H’ AND MENDELSOHN QUADS. PHONE NUMBER IS FOR STUDENTS ONLY; NO DEPENDENTS
USING YOUR INSURANCE PLAN WISELY, CONTINUED ALL STUDENTS MUST PAY AN INFIRMARY FEE EACH SEMESTER. THE SPRING 2011 FEE IS $ THE INFIRMARY FEE PAYS FOR MEDICAL CARE ONLY AT THE CAMPUS INFIRMARY. (NOT AT UNIVERSITY HOSPITAL). YOUR MANDATORY HEALTH INSURANCE PLAN WILL START PAYING YOUR NECESSARY MEDICAL BILLS AFTER YOU USE THE INFIRMARY. THE $50 PLAN DEDUCTIBLE WILL BE WAIVED IF YOU USE THE INFIRMARY FIRST.
USING THE EMERGENCY ROOM (ER) IN THE U.S. THE EMERGENCY ROOM (ER) IS THE PLACE TO GO IF YOU HAVE A LIFE- THREATENING PROBLEM (such as chest pain, a broken bone, problems breathing, or bleeding that cannot be stopped). No matter where you are, if you are NOT SURE if you have a true emergency, go to the closest emergency room, and visit our office when you feel better so we can help you with your claim. If you are SURE you DO NOT HAVE a true emergency, then go to the west campus Infirmary first, and follow the nurse or doctor’s recommendations. If you are away from campus and have a bad cold you may go to a walk-in or urgent care clinic. In this situation you will pay the first $50of your medical bill.
MEDICAL CARE IN THE U.S. We have some of the best medical professionals in the world. Physicians either have a private “practice” of their own, or join up with other physicians in a larger “practice”, or see patients at a hospital office. Some physicians offer “family medicine” or a “general practice”; some are specialists in specific diseases such as “internists”, who specialize in many medical problems, including digestive problems. A physician who has a State license to practice medicine, and is also an “acupuncturist” is covered by our plan.
More… Expect to be charged a minimum of $100 for a physician office visit. If you consult a specialist, the cost could be $250 or more for an initial visit, depending on the specialty and what the physician provides. The international insurance plan will pay in full for these costs ONLY if you have been seen by a physician in the Infirmary first. If you consult a physician in a hospital setting, you will receive a bill from the hospital, as well as a bill from the physician, for the professional analysis of any diagnostic tests or x-rays that are done.
WHAT DOCTORS CAN I USE WITH THE MANDATORY PLAN? Our insurance company has made an agreement with a “preferred provider organization” (PPO) called Aetna. There are many doctors and other medical providers associated with this PPO. Try to use these medical providers, since they usually charge less for their services, and usually you will not owe them anything after HTH pays your bill. Locate these providers before you make a medical appointment : (enter Stony Brook, then look for Docfind, and then ‘open choice PPO’).
HOW DO I GET THE INSURANCE COMPANY TO PAY MY MEDICAL BILLS? SHOW YOUR HTH INSURANCE ID CARD TO THE BILLER AT THE HOSPITAL OR DOCTOR’S OFFICE. TELL THE BILLER THAT YOUR PLAN USES AETNA OPEN CHOICE PPO. ASK THE BILLER TO SEND AN ITEMIZED BILL TO HTH—THE ADDRESS IS ON YOUR HTH ID CARD. OR THEY CAN SEND AN ELECTRONIC BILL TO PAYOR # LABORATORIES MAY SEND THE BILL DIRECTLY TO YOU. IF YOU RECEIVE A MEDICAL BILL BRING IT TO OUR OFFICE RIGHT AWAY AND WE WILL HELP YOU COMPLETE A CLAIM FORM. BASED ON THIS MATERIAL, THE INSURANCE COMPANY WILL PAY YOUR BILL AND INFORM YOU OF THEIR ACTIONS.
PRESCRIPTION MEDICINES If you consult with a physician at the Infirmary, and receive a written prescription, you may fill it at the Infirmary pharmacy. The full cost of the medicine will be billed to your University account. You must pay your pharmacy bill at the Bursar in the Administration Building. You MUST then complete an HTH claim form, and send the claim form and the full pharmacy receipt (including the names of the physician and medicine) to HTH. Within four weeks HTH will send the full reimbursement to you.
MEDICINES, Continued MEDICINES, Continued If you see a physician outside the Infirmary, and he gives you a written prescription, you cannot bring it to the Infirmary to be filled. Instead, you must take it to an outside pharmacy. You will need to show your HTH ID card, and pay $20 (called a co-pay)before you can pick up the medicine. In addition, the Infirmary pharmacy does not carry every medicine that students require; there may be times that you must bring the prescription to a pharmacy outside the Infirmary. In this case, as explained above, you must pay a co-pay at that pharmacy before you can pick up the medicine.
WHAT ABOUT CAR ACCIDENTS? If you are involved in a car accident, even as a pedestrian or cyclist, call “911” or ask someone to do this. When the police arrive, show them your car registration (if you were driving), driving license, and insurance card. If another driver is involved, share your license, registration, and insurance card information with that person. If you are injured, you should go to the nearest hospital emergency room, show them your health insurance card, and follow their medical recommendations. If you have car, body, or property damage, you must contact your car insurance company as soon as possible.
FOR GAs, TAs, AND RAs You must complete an enrollment form in the Health Insurance Office, within 30 days of your appointment. You must bring with you for each enrollee: A copy of a birth certificate or passportA copy of a birth certificate or passportAND A copy of a Social Security cardA copy of a Social Security cardAND A copy of your marriage certificate, if you are enrolling your spouseA copy of your marriage certificate, if you are enrolling your spouse
WHAT IF MY DEPARTMENT IS SLOW GETTING MY RA MATERIALS TO PAYROLL? We have a cut-off date for enrollments in the RA health insurance plan. If your paper work is received late—after March 16— you will remain covered by the mandatory health insurance, and you must pay for it. If you wish, you may discuss this additional cost with your academic department.
MORE If there is any gap (even of one day) between the ending date of your TA or GA or RA health insurance coverage, and the extension date of your insurance, your University account will be billed for the International Health Insurance for at least one month. For example, if your assistantship ends March 20, and a new or extended assistantship begins April 1, we must charge you for one full month of International Health Insurance. If your TA, GA, or RA insurance ends at any time, and is not extended, your University account will be billed for the mandatory International Health Insurance for the remainder of the semester (through August 14). Even if you are enrolled in the TA, GA, or RA insurance plan you will still be billed separately for MEDEX ( Spring 2011 cost is $43.75). This special plan ensures you will be returned to your home country if you are extremely ill and need medical transport.
J-1 AND J-2 WITH ASSISTANTSHIPS YOU ARE NOT ELIGIBLE FOR THE TA, GA OR RA INSURANCE PLANS. However, we will enroll you in the mandatory International Health Insurance at a discounted rate, which is $59 for Spring The cost of MEDEX ($43.75) is additional to this. All TAs, GAs, and RAs must have insurance and MEDEX coverage. If your assistantship ends before August 14, you will be billed for the mandatory insurance at the full rate of $84.75 for every month you do not have an academic appointment and no TA,GA, or RA insurance coverage. The cost of MEDEX, as indicated above, is additional to this fee.
FOR ALL GRADUATE STUDENTS If you become a University employee and are offered University employee insurance (e.g. as an adjunct professor), you are no longer a TA, GA, or RA! YOU MUST INFORM US WITHIN 30 DAYS OF YOUR NEW APPOINTMENT DATE IF YOU HAVE OTHER INSURANCE IN EFFECT, AND WISH TO FILE A WAIVER APPLICATION. Otherwise, we will charge you for the International Health Insurance for the entire semester, even though you may already have insurance coverage as an adjunct.
MORE FOR ALL GRAD STUDENTS … If you register for classes, but will study or do research in your home country for the entire semester, you MUST inform our office. We will verify this information with your academic department, and then remove the mandatory SUNY insurance fee from your University account. You must discuss this with us by February 14, 2011.
PRACTICAL TRAINING PARTICIPANTS (OPT ) If you graduate from Stony Brook in May, and are offered practical training, you will remain on our insurance plan through the end of the semester (August 14 ). The International Health Insurance is NOT mandatory for you after August 14. We do recommend you enroll in an insurance plan during your OPT. The International Insurance plan is available to you for up to a year after graduation, and is very reasonably priced. Please come to the Health Insurance Office to discuss this.
THINGS TO REMEMBER We want to communicate with you. SO PLEASE DO THE FOLLOWING: 1. CHANGE OF ADDRESS—update your “preferred” mailing address via your SOLAR account, or report this to the Registrar/Records Office in the Administration Building 2. UPDATE YOUR ADDRESS on the HTH WEBSITE (www.hthstudents.com) 3. CHANGE OF IMMIGRATION STATUS (such as J-1 to F-1, or F-1 to H-1, or approval of permanent United States residency)—report this to the Office of Visa and Immigration Services in the Computer Science Building.
IMPORTANT NUMBERS INFIRMARY OPEN by appointment, M-F, 8am-5:30pm;Tuesdays to 7:30pm ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ HEALTH INSURANCE OFFICE OPEN M-F, 9 am-4:15 pm OPEN M-F, 9 am-4:15 pm INTERNATIONAL: INTERNATIONAL: ; ; TA/GA/RAs: TA/GA/RAs: ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ HEALTH INSURANCE COMPANY (HTH) WEB-SITE: or