1. Medical Care at WKU and Insurance
Presented by: Linda Heady, MBA
Benefits Administrator

2. Things you should know about the US Health Care System:
The system is privately funded, not government sponsored or socialized
Payment is the responsibility of the individual, with or without health insurance
Even with health insurance, medical treatment in the US can be very expensive. Without health insurance medical treatment can be extremely expensive
Before you visit a doctor, hospital or facility, always check to see if your insurance will be accepted.

3. More info about US Health Care
Keep copies of all bills and papers for at least one year.
You can ask a second doctor for an opinion before getting treated
Inform your doctor about the conditions and medications you have had in the past
You can ask the doctor questions about your conditions and medications you have had in the past

4. What do I do if I get sick?
Monday: 8:00am – 6:00pm Tuesday: 8:00am – 6:00pm Wednesday: 8:00am – 6:00pm Thursday: 8:00am – 6:00pm Friday: 8:00am – 12:00pm
Saturday: 8:00am – 12:00pm
Call CARE [2273] for
Appointment or Walk in
Documentation of your visit can be
provided upon request.

5. What if WKU Health Services is closed?
Go to: Urgent Care: 8AM – 8PM everyday Phone: Cost is $50 Greenwood Clinic: 8AM-6PM Mon-Fri, 8AM-2PM Sat Phone: Cost is $50

6. What to do in an EMERGENCY?
Call 911
Go to the Hospital:
Greenview Emergency Room (Hospital): Phone
Medical Center Emergency Room (Hospital): Phone
Cost is at least $250 or more depending on the number of services required.

7. Welcome Lobby

8. Laboratory

9. Patient Exam Room

10. X-Ray

11. Services Provided Men’s and Women’s Health Wellness Examinations
Immunizations
Laboratory Tests
Medications
Psychiatric Mental Health
Birth Control/Contraceptives
STD Testing
Women – Yearly Exams
Allergy injections
X-Rays

12. Counseling Services offered at WKU
Monday thru Friday from 8 a.m. – 4:30 p.m.
Potter Hall, Room 409 Phone
There is a ONE-TIME $20.00 fee for paperwork and documentation. After the one-time fee, students have unlimited access.
Services are confidential and NO information is released without the student’s written permission, unless in an emergency situation.
Individual and group counseling services are offered to help with coping strategies, conflict resolution, and crisis situations related to:
College Adjustment Eating Disorder
Decision Making Bipolar Disorder
Problem Behaviors Stress Management
Grief/Loss Depression/Anxiety
Relationship Issues Suicide Prevention
Sexual Assault/Abuse

13. I need to see the Doctor what should I do?
Call to schedule an appointment with Graves Gilbert Clinic at WKU – if urgent, come directly to Graves Gilbert Clinic at WKU
At appointment time, have a copy of your insurance card and photo identification.

14. United Healthcare
Student Health Insurance – Major Medical Insurance Plan
You will need to pay $840 in August for Fall 2015 Semester (coverage dates are August 1st through December 31st 2015.
You will need to pay for health insurance AGAIN each semester.

15. United Healthcare Student Resources
To access your account, go to
to “Create Your Account”.
On this site, you can:
Request an ID Card
View/Print an insurance card
Locate a Doctor
View/Print proof of coverage

16. Insurance Terms
Deductible – Dollar ($) amount you will need to pay before the insurance will pay. Co-Payment (Copay) – Specific dollar ($) amount you must pay at the time of service. Co-Insurance - Dollar ($) amount based on a percentage you must pay for services.

17. Insurance pays 100% at Graves Gilbert Clinic at WKU
Preventative Care
Annual Examinations
Tobacco use screening and cessation
Depression screening for adults
Well women Exams
Contraceptives/Birth control
Immunizations/Vaccines
Hepatitis, HPV, Flu, MMR, Meningitis, Pneumonia, Tdap, Varicella

18. Physician Office In-Network Provider (United Health Care)
Health Services
In-Network Provider
(United Health Care)
Out-of-Network
Provider
You pay $0
Insurance pays 100%
(Except if you see the Psychiatrist, it will be a $50 copay)
You pay $50 (copay)
Insurance pays 75% and you pay 25%

19. Urgent Care or Emergency Room
In-Network Provider
(United Health Care)
Out-of-Network
Provider
Urgent Care
You pay $50
AHP pays 100%
AHP pays 75% and you pay 25%
Emergency Room (Hospital)
You pay $250
AHP pays 75% - you pay 25%

20. Laboratory Health Services IN NETWORK United Health Care
(If a complex Lab, Graves Gilbert Clinic it to Quest)
OUT-OF-NETWORK
You pay $0
AHP pays 100%
Some of these include: UA, Glucose, CBC, Flu, Strep, Mono, Pregnancy Test, Wet Prep Stain, prep for fungal elements on skin
$50 copay
Some of these include: Pap Smears, Lipid Panel, Liver Tests, Comp Metabolic Panel, Gonorrhea & Chlamydia testing
AHP pays 75% - you pay 25%

21. Hospital and Surgery Coverage
IN NETWORK
United Health Care
OUT-OF-NETWORK
Hospital Expenses
AHP pays 80% of Preferred Allowance (You must first pay $250 deductible, then 20%)
60% of Usual and Customary Charges
(You must first pay $600 deductible, then 40%)
Surgery

22. Immunizations and Prescription Drugs
Health Services
IN NETWORK
United Health Care
Prescription Drugs
Some medications
available
You pay $15 for generic
You pay $30 for brand name

23. What happens after you go to the doctor?
You will receive an EOB (Explanation of Benefits) from HealthSmart (THIS IS NOT A BILL)

24. Dental Care For those under age 21:
Most services paid at 50% after meeting a $500 deductible.
Pre-authorization is required for orthodontic services or any procedures over $300.
FOR EVERYONE ON CAMPUS - Dental Hygiene Program operates a clinic on the 2nd floor of Academic Complex – Room 223
Services offered include: X-Rays, Sealants and Prophylaxis (Cleaning)
Fee: $15 student, $20 non-student
Call for appointment

25. Vision Care Services (for those under age 21)
Spectra Eyecare Networks – these can be found by going to or call
Routine Vision Examination or refraction only in lieu of a complete exam – one per year
Eyeglasses Lenses – Once per year
Eyeglass Frames – Once per year
Contact Lenses – Limited to a 12 month supply

26. Need assistance?
Go to Contact Linda Heady, at or by at Call for assistance with your insurance questions.