1. An Introduction to Healthcare & Insurance at The University of Chicago STUDENT HEALTH AND COUNSELING SERVICES An Introduction to Healthcare & Insurance at The University of Chicago STUDENT HEALTH AND COUNSELING SERVICES

2. Student Health Service (SHS) 860 E. 59 th St. (Goldblatt Pavilion Entrance), R-100 (773) 702-4156 healthcare.uchicago.edu Student Counseling Service (SCS) 5737 S. University Avenue (773) 702-9800 counseling.uchicago.edu Health Promotion & Wellness (HPW) Woodlawn Social Services Center, 950 E. 61 st St., 3 rd floor (773) 702-8247 wellness.uchicago.edu Accessing Healthcare at UC

3. All registered students pay a quarterly Student Life Fee. – Provides access to Student Health Service and Student Counseling Service Health services covered by the Student Life Fee: e.g., acute/chronic care, routine physicals, short-term psychotherapy, academic/study skills counseling, etc. Private insurance / U-SHIP covers: – Prescriptions, hospitalizations, ER care, lab tests, long-term psychotherapy, consultation and treatment by specialists, etc. Student Life Fee vs. Insurance (U-SHIP)

4. Primary medical and mental health care, wellness programming: Covered by Student Life Fee & provided by SHS, SCS, HPW Referrals provided to specialists / for tests If on U-SHIP, referral required from SHS/SCS; if referral is not obtained in advance, $50 penalty is assessed Is it an Emergency? If SHS closed, call 24-hour Nurse Advice Line – 773.702.1915 – to determine if ER services are required (otherwise, claim may be denied) Where to Go for Services

5. UC requires ALL students to have adequate health insurance All registered students enrolled annually in U-SHIP Deadline: by 4 th Friday of one’s first registered quarter, each year, all students must either: – Waive out of U-SHIP (comparable coverage required) or – Enroll dependents Students remain enrolled for the full academic year Enroll or waive at: http://studentinsurance.uchicago.edu Student Health Insurance Plan: U-SHIP

6. Insurance Terminology Premium – The amount of money – generally paid on a monthly, quarterly or annual basis – that you pay to cover the cost of your health insurance. Deductible – The amount you need to pay before your insurance plan starts to cover your medical costs. Annual out-of-pocket maximum – The amount your insurance plan does not pay and you are expected to pay. Co-insurance – A percentage of the cost of your treatment that you are required to pay (i.e., 10%, 20%, or 30% typically), after your plan’s deductible has been fully paid. For additional help, see the “Health Insurance Glossary” on the SCHS website: studenthealth.uchicago.edu Navigating Health Insurance

7. 2013-2014 Premium – $3,021 (billed in 3 quarterly installments of $1,007) Deductible – $200 (in-network); $500 (out-of-network) Annual out-of-pocket maximum – $1,500 (in-network); $2,500 (out-of-network) Co-insurance – 10%; plan pays 90% after deductible has been met Prescriptions paid by co-pay, 3 tiers of coverage ($10, $25, $40) Navigating Health Insurance : U-SHIP

8. You’re running across the quad, slip on the ice, and break your leg. Ooops. SHS refers you to a specialist who sends you to X-ray, then sets your leg, and gives you a cast. When the cast is removed, you are referred to 12 sessions of physical therapy. Here’s the bill, BEFORE insurance, and with U-SHIP applied: Navigating Health Insurance : U-SHIP Example Aggregated doctor/hospital bill:What you’re responsible for: Specialist visit (with tests): $ 3,480Deductible: $ 200.00 Cast & crutches: $ 927(balance is now $ 11,277) Follow-up doctor’s visit: $ 2,750U-SHIP covers 90% ($10,149.30) Physical therapy: $ 4,320Co-insurance costs (10%): $ 1,127.70 Total billed costs: $ 11,477Your total bill for injury: $ 1,327.70

9. Here are two more possibilities, with two alternate insurance plans: Here’s how the insurance scenario plays out: Alternative Insurance Examples UHC Internat’l PlanISO Plan $ 1,754Premium$1,428 $350Deductible$500 $7,500Out-of-Pocket$1,500 80%Co-insurance80% UHC Internat’l PlanISO Plan $ 11,477Total billed amount$ 11,477 $350Deductible owed$500 $2,225.40Co-insurance owed$2,195.40 $2,575.40Total amount due$2,695.40 $4,329.40Total paid (w/ premium)$4,123.40

10. To waive U-SHIP, students must have active insurance with comparable coverage: 2013-2014 plan year Alternate plans must include list of UC-designated required benefits Must provide benefits at established coverage levels (i.e., 80%) 2014-2015 plan year – requirements tied to ACA Alternate plans must include ACA “essential health benefits” Individual plan out-of-pocket maximum < $6,350 Family plan out-of-pocket maximum < $12,700 Must also provide coverage for non-emergency care in Chicago! Provides greater flexibility for students and families Wider range of plans will meet requirements to waive coverage Alternative Insurance: Comparable Coverage

11. To waive U-SHIP, alternate insurance plans must: Meet University requirements for comparable coverage Be active from the time of the student’s arrival on campus through the end of their program or the end of the current academic year Researching Alternatives to U-SHIP Beginning in 2014-2015, a subset of alternate insurance plans will be audited for compliance.

12. Student Health Insurance office Woodlawn Social Services Center, 950 E. 61 st Street, 3 rd floor United Healthcare Student Resources On-campus insurance reps: Sue Williams & Janice Thomas Mon-Fri, 8:00 am-4:30 pm, rooms 368 / 370 773.834.4543 (option #2) or uchicagoadvocates@uhcsr.com UC Student Health Insurance Coordinator Student advocate: Marcy J. Hochberg Mon-Fri, 8:30 am-5:00 pm, room 366 773.702.1279 or mhochberg@uchicago.edu Accessing Insurance Assistance at UC

13. ONE SERVICE <<< MULTIPLE LOCATIONS

14. Reviewing alternate insurance plans: Consider impact of all costs: premium, deductible, out- of-pocket max, co-insurance, co-pays Must meet UC requirements for comparable coverage Review exclusions carefully! Summing Up – Affording Health Care at UC Health care access: Student Health / Student Counseling – covered by Student Life Fee Additional services, testing, specialists – covered by insurance

15. Questions? shcs.uchicago.edu