The UNL Healthy Option Student Plan
Medical, Dental and University Health
Center Pharmacy Coverage
Premium Benefit for Graduate Students
FREQUENTLY ASKED QUESTIONS AND ANSWERS FOR STUDENTS
Academic Year 2009-2010
What does
this plan cover? Your plan will pay for covered
medical expenses for accidents or illnesses up to a total of $250,000 in the
policy year (August 14, 2009 to August 13, 2010.) The annual deductible is $400
per insured per policy year. When the Health Center fee via UPFF fees has been
paid, covered medical expenses incurred at the University Health Center will be
payable at 100% with waiver of the deductible. For treatment received outside
the Health Center, covered preferred provider expenses are paid at 80% of the
negotiated charge for the first $9,750 of covered medical expenses; 100%
thereafter. Covered non-preferred provider expenses are paid at 60% of the
reasonable charge for the first $4,875 of covered medical expenses; 100%
thereafter. Co-Pay: In addition to the
policy year deductible and co-insurance maximum, each insured person will be
responsible for a $250 emergency room visit co-pay amount and a $250 per
inpatient admission co-pay amount; however, the per inpatient admission co-pay
will be waived if you are admitted directly from the Emergency Room. The co-pay
amount normally does not apply to urgent care center charges. A Well Baby benefit of $250 per policy year
has been added when your child is covered by this policy. Medical evacuation and repatriation benefits
are included in this policy without additional cost.
What is
the cost to insure myself? The total
cost of the insurance premium is $1363. Graduate assistants will contribute
about 21% ($287) of the total annual cost of $1363. The total premium cost for
the first semester (August 14 - December 31, 2009) is $536; of that amount, the
graduate assistant cost is $113 and the university-paid portion is $423. The
total premium cost for the second semester and summer
(January 1 - August 13, 2010) is $827; of that amount, the graduate assistant
cost is $174 and the university-paid portion is $653. The student's cost for
individual coverage will be posted to their student account. We encourage all students to participate in
the program, because similar policies from other insurers are more costly plus
covered medical expenses incurred at the University Health Center are fully
paid with waiver of the policy year deductible. Your cost averages to about $0.78
a day and provides peace of mind allowing you to complete your coursework
rather than jeopardize your academic career dealing with unexpected medical
bills.
Can I
insure my dependents? Yes, dependents may be insured
as long as the student's coverage remains in force. The annual premium cost for
each child is $2243; the annual premium for a spouse or eligible domestic
partner is $4482. If you wish to insure dependents, you may sign up by stopping
in at the University Health Center – Room 102.1. Enrollment is per fall semester and
spring/summer semester. Premium may be paid with a U.S. check, money order, VISA
or MasterCard.
What is
the deadline to obtain insurance? Enrollment completed
prior to September 15, 2009 will be effective from August 14, 2009. Coverage
for students who sign up at the Health Center after September 15, 2009 will be
effective on the date the enrollment form is completed at the University Health
Center. Please note that a graduate assistant who is hired late may not be
eligible for either a tuition waiver benefit or the university-paid portion of
the insurance benefit for the semester for the late start.
How do I get
an enrollment form? Enrollment forms are available at the
University Health Center. HOWEVER graduate assistants or international students
(F1 or J1 visa holders) should NOT fill out the enrollment form or sign up on
the WAM account to obtain the individual basic coverage. Dependents of students; however, will need to
complete an Enrollment Form. Graduate
Assistants will be automatically enrolled.
Please note that it is not mandatory for U.S. domestic students to
participate in the student health insurance program however, F1 or J1 Visa
holding international students must participate unless they provide proof of
comparable insurance and complete a waiver each semester by the published deadline.
Who is
eligible to buy this insurance? All students enrolled
in three or more credit hours at UNL and who have paid the University Health
Center facility fee are eligible to purchase this plan. Students who are
enrolled for 7 or more credits during an academic semester will have paid the
University Health Center fee as part of the Program and Facilities Fee (UPFF
fees). Students who are enrolled for fewer than 7 hours (including those who
are certified as full-time) must pay the University Health Center fee (because
it is not part of the University Program and Facilities Fee at the lower
enrollment level) in order to use the University Health Center and file an
Aetna Student Insurance claim.
What if I
don't want the benefit? To opt out
of the plan requires completion of the Student Health Insurance Waiver Request
Form by 09/11/09 – Fall OR 02/01/10 – Spring/Summer otherwise a graduate
assistant will be automatically enrolled in the plan and their student account
will be charged. A printable PDF of the
form is available on the UHC webpage, www.unl.edu/health. The form must be filled out EACH semester and
returned to the University Health Center by the published deadline. The form can be printed and mailed to UHC at
P.O. Box 880618, Lincoln, NE 68588-0618 or completed and attached to an e-mail
message to bheiserman1@unl.edu or
faxed to 472-7432.
Will I
get an identification card to use? Identification
cards will be mailed by Aetna Student Health after October 1, 2009. You may also print your identification card
by going to www.aetnastudenthealth.com
any time after October 1, 2009. Access
Aetna Navigator on the Nebraska page and follow the instructions for
registering. Once registered your
identification card may be printed, you may also view your claims
processing. Dental identification cards
will be mailed to you by Ameritas; the dental insurance underwriter.
Where can
an insured person receive medical care? Students
must receive a referral from the
Is dental care covered? YES, Dental care is a covered service. A Preventive/Basic policy package Underwritten
by Ameritas has been added, covering up to $500 per year, with preventive
treatment covered 100% with $0 deductible for treatment at the
deductible for all treatments and a lower plan schedule payment. You will receive the maximum benefit from your Dental coverage if you utilize the preferred providers located at the University Health Center Dental Office. For more information about your Dental coverage please call Sue Heng at 402-472-7402.
Are
prescriptions covered? YES, Prescription
drugs are covered by the University Health Center Prescription Program with a
$300 policy benefit for Fall Semester and $300 for Spring/Summer, $10 co-pay
for generic drugs and $25 co-pay for brand name drugs.
What
about vision care? Insured persons are eligible for
certain discounts under the Vision One program. Call Aetna Student Health at
1-800-927-0812 for a listing of services and providers or through the Internet
at www.aetna.com/docfind .
These
questions and answers are designed to be a quick summary of The UNL Healthy
Option Student Plan. Students should refer to the health insurance brochure
located at www.aetnastudenthealth.com,
or the dental insurance brochure located at www.ameritasgroup.com/students/unl
if they have specific questions about
insurance benefit provisions. Or they can call the Health Center's student
health insurance coordinator at (402) 472-7507.