Student Health Insurance FAQs for Plan Year 2012-2013
What is Student Health Insurance?
Student Health Insurance (SHI) is an optional medical insurance plan available to admitted and enrolled UNLV students. The plan offers a network of providers but gives you the option of seeking services outside the network. Individuals participating in the plan are required to pay a portion of the cost of services received.
Where can I use it?
SHI can be used at the Student Wellness Center for medical, mental health, laboratory and pharmacy services, and throughout the country with providers who participate in the Aetna Provider Network.
When the UNLV Student Wellness Center is closed (weekends and holidays), where do I go?
If you have a life-threatening emergency, you may go to any hospital emergency room. You can go to any network provider including UMC Quick Care Centers. You may also call the 24-hour Nurse Advice Line at 1-800-556-1555 or TDD at 1-800-278-2386.
How do I find a network provider?
You can go online to the insurance company's website at DocFind and search for a provider.
What does it cover?
Coverage is based on medical necessity and covers inpatient and outpatient hospital visits, mental health services, physician services, emergency and diagnostic services, treatment for alcohol and chemical dependency, maternity, ambulance and home health care.
Do I have a deductible or co-pay?
There are no co-pays or deductibles for services received at the Student Wellness Center. When you receive services outside of Student Wellness, you will pay an annual deductible of $300. That means you will pay the first $300 towards services received during the policy year. There are also co-pays for services outside Student Wellness which include: $15 for a doctor’s visit; $25 for therapy visits, and $100 for an emergency room visit. Prescriptions have a co-pay of $20 when used at the SHC pharmacy.
What pharmacy do I use?
Prescriptions have a co-pay of $20 when purchased at the SHC pharmacy. If you use an outside pharmacy you pay 75% of the costs after you have met your deductible.
How is it different from the Student Health Fee?
The Student Health Fee is a mandatory fee assessed to enrolled students. It is paid each semester with tuition and registration fees. This fee supports various services offered by the Student Wellness Center including: medical office visits, counseling services, education on nutrition, stress, body image, and various support groups. There is no charge for medical office visits or counseling sessions at Student Wellness. The health fee only covers services received in Student Wellness, whereas the SHI covers services received from Student Wellness and from community providers.
Are all students eligible to enroll?
No. Only students who have been formally admitted to a program and are taking a minimum of six undergraduate credits or three graduate credits are eligible to enroll.
Does it have any pre-existing condition limitations?
Yes, if medical care or treatment was recommended or received during the six months prior to the effective date of the policy, then it is considered pre-existing. The insurance will only pay for services after being continuously insured for 6 months. The pre-existing condition limitation is waived for services received at the Student Wellness Center or there was other insurance coverage prior to enrolling in the SHI. The pre-existing condition exclusion does not apply to pregnancy or an insured person who is under age 19.
Are dental and vision benefits included in SHI?
No, optional plans are available to purchase to meet these needs.
Is my family eligible for SHI?
Yes, you may add your spouse and/or children; however, they cannot be seen at the Student Wellness Center.
What does it cost?
The annual premium for 2012-2013 plan year is $1,923 for graduate, undergraduate, and international students. Dental students will pay $2,214 per year. There is the option to pay by semester. The premium is higher if you wish to add your spouse and/or children.
Can I sign up any time?
The Student Health Insurance has two open enrollment periods. Enrollment for the entire school year or for the Fall semester only occurs during the first six weeks of the fall semester. Enrollment for the Spring only or Spring and Summer sessions occurs during the first six weeks of the spring semester. However, whenever you are terminated from another insurance policy, you can join the health insurance any time within 30 days of the termination of your policy. This will prevent any loss in insurance coverage.
How do I sign up?
You can sign up directly from the website for Aetna for the 2012-2013 plan year beginning in August 2012, or you can call the plan broker, Wells Fargo Insurance Services directly at 800-853-5899, 8:30 a.m. to 5 p.m. (Pacific Time).