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Health insurance (Aetna) information

Frequently Asked Questions (Aug 2019)

Insurance FAQS

(Version: August 2019)

Other Frequently Asked Questions

This set of Frequently Asked Questions (FAQ) was compiled by Kris Murray, GSG Healthcare chair 2017-2018, 2018-2019. Last edited March 2018.

Help! I have a bill I don’t understand and/or can’t afford to pay!

Relax, and don’t pay it with a credit card. If you have questions about your bill, think it is too high, or think something is wrong, contact Connie Morrow (cmorrow@nd.edu) and with your consent she will be able to look into your claim and try to negotiate down to a lower price. If you’re still unable to pay the bill there are options available to help you, including the Shirt fund, which exists to help students pay extraordinary medical expenses.

My dependent has a medical bill that we cannot afford, is there any way I can get help?

Yes, while the Shirt fund is only for student medical costs, there are other options available for dependents. Contact Connie Morrow (cmorrow@nd.edu) for more information.

I don’t want or think I need health insurance. Do I have to have it?

The University requires that graduate students be covered by a health insurance plan. For full time students, a premium subsidy is available.

Do I have to be on the University Insurance Plan?

You are required to be insured, but if you have access to different, comparable insurance coverage (through a spouse or your parents for example), you can waive out of the University plan. Through the waiver process it will be determined if your other insurance plan is eligible, and if so, you will receive a $500 credit.
 

Do I have to pay to go to UHS to get care?

If you have the Aetna school plan, anything done at UHS is covered at 100%, but there are co-pays for prescriptions and any lab work that may need to be done. You can get a routine exam (i.e. a checkup) once per school year, and things like x-rays, immunizations, and physical therapy are all covered. If you have an outside insurance plan, than the costs will go to your student account.

Can spouses and dependents be covered?

Yes. Dependents are insured directly through Aetna, but are not eligible for premium subsidies. If they need to be added to the insurance plan in the middle of the year their premium will be prorated for how long they will be on the plan for the year, but it is recommended that they be added at the beginning of the year if they are eligible to do so.

How does the deductible work?

At any off-campus provider, you will have to pay the first $500 worth of charges before Aetna will begin paying the claim. Once you satisfy the deductible, Aetna will pay the claim at the appropriate level (at in-network providers they will cover 80% of charges; at out-of-network providers they will cover 60%). You can look up which providers are in network at Aetna’s website for Notre Dame. Any emergency room bills will be covered at the in-network rate by Aetna, regardless of whether that hospital is actually in-network.

If I’m leaving for an internship somewhere else in the country/internationally, can I keep my coverage?

Yes, you can use your insurance anywhere you go in the world. The insurance plan covers you everywhere.

If I need medical care when St. Liam’s is closed, what should I do?

There is a Nurse Triage line that you can call when UHS is closed at (574-631-7497), and in talking with them they will help you determine if you can wait until the center opens or if you should seek care elsewhere.

What is the On Call travel assistance?

If you need medical care when you are far from home or the University (i.e. greater than 100 miles), you can utilize the On Call service. You can call and receive medical advice or they will help you get to where you need to go to get care. If you are in a place where you cannot get proper care, they will arrange for you to get the proper care. They will also pay to fly a family member out to you if you are extremely ill/injured, or will pay to get you home to see a critically sick/injured family member. They will only pay for one way of travel, you will have to find your own way back. You can find more information at their website, or you can call them at 1-866-525-1956 in the US and Canada, or at 1-603-328-1956 internationally.

What options are there for dental care?

Dental is not bundled into the Aetna Health insurance plan. You can get dental insurance through Delta Dental, which has 3 tiers of coverage. You can enroll with Delta at any time during the year and the coverage will last for 12 months, but there may be a waiting period depending on the plan you choose before you can use the insurance. You can also get a Dental discount card through Aetna, which for $25 will get you up to a 50% discount at eligible dental providers during the remainder of the plan year. At IUSB you can get cleanings and fillings for around $5, and if you go to either Afdent or Aspen dental they will give free examinations and consultations on any dental procedure you may need. Afdent and Aspen also have payment plans if you cannot afford to pay for a procedure all at once.

What options are there for vision care?

A vision discount is included in the Aetna medical premium, you can use your Aetna insurance card at eligible providers to get up to a 60% discount on contacts, eye exams, frames, etc. at the time of service. For a medical procedure related to your eyes (ex. A detached retina), you will be covered at the normal medical rate (80% in-network, 60% out-of-network) after the deductible.

What options are there for psychological services?

Psychologists and psychiatrists are available at the University, and you can make an appointment with them to meet either at UHS or somewhere that would feel more comfortable meeting. There are plenty of psychologists/psychiatrists in the community you can go to as well, but seeing them would be subject to your deductible/co-insurance.

I see a doctor/specialist or go to a facility outside of the University that is out-of-network. Is it possible to get them in-network so I could get a better rate?

Yes! If you contact UHS they will talk to Aetna to try and get them to negotiate with them to be in network.

Can my dependent be on the insurance plan for part of the year and then switch to something else?

You can cancel the plan up to a month after you start, but after that you cannot stop the plan in the middle of the year for a dependent. If you know you will only be here for the part of the year (ex. December graduation), you can get coverage for only a semester.

If I have a baby during the year, can I get them insured?

Yes, contact UHS within 30 days after the baby is born and they will provide you with the prorated premium cost and an application to add the baby. You will need to submit the application to Aetna directly.

Is STD testing covered?

STD testing can be done at St. Liam’s Hall and is confidential. There will be a 20% co-pay for any tests that require lab work if you are on Aetna. If you have insurance other than Aetna, it is subject to your plan’s benefits. Also know that the lab does do a 50% discount when paid at the time of service.

If I waived the University plan but lose my other insurance, can I get onto it?

Yes, contact UHS and they will enroll you in the plan starting the day you need it at a prorated cost.

Are fertility tests covered?

You cannot get fertility testing done at St. Liam’s, but you can have it done at another facility and it will be subject to your deductible. Aetna covers the cost to diagnose infertility but does not cover treatment.

Where on campus can I take my dependents to get help/treatment?

The Wellness Center is where dependents of those on the student plan should go, not St. Liam’s. Their healthcare is covered at 100% at the Wellness Center the same way it is for students at St. Liam’s when on the Aetna student plan, excluding certain lab work and prescriptions.

If you have a healthcare / health insurance question that is not listed here, please email gsu@nd.edu.

Useful links to healthcare resources

 

Useful links: healthcare in the Community