Aetna Student Health 2008 - 2009
Frequently Asked Questions
How much does this plan
cost and how long is the coverage?
The cost for this plan is $450.00. The coverage begins September
1, 2008 (or when you are required to be on campus) through August 31, 2009. Once you have been placed on
this policy you cannot be taken off. You may only enroll at a later date if you provide evidence that you are no longer covered by your previous insurance.
Is there a deductible/co-pay amount?
The average co-pay or deductible amount for 08-09 is $20.00 per sickness/injury.
Once you pay the $20.00 deductible/co-pay, the insurance will pay
80% of the remaining balance of your bill (making sure it is
for services that the insurance company covers') and then you would
be responsible for the remaining 20%. Note that some services/care may have different coverage (more/less) - be sure to check the policy.
Where can I be seen with this health insurance?
YOU DO NOT NEED THIS COVERAGE TO BE SEEN AT THE MACALESTER HEALTH & WELLNESS CENTER.
Most clinics and hospitals will accept this insurance coverage.
However, when making an appointment you would want to check with
the clinic to see what their requirements are. Some clinics will
make you pay the bill in full and give you an itemized receipt for
the services and then you would need to submit this claim to the
insurance company for reimbursement. The Aetna Student Health site has a "Find a Doctor" function which may assist you in identifying providers.
What does it cover?
This policy covers most all sickness/injury type cases. The brochure will go into more detail regarding what is included and
what is excluded. It does not cover routine dental exams/appointments,
routine eye exams, glasses, contact lenses, pre-existing conditions (medical - within 6 months; waived for mental health). Please check the web site to see the exact coverage as well as additional resources provided.
Am I covered if I am traveling or on a
study away program?
Yes, if you are traveling or on a study away program you would
be covered under this policy. Again, if it is something that the
insurance covers, you may need to pay the bill at the time that
you are seen, have the clinic/hospital give you a receipt (in English
and U.S. dollars') and then submit this receipt with a claim form
for reimbursement.
Who can I ask for assistance on campus
regarding insurance?
If you have insurance through Aetna, you may wish to contact the company first. Sue Rothenbacher in the Health & Wellness Centeris also available to help you with
questions, assisting in completing claim forms, etc. Sue is in Monday - Friday during the academic year. Contact Sue at ext. 6199 or rothenbacher@macalester.edu or call the Health & Wellness Center at ext. 6275.
How do I complete an insurance claim form?
Aetna will accept direct billing from most providers (exceptions are drug claims and international/travel assistance). Claim forms are available online
at www.aetnastudenthealth.com under the Help Center.
If you need assistance completing these forms, contact Aetna first or your health care provider who has provided the service.
How long does it take to process a claim?
Claims take approximately 4-6 weeks to process. After you have
submitted the claim form to the Insurance company they will send
an "EOE3" (explanation of benefits) back to you explaining
what amount has been paid on this claim; as well as what you still
owe.
How much does this accident Insurance
policy cost and how long am I covered?
The cost for the Accident Plan for 08-09 is $50.00. The coverage
period begins September 1, 2008 and goes until August 31, 2009.
Why would I need this accident plan?
This policy is strongly recommended for those students participating
In athletics and has served as an attractive complement to existing policy coverage. This policy would work along with your policy from
home to include coverage as far as deductibles and such that your
Insurance company may not cover when out of your network; and this
would also be true if you are not participating in athletics.
What does this policy cover?
This policy covers medical expenses caused by accidental injury.
Who can ask for assistance on campus regarding
insurance?
Sue Rothenbacher in the Health & Wellness Center is available to help with questions,
assisting in completing claim forms, etc. Sue is in her office Monday-Friday.
Contact Sue at ext. 6199 or stop by the Health & Wellness Center after August 11, 2008.
How do I submit a claim for this accident
Insurance?
Aetna will accept direct submission of claims from the provider. Claim forms and information for drug claims and international/travel assistance are available online
at Aetna Student Health. Sue can also assist you in completing these forms.
How long does it take to process these
claims?
Claims generally take 4-6 weeks depending upon all of the Information
being accurate in completing these claim forms. These may take a little
longer depending on the primary insurance coverage. |
