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Frequently Asked Questions Regarding the Emory University Student Insurance Plan (EUSHIP)

  1. Questions about the quality and cost of the EUSHIP plan and scope of coverage
  2. Questions about enrollment in EUSHIP
  3. Questions about dates of coverage, including the continuation plan and dependent enrollment
  4. Questions about primary care at Student Health Services and referrals for specialist care
  5. Questions about other optional coverage, including the dental plan
  6. Questions about payment options under EUSHIP, including financial aid
  7. Questions about the waiver process, including appeals
  8. Questions about how to get help if you have a question or problem

1.  Questions about the quality and cost of the Emory University Student Health Insurance Plan (EUSHIP) and Scope of Coverage:

Is the Emory student insurance plan any good?

We feel strongly that our student health insurance plan is among the best student plans in the nation. The 2018-19 Emory University Student Health Insurance Plan (EUSHIP) features the following:

  • An annual student premium of $3,466 from July 15, 2018 to July 14, 2019 for medical students, August 1, 2018 to July 31, 2019 for international students and August 15, 2018 to August 14, 2019 for all other students. Three-tiers of coverage, including an Emory Healthcare Core (90% coverage with $150 deductible for outpatient and inpatient care after co-payment of $25 for specialist care and $75 for Emergency Room; $100 per procedure co-payment for out-patient surgery; $35 co-payment for hospital out-patient department visits; co-payments are waived at Emory Student Health and Counseling Services), Preferred Care at Aetna PPO providers and Out-of-Network care.
  • An Aetna PPO national preferred provider network of over 610,000 providers and over 3,700 hospitals.
  • Students do not have to personally complete and submit claim forms for care received. The provider submits bills directly to Aetna.
  • There are no pre-existing condition exclusions under the Emory/Aetna student plan and no waiting period for coverage to begin.
  • The plan covers 100% of covered medical expenses at Emory Student Health Services, including the on-site EUSHS Dermatology clinic (after specialist $25 co-payment), immunizations, TB skin tests, colposcopies, IUD insertions and Travel Clinic.
  • The plan covers 90% of covered medical expenses at all other inpatient and outpatient Emory Healthcare facilities (the Emory Core), with $150 deductible, after co-payment of $25 for specialist care and $75 for Emergency Room (waived if the patient is admitted to the hospital), and $100 co-payment per procedure for out-patient surgery .
  • The plan covers 80% of negotiated charges outside Emory University Student Health Services (EUSHS) and within the Aetna network. There is a $300 total annual deductible in-network and a $35 co-pay for physician visits outside EUSHS. Outside the Aetna network, coverage is 60% after co-payments with a $450 annual deductible.
  • All non-emergency specialist care must first have a written referral from the Student Health Service, unless you are more than 50 miles away from Emory or the EUSHS is closed. There are also no referrals needed for the emergency room, when students are seen during breaks or vacation periods, for OB/GYN or Dermatology services, or after you graduate/leave the university (while still insured by the plan).  If you have questions about this referral requirement, or if you need a renewed referral for ongoing care of medical services, contact our Referral Coordinator at 404-727-0207. For renewals of a mental health referral, contact the Psychiatry Dept. at 404-727-6145.
  • The plan offers unlimited outpatient prescription pharmacy coverage (after co-pays) at both SHS and outside pharmacies.
  • Mental health outpatient and inpatient coverage has no cap on coverage, including treatment for alcohol and substance abuse.
  • Coverage is also available for a spouse, qualified domestic partner and a child/ren. Dependents over 18 years of age should seek care at the Student Health Services first.

What's New This Year:

  • The Emory University Student Health Insurance Plan (EUSHIP) is a Self-Insured (self-funded) plan.
  • Annual 2018-19 premium remains at $3,466. First time with no premium increase since 2010.
  • No plan benefit changes. First time with no plan changes since 2010.
  • The plan group number has changed to 686178.
  • Continuing students will be assigned a new Aetna ID number, so please print off a new and updated ID card through the Aetna online site, click here.
  • 90 day supply of medication and mail order options are available
  • Payment for the Continuation Plan and Dependent coverage is managed by the Emory storefront.
  • The same Aetna ID card used for medical, dental and pharmacy.

We strongly encourage you to read the plan brochure before you draw conclusions about the quality of coverage. Click here to view the 2018-2019 Aetna Student Health Insurance Plan Design and Benefit Summary information.

What are the 2018-19 premium rates of the EUSHIP plan?

The 2018-19 annual student premium is $3466.

Why is this student insurance plan so expensive? My spouse/partner pays a lot less for his/her health insurance.

While it is possible that that is true, it is unlikely if the coverage is comparable. Many employers provide health insurance as an employee benefit, and provide a large subsidy toward the employee's premium. That being said, if you want lower rates, get your friends to sign up! The more students on the plan, the more widely the risk is spread, so the rates go lower.

Aren't there cheaper insurance policies available that meet the minimum waiver criteria?

Yes, there are. As noted earlier, the EUSHIP student policy far exceeds the waiver coverage minimums in several areas. However, you get what you pay for, and insurance companies are in business to make money. We implore you to read the summary of benefits (and the fine print) and compare and contrast insurance policies before you make your decision to purchase one plan over the other. You should particularly note the excellent coverage for care delivered within the Emory Healthcare Core. The time to determine whether your level of coverage is adequate is now, not when you are sitting in the emergency room or lying in a hospital bed.

Why should students who already have excellent insurance coverage via their parents' or spouse/partner's plans be forced to also pay for the Emory plan?

They won't be. Emory has a student health insurance requirement with a "hard waiver". Under this approach, students must either purchase the Emory Student Health Insurance Plan or show evidence of enrollment in a comparable health insurance plan. If the student has not waived out of the Emory plan by early July, he/she will be automatically enrolled in the Emory plan and billed via Student Financial Services. However, the student will still have until the first day of Fall Semester classes (August 29, 2018) to complete the waiver through OPUS and get the insurance enrollment and charge reversed. Therefore, no student should find himself or herself in a situation where they have two insurance plans. . . . unless he/she ignores deadlines.

When I leave Emory, will I automatically lose my insurance coverage?

No, not necessarily. The EUSHIP is a student plan, and if you graduate in May 2019 your plan will continue until the end of your plan year in July or August. That should give you time to get settled at your new job, school or the like. If you want to extend your coverage beyond that, you will be eligible for the Continuation Plan, which can cover you for up to an additional 3 months. That should give you time to get settled at your new job, school or the like. You will have 31 days from the termination date of your prior coverage to apply for the Continuation Plan.  Applications are available on the Student Health website. Click here, then choose the appropriate continuation application form.

If you graduate in December, or if you take a leave of absence and do not enroll for classes in the Spring, your insurance plan will terminate on December 31st. However, if you want to extend your coverage beyond that, you will be eligible for the Continuation Plan, which can cover you for up to an additional 3 months. In addition, insurance exchanges under the Affordable Care Act became available in January 2015.

I will be going abroad in the Spring Semester. Will the Emory plan give me coverage while I am away from the United States?

Yes. The EUSHIP gives coverage both in the United States and abroad.

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  2.  Questions about enrollment in the Emory University Student Health Insurance Plan:

Can I waive insurance for the Fall, and then sign up for the Spring or Summer when my finances are in a little better shape?

Sorry, no. The EUSHIP is an annual plan, with annual enrollment in the Fall. The only students eligible to enroll in the Spring or Summer are students new to Emory during that semester or students with a qualifying event (see below).

What if I find out that I have a serious illness or suffer an injury after the enrollment deadline, can I sign up for the insurance plan then?

Sorry, no again. The EUSHIP is an annual plan with no pre-existing condition exclusions. If the insurance company let students sign up at any time during the semester, after finding out that they have a serious, expensive medical problem or injury, then the rates of coverage would go way up for everybody else covered under the plan. That's why it is called an insurance plan, not a "wait until I need it and then sign up" plan.

What if I lose my current insurance during the school year. Can I sign up for the Emory insurance plan then?

Yes, you can. After the enrollment deadline, students who have involuntarily lost health insurance coverage through a "Qualifying Life Event" (such as (1) removal from a parent's health insurance plan after achieving a landmark birthday that disqualifies them from a parent's health insurance plan, or (2) losing private insurance through loss of employment or divorce) may apply for late enrollment in the Emory University Student Health Insurance Plan. These students must provide proof that they have lost insurance through another group (certificate and letter of ineligibility) within 31 days of the qualifying event. The premium will be the same as it would have been at the beginning of that period, but the effective date would be the later of the date the student enrolls and pays the premium or the day after prior coverage ends. Premiums are not pro-rated, and the student will be responsible for paying the full premium for the term in which they enroll.

Can I enroll my spouse, or qualified domestic partner and/or children in the Emory University Student Health Insurance (EUSHIP) plan?

Domestic and international students are eligible to enroll their spouse, qualified domestic partner and/or children in the Emory University Student Health Insurance Plan as long as the Emory student is also enrolled in the plan.

What are the requirements for a qualified domestic partner in the plan?

To be considered a Qualified Domestic Partner, and eligible to be covered as a Dependent of an Insured Student under the EUSHIP, you must meet the following criteria:

  1. The Emory University student must be an enrolled student.
  2. The Domestic Partnership must have been in existence for a period of 12 consecutive months prior to the application for coverage under this Plan.
  3. The members of the Domestic Partnership are not legally married to anyone.
  4. The members of the Domestic Partnership must be 18 years of age or older.
  5. The members of the Domestic Partnership are not related by blood closer than would bar marriage in the State of Georgia and are mentally competent to consent to a contract.
  6. The members of the Domestic Partnership are each other's sole Domestic Partner, and intend to remain so indefinitely and are responsible for their common welfare.

International students who elect to enroll their Domestic Partner are required to complete an Affidavit for Domestic Partnership, which is available at the Emory Student Health Insurance Plan Office in the 1525 Clifton Road Building. Call 404-727-7560 if you have questions.

I am a U.S. domestic student.  What are my alternate options for enrolling my spouse or dependents in a health insurance plan?

Please review the available information about utilizing the insurance options created by the Patient Protection and Affordable Care Act commonly referred to as the Affordable Care Act (ACA).   For some frequently asked questions concerning this and how it may affect Emory students, please click here. Please keep in mind that if your spouse or dependents would like to utilize the Emory Healthcare (‘The Emory Clinic’) System for their medical care, some ACA exchange insurance plans are not accepted at Emory Healthcare: for more information, click here.

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3.  Questions about dates of coverage, including the continuation plan:

What are the dates of coverage of the 2018-19 EUSHIP plan?

The EUSHIP is an annual plan. Dates of coverage for the remainder of the plan year for new students entering in Spring semester are as follows:

  • Medical students/ 2 year MBA students: 7/15/2018 - 7/14/2019
  • International students/ Allied Health PA students: 8/01/2018 - 7/31/2019
  • All other students: 8/15/2018 - 8/14/2019

The only students eligible to enroll in the Summer are students new to Emory during that semester or students with a qualifying event (see above).

What if I want to continue coverage after I graduate or otherwise leave Emory? Can I do so under the EUSHIP plan?

Yes. Students can purchase a continuation plan to continue coverage for 3 months after they leave Emory. For more information about the continuation plan, click here for more information.

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4.  Questions about primary care at Student Health Services and referrals for specialist care:

Where do I get my primary medical care under the Emory University Student Health Insurance Plan? At Student Health Services?

Yes. Emory Student Health Services is the primary care provider under the plan. Visits to EUSHS are free for enrolled students, and the EUSHIP plan pays 100% of covered services at EUSHS (lab tests, medical supplies, annual physical examinations, medications, immunizations, Travel Clinic, etc.).

What if I don't have the EUSHIP plan? Can I still go to Student Health Services?

Yes, absolutely! Your visits are still free (covered by your tuition).

What if I don't have the EUSHIP insurance plan and I get billed for ancillary services at Student Health Services?

Please view information about fees/charges and insurance coverage here.

I have heard that I have to have a referral to see a specialist under the Emory University Student Health Insurance Plan. Is that true?

Yes, it is. There is a referral requirement under the plan. Emory University Student Health Services (EUSHS) offers students comprehensive primary and specialty services coordinated by EUSHS. All covered students and covered student’s spouses and/or covered dependents age 18 years or older in need of medical care should, except in the case of a medical emergency, first seek treatment and be evaluated at EUSHS. You may be referred to an outside medical provider if required specialist medical care is unavailable at EUSHS. If you are enrolled in the Student Health Insurance Plan, a referral is necessary to receive the maximum benefit under your Student Health Insurance Plan.

There are, however, some situations when a referral is NOT REQUIRED: these exceptions are posted below:

  1. Treatment of an Emergency Medical Condition; or
  2. When EUSHS is closed; or
  3. When the service is rendered at another facility during breaks or vacation periods; or
  4. When medical care is received by a Covered Person who is more than 50 miles from campus; or
  5. When medical care is received by a Covered Person who is no longer able to use the EUSHS due to a change in student status such as graduating or LOA/withdrawal; or
  6. OB/GYN services; or
  7. Dermatological services; or
  8. Chiropractic care; or
  9. All x-rays, Labs and High Cost Procedures; or
  10. Routine Dental services including the treatment and extraction of wisdom teeth; or
  11. Preventive/Routine Services (services considered preventive according to Health Care Reform and/or services rendered not to diagnose or treat an Accident or Sickness).
  12. Continuation Plan

A new referral must be obtained if continuous treatment is being received from one Policy Year to the next. Please note that student’s dependents under age 18 are not permitted to use EUSHS and therefore are exempt from the referral limitations and requirements.

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5.  Questions about other optional coverage, including dental and supplemental plans:

I am interested in getting dental coverage. Does the EUSHIP plan cover dental care?

Yes. Routine dental coverage is available under the Emory University Student Health Insurance Plan.  For care of injuries to sound, natural teeth and TMJ care, including impacted wisdom teeth, treatment is covered under the medical plan. The Vital Savings Discount Program is available.   Additional information is available on Aetna's website at www.aetnastudenthealth.com.

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6.  Questions about payment options under the Emory University Student Health Insurance Plan, including financial aid:

How will I be billed for the EUSHIP plan?

If you are enrolled into the EUSHIP plan, you will be billed by Emory Student Financial Services via your student account. If you have the payment plan, the cost of the insurance will be divided into your individual Fall and Spring payments. You should see your first insurance charge with your July bill. If you are not on the payment plan, but would like to be, contact Student Financial Services at 404-727-6095.

Can I get financial aid to cover the EUSHIP plan?

Because health insurance is mandatory for all Emory students, if you are eligible for financial aid, you can request access to additional loans for the amount of the premium. Contact the Office of Student Financial Aid at 404-727-6039 or stop in at their offices at the B. Jones Center.

Can I charge the cost the EUSHIP plan for my spouse, domestic partner or children to my Emory Student Financial Services account?

Sorry, no. If you wish to enroll dependents in the plan, you must follow the instructions posted on this link. Emory Student Financial Services will only bill enrolled students for the EUSHIP insurance, since students are required to have insurance. Spouses, partners and children are not.

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7.  Questions about the waiver process, including appeals:

If I waived off the EUSHIP insurance plan 2018-19, then I am good for the next four years at Emory, right?

No! Every Emory degree-seeking and international student must complete the enrollment/waiver process once a year (each Fall Semester) every year.

What if I make a mistake while I am completing the waiver, or if my insurance situation changes between the day I complete the 2018-19 waiver and the August 29th deadline?

You may reenter the OPUS mandatory insurance waiver site as many times as you wish prior to August 30th and cancel or change your waiver.

Why does Emory have a requirement that the individual annual deductible on my plan must be $2,500 or less or I must have a certified Healthcare Savings Account (HSA)?

Emory has found that students avoid going to the doctor or the emergency room, refuse needed hospitalizations, or won't allow important tests, x-rays or scans to be done, if their deductible is very high (e.g. $5,000, $10,000). The whole point of the mandatory insurance requirement is to give Emory students insurance coverage that will allow them to get important, needed healthcare so that they can successfully complete their degrees. This waiver criterion helps us to achieve that goal.

What if I fail the waiver process or I miss the deadline and get charged for the EUSHIP plan and I want to appeal the charge? Can I do that?

Yes. Emory will have a formal committee to review and vote on appeals. Each Fall, the deadline for this appeals process for the annual plan will be on or about September 15th. If you have questions or concerns about the student insurance requirement or your individual situation relative to the requirement, please contact the Emory Student Health Insurance Plan Office at 404-727-7560 (for Students last name A to M) or 404-778-6692 (for Students last name N to Z) or mandatoryinsurance@listserv.cc.emory.edu.

When can I complete my waiver for 2018-19?

The on line student insurance requirement waiver site for new and continuing Emory University students (including Oxford College) typically opens in mid spring (April/May) and will close at 5:00 pm on the first day of classes, in late August.  You will access this waiver site via your OPUS account at www.opus.emory.edu.

I already completed my insurance waiver for Summer 2018. Now I hear that I also have to do a waiver for 2018-19. Is that true?

Yes! At Emory, we say “Student Insurance Requirement: Every Student, Every Year.” If you do not wish to enroll in the Emory Student Health Insurance Plan, the waiver process must be completed EACH year you are enrolled at Emory University for the upcoming academic year. If you have questions about the insurance waiver/enrollment process, you may contact the Emory Student Health Insurance Plan Office at mandatoryinsurance@listserv.cc.emory.edu, 404-727-7560.

I made a mistake on my waiver (or my insurance situation has changed) and I need to change the information I provided on the waiver site. Can I do that?

Yes. Students can change information on the waiver site as many times as necessary up to the time the site closes.

I waived the student insurance plan, but now I have changed my mind and want to enroll for 2018-19. Can I do that?

Yes. Students can change information on the waiver site as many times as necessary up to the time the site closes, including canceling a waiver and deciding to enroll in the Emory Student Health Insurance Plan.

My waiver was rejected and I am very unhappy about it.

University policies (like laws) are made with an attempt to meet the needs of the majority, and if possible, the overwhelming majority. However, virtually never are they "one size fits all." The University did its best to create a series of minimum requirements that would insure that students were properly covered (otherwise, saying "you must have insurance" would lead to people purchasing $15 annual policies), but knew that there would be requests for exceptions and that many would be legitimate. Therefore, an Appeals Committee, consisting of students, faculty and staff, has been formed and will hear the written appeals requests of individual students. You can find information about the appeals process, and an appeals form for the current waiver/enrollment process by clicking here. If you appeal, we will ask Student Financial Services to not place any charges for insurance on your account pending your appeal. However, if you receive a bill in error prior to the completion of the appeals process, please contact us at mandatoryinsurance@listserv.cc.emory.edu, 404-727-7560 (for Students last name A to M) or 404-778-6692 (for Students last name N to Z).

I am an international student here for only one year and I will not be getting an Emory degree. Why am I still required to have insurance if I am non-degree seeking?

Our international students do need insurance while here, even if they are not degree-seeking. It is an Emory University requirement, and also may be a requirement of your visa.

I am a student in the Laney Graduate School of Arts and Sciences (LGS) for 2018-19 and I am eligible to get a subsidy to help pay for insurance. I would like to enroll in the student insurance plan. Do I still need to go to the OPUS web site?

No, the waiver site is for waivers only, not insurance enrollment. LGS will then post the subsidy to your Student Financial Services account for their portion of the premium. If this still does not make sense, contact the LGS Student Affairs office.

I still don't understand this requirement, the waiver process, etc. Can you help me?

For more information about Emory's health insurance requirement and the Emory Student Health Insurance Plan, go to this link: Student Insurance Requirement Information. If you have further questions about the insurance enrollment/waiver process, please contact the Emory Student Health Insurance Plan Office at mandatoryinsurance@listserv.cc.emory.edu or 404-727-7560 (for Students last name A to M) or 404-778-6692 (for Students last name N to Z).

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8.  Questions about how to get help if you have a question or problem:

Where do I go if I have questions about Emory's health insurance requirement or the online enrollment/waiver process?
 
For answers to these questions, please contact:
 
Emory University Student Health Services
Student Health Insurance Plan Office
1525 Clifton Road Atlanta, GA 30322
404-727-7560 (for Students last name A to M) or
404-778-6692 (for Students last name N to Z) 
mandatoryinsurance@listserv.cc.emory.edu

Where do I go if I have questions about enrollment, insurance benefits or claims processing?

For answers to these questions, contact:

Aetna Student Health Claims Administrators, Inc.
P.O. Box 981106 El Paso, TX 79998
(877) 261-8403

What if I am more comfortable looking up answers to my questions and getting information on line?

As an Aetna Student Health insurance member, you have access to Aetna Navigator®, your secure member web site, packed with personalized benefits and health information. You can take full advantage of this interactive web site to complete a variety of self-service transactions online. By logging on to Aetna Navigator, you can:

  • Review who is covered under your plan.
  • Request member ID cards.
  • View Claim Explanation of Benefits (EOB) statements.
  • Estimate the cost of common health care services and procedures to better plan your expenses.
  • Research the price of a drug and learn if there are alternatives.
  • Find health care professionals and facilities that participate in the Emory Student Insurance Plan.
  • Send an e-mail to Aetna Student Health Customer Service at your convenience.
  • View the latest health information and news, and more!

To register for Aetna Navigator:

  1. Click here.
  2. Click on Members Aetna Navigator.
  3. Follow the instructions for First Time User by clicking on the "Register Now" link.
  4. Select a user name, password and security phrase.

If you need help with registration, assistance is available toll free, Monday through Friday, from 7 a.m. to 9 p.m. Eastern Time at 1-800-225-3375.

What if I have questions about or problems with my Aetna insurance ID card?

Permanent ID cards will be available online at www.aetnastudenthealth.com/emory.  If you need medical attention before your ID card is received, benefits will be payable in accordance with the Policy. You do not need an ID card to be eligible to receive benefits. If you need a temporary ID card, you can obtain one from the Aetna Student Health website at www.aetnastudenthealth.com/emory or contact the EUSHS Student Health Insurance Plan Office for assistance. Once you have received your ID card, present it to the provider to facilitate payment of your claims. You will receive a unique Aetna member ID number on your membership card. For lost ID cards, contact Aetna Student Health Administrators, Inc. at (877) 261-8403, or visit here.

How do I find a list of preferred providers under the Emory University Student Health Insurance Plan?

A complete list of preferred providers can be found at Emory University Student Health Services (EUSHS), or you can use Aetna's DocFind® Service located here. Click on the Find a Doctor link.  You can use DocFind® to find out whether a specific provider belongs to Aetna's network or to find Preferred Providers practicing in your area.

What if I want to talk to the main person in charge of all of this, the Student Health Executive Director themselves?

To reach the Student Health Services Executive Director, please contact:

Sharon Rabinovitz, MD
Interim Assistant Vice President and Executive Director
Emory University Student Health Services
1525 Clifton Road
Atlanta, GA 30322
404-712-8652
Sharon.rosen.rabinovitz@emory.edu

 

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Revised: 3/6//2019