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Frequently Asked Questions about the Health Insurance Requirement


  1. Questions about issues of importance to International Students
  2. Questions about primary care at Student Health Services and referrals for specialist care
  3. Questions about the waiver process, including appeals
  4. Questions about insurance exchanges and the Affordable Care Act
  5. Questions about how to get help if you have a question or problem

1.  Questions about issues of importance to International Students:

I am an international student and I have always been required to have health insurance at Emory. However, I never heard about this 'United States-domiciled' insurance company requirement. Is this new? Can't I have insurance from my home country?

All international students at Emory have been required to have health insurance or to purchase the Emory student plan. However, the requirement that the insurance company be domiciled in the United States is a Fall 2005 change in the insurance requirement for international students. Emory has found that receiving health insurance benefits from international carriers for medical care in the United States can often be incomplete and problematic.

Under certain circumstances, we will allow students to have insurance with an international carrier if the insurance company has a claims-processing agreement with an American firm. Please contact our Student Health Services Insurance Office if you have questions about this situation.  The Emory University Student Health Insurance Plan, offered by Aetna Student Health, meets all additional insurance requirements for international students.

Are there any additional insurance requirements for International Students that do not apply to domestic students?

Yes. In addition to the coverage requirements listed for all students, additional requirements are available on the International Student and Scholar Services website at isss.emory.edu.

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2.  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, except in the following instances:

  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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3.  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 Emory University Student Health Insurance 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 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.

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 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.

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4.  Questions about insurance exchanges and the Affordable Care Act:

If an Emory student is on the Emory University Student Health Insurance Plan for 2018-19, can he/she switch on January 1, 2019 to a cheaper Health Insurance Exchange plan?

The ACA insurance exchanges were developed for people who do not have access to other health insurance. They should not be used as an alternative option for people who already have qualifying health insurance and are looking for a less expensive option. Students on the EUSHIP have an individual contract with Emory for insurance for the entire 2018-19 academic year. Because the insured students have contracted with Emory for an annual plan, students will not be eligible to voluntarily cancel the Emory University Student Health Insurance Plan for purposes of enrolling in the ACA exchanges for the remainder of the 2018-19 academic year. Emory's policy is that the eligibility for an exchange plan is not considered a Qualifying Life Event.

 What if an Emory student on the Emory University Student Health Insurance Plan graduates at the end of the 2018 Fall semester or takes a leave of absence for the Spring Semester? Can those students enroll in an insurance plan through the ACA exchanges?

 Yes. If a student on the EUSHIP experiences a Qualifying Life Event (QLE) due to graduation or withdrawal/leave of absence from Emory, and loses coverage under the EUSHIP, there are several options for ongoing coverage:

  • The Emory University Student Health Insurance Plan offers three months of extended coverage under the Continuation Plan. For more information about the continuation plan, click here to access the Forms page on our website, then click on the Emory Insurance Continuation Application form link, or contact our EUSHS Insurance Office at 404-727-7560.
  • The graduated or former student may obtain insurance through a new job, or through a parent/family policy due to a Qualifying Life Event.
  • In addition, there may be insurance options available through the ACA Healthcare Marketplace at healthcare.gov. This ACA “special enrollment period” is open 60 days before the loss of coverage and 60 days after. The ACA website recommends that enrollment in the new plan be completed no later than 15 days prior to loss of coverage, in order to reduce the risk of a gap in coverage.

What happens when I graduate in the spring or decide to leave the Emory University Student Health Insurance Plan after the 2018-19 policy year ends in the summer? Isn't it then too late for me to enroll in a plan on the ACA health insurance exchanges?

No, it won't be too late for you to enroll in an exchange plan as long as you experience a qualifying life event.  If you are eligible for an exchange plan, and you have concluded your enrollment in the EUSHIP 2018-19, you will have an ACA exchange “special enrollment period” open 60 days before the loss of coverage and 60 days after. The ACA website recommends that enrollment in the new plan be completed no later than 15 days prior to loss of coverage, in order to reduce the risk of a gap in coverage.

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5.  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
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: 8/19/2018