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 2016-17 Emory/Aetna plan features the following:
Plan changes for 2016-17:
We strongly encourage you to read the plan brochure before you draw conclusions about the quality of coverage. Click here to view the 2016-2017 Aetna Student Health Insurance Plan Design and Benefit Summary information.
What are the 2016-17 premium rates of the Emory/Aetna plan?
The 2016-17 annual student premium is $3164.
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 Emory/Aetna 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 24, 2016) 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 Emory/Aetna is a student plan, and if you graduate in May 2017 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 terminatin date of your prior coverage to apply for the Continuation Plan. Apllications 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 January 7th. 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 Emory/Aetna Student Plan gives coverage both in the United States and abroad.
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.
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, International Students must have insurance that meets the following additional requirements:
The Emory University Student Health Insurance Plan, offered by Aetna Student Health, meets all additional insurance requirements for international students and dependents.
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 Emory/Aetna insurance plan 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 Emory/Aetna insurance plan 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/Aetna plan?
Only international students are eligible to enroll their spouse, qualified domestic partner and/or children in the Emory/Aetna Student Health plan.
What are the requirements for a qualified domestic partner in the plan?
Again, this is only eligible to international students. To be considered a Qualified Domestic Partner, and eligible to be covered as a Dependent of an Insured International Student under the Emory/Aetna Student Health Insurance Plan, you must meet the following criteria:
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, since I cannot enroll them in the Emory/Aetna 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.
What are the dates of coverage of the 2016-17 Emory/Aetna plan?
The Emory/Aetna student health insurance is an annual plan. Dates of coverage for the remainder of the plan year for new students entering in Spring semester are as follows:
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 Emory/Aetna 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 to access the Forms page on our website, then click on the appropriate Aetna/Emory Insurance Continuation Application form link, or contact our EUSHS Insurance Supervisor at 404-727-7560.
Where do I get my primary medical care under the Emory/Aetna student 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 insurance 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 Emory/Aetna 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 Emory/Aetna plan and I get billed for ancillary services at Student Health Services?
EUSHS accepts cash, checks, EmoryCard, Visa and MasterCard for ancillary services (lab, medications, etc.). Payment for deductibles and coinsurance is due at the time of service.
EUSHS participates in the Emory-endorsed student insurance plan and in a number of major medical plan PPOs. If we are a part of your PPO, you should carefully check to see any limitations of coverage you may have (including co-pays and deductibles) prior to receiving care at EUSHCS. At your request, we file medical charges you incur at EUSHS with your primary insurance carrier. It is possible that your carrier may not pay for all charges.
Please note that EUSHS does not participate in Blue Cross/Blue Shield, Federal Medicare and state Medicaid programs and will be unable to bill for services under these plans.
I have heard that I have to have a referral to see a specialist under the Emory/Aetna 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 international 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:
A new referral must be obtained if continuous treatment is being received from one Policy Year to the next. Please note that international student’s dependents under age 18 are not permitted to use EUSHS and therefore are exempt from the referral limitations and requirements.
I am interested in getting dental coverage. Does the Emory/Aetna plan cover dental care?
No, except for care for injuries to sound, natural teeth and TMJ care. The Vital Savings Discount Program is available. Additional information is available on Aetna's website at www.aetnastudenthealth.com.
Does Emory require dental insurance for students?
No, it does not.
How will I be billed for the Emory/Aetna insurance plan?
If you are enrolled into the Emory/Aetna insurance 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 15, 2016 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 Emory/Aetna insurance 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 Emory/Aetna insurance 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 go to this link. Emory Student Financial Services will only bill for student insurance, since students are required to have insurance. Spouses, partners and children are not.
If I waived off the insurance plan 2016-17, 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 2016-17 waiver and the August 24th deadline?
You may reenter the OPUS mandatory insurance waiver site as many times as you wish prior to August 24th 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/Aetna 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 email@example.com.
When can I complete my waiver for 2016-17?
The on line student insurance requirement waiver site for new and continuing Emory University students (including Oxford College) opens on May 26, 2016 and will close at 5:00 pm on the first day of classes, August 24, 2016. You will access this waiver site via your OPUS account at www.opus.emory.edu.
I already completed my insurance waiver for Summer 2016. Now I hear that I also have to do a waiver for 2016-17. 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 firstname.lastname@example.org, 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 2016-17. 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 email@example.com, 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 2016-17 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 firstname.lastname@example.org or 404-727-7560.
If an Emory student is on the Emory Aetna student plan for 2016-17, can he/she switch on January 1, 2017 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 Emory/Aetna student plan have an individual contract with Aetna for insurance for the entire 2016-17 academic year. Because the insured students have contracted with Aetna for an annual plan, students will not be eligible to voluntarily cancel the Emory/Aetna Student Health Insurance Plan for purposes of enrolling in the ACA exchanges for the remainder of the 2016-17 academic year. Aetna’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/Aetna plan graduates at the end of the 2016 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 Emory/Aetna plan experiences a Qualifying Life Event (QLE) due to graduation or withdrawal/leave of absence from Emory, and loses coverage under the Emory/Aetna student plan, there are several options for ongoing coverage:
The Emory/Aetna Student Health Insurance Policy 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 Aetna/Emory Insurance Continuation Application form link, or contact our EUSHS Insurance Supervisor 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 www.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/Aetna student plan after the 2016-17 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 Emory/Aetna 2016-17 plan, 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.
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
What if I want to talk to the main person in charge of all of this, the Student Health Executive Director himself?
To reach the Student Health Services Executive Director, please contact:
Michael Huey, MD
Assistant Vice President and Executive Director
Emory University Student Health Services
1525 Clifton Road
Atlanta, GA 30322
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
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:
To register for Aetna Navigator:
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 after the enrollment/waiver on line site closes. 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 my Emory/Aetna 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.