The Emory University
Student Health Insurance Plan

Information: (If you have graduated or taken a leave of absence and would like to continue the Student Health Insurance Plan):

• If you graduate in May, your Student Health Insurance Plan coverage will remain active until the end of the policy year, which will be July 31 for all plans.
• Once your Student Health Insurance Plan terminates, or if you do not return in the fall as a result of a leave of absence or withdrawal, you will be able to extend coverage for an additional one month under the Student Health Insurance Continuation Plan as long as you were covered under the plan, the semester prior. Benefits under the continuation plan remain the same as the basic student plan. Under the new policy year, all out-of-pocket expenses (including copays, deductibles and co-insurance) will reinstate. You will have 31 days from the termination date of your prior insurance to enroll. The cost of the continuation plan is $1,000.
• If you graduate in December or take a leave absence and do not return for the next Spring Semester, coverage will terminate on December 31st. You will then be eligible to extend coverage for an additional one month under the continuation plan. You will have 31 days from the termination date of your prior insurance to enroll.

How to Apply/Enroll/Submit Payment for the Continuation Plan:

• Once you are eligible to apply/enroll for the Student Health Insurance Continuation Plan (see above), both the online enrollment and payment submission are accessed at the same location through Aetna Student Health. Click here to apply/enroll/submit payment.

To obtain your Aetna ID card, select one of following:

1. Access Aetna’s website at https://www.aetnastudenthealth.com/en/school/686178/members/get-id-card.html and Click on the “Print Your ID Card”. Enter your Emory ID number and date of birth.
2. Request a permanent ID card by calling Aetna Student Health at 1-877-261-8403
3. Download the Aetna Mobile App on your Smartphone by visiting www.aetna.com/mobile.

Save with Generic Drugs

Your prescription may be filled with a generic drug. A generic drug contains the same active ingredients in the same amount as the corresponding brand-name drug. The Food and Drug Administration (FDA) requires that generic drugs meet the same strict manufacturing standards for strength, purity and quality as brand-name drugs. Ask your doctor to allow a substitution, if appropriate, whenever you get a prescription. If your doctor has prescribed a brand-name drug, ask your pharmacist whether there is a generic equivalent.

CVS Caremark® Mail Service

Save time and money by ordering your prescriptions through Aetna's mail-order prescription drug service, CVS Caremark Mail Service.

CVS Caremark Mail Service offers you:

• Convenience -- Quick, confidential shipping of your maintenance medications right to your home, your place of work or any other location you choose.
• Ease of use -- Our simple, two-step process makes ordering your maintenance medications easy.
• Quality of service -- Registered pharmacists check orders for accuracy and are available 24 hours a day, 7 days a week in case of emergency.
• Cost savings -- Depending on your Aetna pharmacy benefits and insurance plan, you could save money by using CVS Caremark Mail Service, and standard shipping is always free.

2023 Aetna Pharmacy Drug Guide – Aetna Standard Plan

EUSHIP Formulary Updates 4/2022

Aetna Student Health website:

https://www.aetnastudenthealth.com/en/school/686178/members/prescriptions.html

Dental

The Student Health Insurance Plan offers routine dental coverage. The applicable out of pocket expenses will apply. For additional information, the dental brochure is available here.

The Pediatric Dental Benefit is available to students under 19 years of age. Routine dental services (exams, cleanings, etc.) are covered at 100% under the plan.

A complete list of dental providers is available on Aetna’s Docfind website here.

A referral from Student Health is not required for dental.

Vision

The Pediatric Vision Benefit is available to students under 19 years of age. Routine vision services (exams, glasses, contacts, etc.) are covered at 100% under the plan. Additional information on this benefit is found on PAGE 38 of the Plan Design and Benefit Summary.

Adult routine vision care is available on a discounted basis only, under the EyeMed Vision One Discount Program. The applicable discount must be applied to services at the time of the visit.

Prescription Savings and Discounts on:

• Designer frames
• Prescription lenses
• Lens options, like scratch coating and tint
• Non-disposable contact lenses
• Savings on LASIK laser eye surgery
• Replacement contact lenses, delivered to your door
• Savings on eyeglass chains, lens cases and cleaners, and nonprescription sunglasses

Your eye exams are always discounted. So even if your plan covers your first exam, you can save on another one from any participating doctor.

Locations

You can visit many doctors in private practice. Plus, national chains like LensCrafters®, Target Optical® and Pearle Vision®. Log in to your member website at AetnaStudentHealth.com to find participating locations.

Built-in plan discounts with no referrals, claims or limits.

A referral from student health is required for all medically related vision services.

A referral is not required for routine services.

Currently, the Emory Eye Center located on the main campus, does not participate in the vision discount program under Aetna Student Health. We are working to partner with Emory Healthcare son. To locate additional vision locations, (Walmart, Target Optical, Lens Crafters, etc), access Aetna’s Docfind website.

The Aetna Student Health Insurance Policy offers both domestic and international coverage including medical evacuation and repatriation. Services rendered internationally are covered at the out-of-network benefit level of 60/40 after the $40 office visit co-pay and $750 annual out-of-network deductible. Additional information regarding coverage abroad is available on Aetna’s website at https://www.aetnastudenthealth.com/en/school/686178/index.html under “Travel Assistance”. A separate ID card is also available on the Aetna website.

Travel Membership Benefits

• 24/7 worldwide medical information and assistance
• Unlimited emergency medical evacuation
• Unlimited medically necessary return home
• Travel arrangements for a family member or friend if you’re alone and are hospitalized and will remain hospitalized
• Emergency return home for the death or life-threatening illness of a parent, sibling or spouse Medical monitoring
• Medical, dental and pharmacy referrals
• Medicine replacement assistance
• Pre-trip information

Travel Assistance

• 24/7 emergency travel arrangements
• Translation assistance
• Assistance with arranging emergency travel funds
• Lost travel documents replacement assistance
• Credit card or traveler’s check replacement assistance
• Legal consultation and referrals
• Delayed baggage tracking

Security Assistance

• Political evacuation
• Natural disaster evacuation

Additional Information

Find out more about On Call travel assistance

See On Call description of services

Print your On Call International ID card

On Call Certificate of Coverage

If you or your eligible dependent (spouse, domestic partner or child) experience a qualifying life event (QLE) by involuntarily losing coverage under another plan by (1) turning 26 and aging off your parents insurance (2) loss of employment/benefits (3) change in marital status (4) new resident to the U.S., you are eligible to enroll in the Student Health Insurance Plan within 31 days of the qualifying event.

You will need to provide a letter of termination from your prior insurance company or a copy of your visa or passport, if entering as a new resident to the U.S. All documents should be submitted to the Insurance Office at MANDATORYINSURANCE@LISTSERV.CC.EMORY.EDU.

The premium is not prorated when enrolling mid-year. You will be charged the semester’s premium and coverage will begin the day after your loss.

The Student Health Insurance Plan offers comprehensive coverage for transgender care and treatment.

Services include charges made in connection with a medically necessary gender reaffirming surgery as long as the covered student or their covered dependent has obtained precertification from Aetna.

https://studenthealth.emory.edu/_includes/documents/Emory_University_SI_PDBS_2223_FINAL.pdf

Covered medical expenses include but are not limited to:

• Charges made by a physician for:
• Performing the surgical procedure; and
• Pre-operative and post-operative hospital and office visits.
• Charges made by a hospital for inpatient and outpatient services (including outpatient surgery).
• Charges made by a Skilled Nursing Facility for inpatient services and supplies.
• Charges made for the administration of anesthetics.
• Charges for outpatient diagnostic laboratory and x-rays.
• Charges for blood transfusion and the cost of unreplaced blood and blood products.
• Charges made by a behavioral health provider for gender reassignment counseling.

Additional benefits added to the Student Health Insurance Plan for 2023-24 include:

• Mammoplasty
• Thyroid Chondroplasty
• Facial Feminization Surgery
• Vocal Folds Shortening
• Retro displacement of Anterior Commissure (VFSRAC)
• Follicular Unit Extraction (FUE)
• Follicular Unit Transplant (FUT)
• Speech Therapy
• Tracheal Shave (Adam’s Apple)
• Removal of Hair for Male to Female patients (Electrolysis and Laser)

Added resources include the Aetna Clinical Policy Bulletin (CPB)

https://www.aetna.com/search-results.html?query=GENDER+AFFIRMING

Aetna Gender Reaffirming Provider List

Referral requirements have been updated to be more customer friendly for specialists visits outside of Student Health (visits with a SHS provider are available if needed but NOT required in all circumstances for insurance purposes). The need for a referral will be determined at the provider’s discretion if the following apply:

1. New patient, not seen at Student Health Services previously
2. New condition, not treated at SHS previously
3. Referral is required by the specialists’ office
4. Recommended for care by a SHS provider

If you are an established patient or require care following an ER visit or hospitalization or requesting the renewal of an existing referral from one plan year to the next, please contact the SHS "Referral Coordinator" via the Student Health Portal by sending a message or by calling 404-727-0207 and a referral will be generated for you. An in-person visit is required.

If you take a leave of absence or withdraw within 31 days into the semester, the Emory student health insurance will terminate retroactively and you will not be eligible to enroll or remain enrolled in the Student Health Insurance Plan for the semester in which your leave occurs.

If you remain an enrolled student 31 days into the semester (or beyond), coverage will remain active for the remainder of the semester.

If you are no longer eligible to enroll in the base plan for enrolled students, the continuation plan is available for extending coverage an additional 1 month if you were enrolled in the plan one semester immediately prior to your leave.

The 1095-B Insurance tax forms have been processed and were mailed to plan members of the Student Health Insurance Plan on Jan 31, 2023 for the 2022 tax year. As per IRS requirements, all 1095-B forms should be distributed by March 31st, including required residents of NJ, DC, RI and CA. If you do not receive your tax form, or you require a correction, please contact the Insurance Office at mandatoryinsurance@listserv.cc.emory.edu or call 404-727-8959 to request a copy.

For the protection of your Personal Identifiable Information (PII), Emory University does not provide Social Security Numbers to third party entities including Aetna Student Health. For your protection, the SSN/TIN referenced on your tax form, is the last 4 digits of your Aetna ID number, which will not affect your tax form in any way.

The 2022 tax filing deadline is April 18, 2023. For more information, please visit https://www.irs.gov/.

Please note: The IRS no longer requires that you submit the 1095-B form with your tax return. Once you receive your 1095-B form, it is recommended that you retain a copy for your records. Penalties will not be imposed.

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.

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