12/19/2014. Health Insurance & Health Care in the U.S. Overview. Who is Required to Have Insurance? Why must you have insurance?

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1 Overview Health Insurance & Health Care in the U.S. Health Insurance Requirements Insurance Waiver Coverage Costs, and Dates Important Terms & Summary of Benefits How to Get Your Insurance ID What To Do When You Are Sick Important Details Spring 2015 Visa & Immigration Service Advising Who is Required to Have Insurance? Why must you have insurance? STUDENTS: All international students and scholars with F-1 or J-1 Visas MUST have insurance. All F-1/ J-1 students are AUTOMATICALLY enrolled in UnitedHealthcare StudentResources plan upon class registration. DEPENDENTS: All dependents with J-2 Visas MUST have insurance. Dependents with F-2 Visas ARE HIGHLY ENCOURAGED to have insurance. Required by the US visa regulations and Old Dominion University; Not subsidized by government; Health care in the US is very expensive; You are responsible for all your health care expenses; Health Insurance helps pay your medical bills. Please contact VISA for dependent s enrollment What Is a Hard Waiver? Students with Home Government Sponsorship University requires students to carry health insurance which meets specific requirements. Very few exceptions are available. Waiver (to opt out of ODU insurance policy) application information can be found on the VISA site under Health Insurance Requirements Waiver Deadline for SPRING 2015 is Friday, 16 th January Receive full sponsorship (tuition & fees, living expenses & insurance); U.S.-based insurance for you for your entire program at ODU (this coverage is equal to or greater than the policy selected by ODU); Your responsibility: one copy of your financial guarantee to VISA and one copy of your financial guarantee the Cashier in Rollins for every semester you are enrolled. Deadline for SPRING 2015 is Friday, 16th January 2015 Delay in getting your sponsorship document? VISA immediately. No notification? You (not sponsor) will be responsible for insurance fees (and late payment penalties, if applied)

2 Refund Policy Refund policy for health insurance fee is the same as for tuition. If you withdraw from school: What Are the Costs & Coverage Dates? Fall: 1 August to 31 December Spring: 01 January to 31 July $144 * 7 months = $1,008 Before January 20, % refund, less any claims paid. Before January 27, % refund, less any claims paid. After January 28, 2015 No refund Where and How Do You Pay? Insurance charges will be added to your tuition statement when you register. Two ways to pay 1. One payment via LeoOnline or Cashier s office. 2. Multiple payments via the payment plan. 9 9 What Does The Plan Cover? Plan Benefits: UNLIMITED Injury and sickness max. benefits per person; 100% student health center ; 100% preventative care (at preferred provider= contract with United); Prescription drugs - use Generic drugs whenever possible; Any doctor/hospital BUT use a preferred provider whenever possible; Emergency Room & Ambulances; Travel Assistance Services (page 4); Generic Drugs: Drugs sold by their chemical name and not by their advertised brands names Medical Evacuation and Repatriation to your home country (FrontierMEDEX); 10 Important Terms/ Benefit Summary United is a PPO (Preferred Provider Organization) Plan Important Terms/ Benefit Summary United is a PPO (Preferred Provider Organization) Plan DEDUCTIBLE* : The amount you pay out-of-pocket before United begins to cover at 80%. In-Network /Preferred Provider $150 per insured Out-of-Network $400 per insured COPAY: The fixed amount you pay at the time of your visits In-Network /Preferred Provider Doctor s visit: $20 per visit Medical Emergency: $100 (waived if admitted to hospital) Out-of-Network Doctor s visit: $20 per visit Medical Emergency: $100 per visit OUT-OF-POCKET MAXIMUM: After the out-of pocket maximum is satisfied, United will covered at 100%. $4,000 per insured $7,000 per insured *The annual deductible does not apply to some services. For example: Immunizations, preventative and contraceptive care, Routine physical exam, Prescriptions COINSURANCE: The % that you pay and the insurance company pays after you have paid the annual deductible. Prescriptions: $25 copay for Tier 1 to 80% of preferred allowance Prescriptions: No Benefits 50% of usual and customary charges

3 Some Common Non-Covered Services *Eye exams, vision therapy, contact lenses or prescription glasses *Dental Care - unless it s due to an injury to Sound, Natural teeth. ODU has a Dental Hygiene Program that provides basic comprehensive dental hygiene care on-campus September through June. For appointments, call *Pediatric Dental and Vision Benefits are included for children under age 19. Refer to plan brochure for more details. Failure to keep a scheduled visit Exclusions and Limitations are listed on page 3-4 of the Summary of Benefits. 13 How Do You Use Your Insurance? Print Out/Request ID Card Always carry your Insurance ID card with you. You must present it to hospitals, doctors and pharmacies. Go to My Account The online user guide to create an account with step by step instructions is here. UHCSR Mobile App: available on the Apple App Store and in Google Play 14 Sample Medical ID Card Discount ID Card UnitedHealth Allies - is a health discount program that can help you save up to 50 percent on a wide range of health-related products and services that are not covered by your benefit plans NOTE: Discount card is included on the same form with the medical ID card What to do when you need to see a doctor? Your first stop should always be the ODU Student Health Services Call (757) for an appointment Most services are paid through the Health Services fee ($ 76) paid by all full-time students (9 GR/12 UG credits). Part-time students are not charged with the health fee; No Co-pays, coinsurance, deductible; Fees for services will be billed to your university account; Fees for services can be reimbursed by United at 100%. A walkout-statement will be provided for you to fax/mail to United. See claims instructions on the back of Insurance ID card. A limited number of prescription drugs are available What If Student Health Services Cannot Treat You? Student Health Services will send you to an off-campus office/facility for services that they cannot provide. Always choose IN-NETWORK/ preferred providers NOT OUT- OF-NETWORK Providers. Locate In-Network providers at Call the doctor to confirm they are part of the UHC Choice Plus Network. You will be responsible for paying co-pay at the time of service. You will receive a bill for any outstanding deductible and your portion of the coinsurance AFTER United pays the provider 18 3

4 EOB- Explanation of Benefits What If Student Health Services Is Closed? If it is not an emergency, wait until Student Health Services re-opens. If you feel you can t wait until their office re-opens: 1. ODU Campus Police at (757) They will connect you with the on-call staff member from Student Health Services. S/He will help you decide what to do (hospital, medicine, etc.). OR 2. 24/7 UHCSR Nurseline service (877) PIN: 211 The number is shown on the front of the medical ID card What If You Have an Emergency? An EMERGENCY is a life-threatening accident or illness. If you need immediate treatment, definitely call 911 to get an ambulance or, if you choose, have a friend take you. If you go to an ER when it is not considered an emergency: the wait will be long; the costs will be high; insurance may not always cover the bill Important Details In Summary UnitedHealthcare StudentResources (United) is Old Dominion University s health insurance provider. Policy/ Group Number: Summary of Benefits Full Certificate of Coverage UHCSR Customer Service: Claims Fax: Claims: No form needed for Medical Reimbursement Prescription Reimbursement Request Form and mail/fax it along with your original pharmacy receipt(s) Read Medical Insurance Booklet Read Summary of Benefits Print Out Your Insurance ID card Familiarize yourself with the United Website Ask Questions

5 Questions Insurance: 1. UHCSR Customer Service Visa & Immigration Service Advising (VISA) or Subsidies for Graduate Assistants: -Your departments -Graduate Studies Department: