Health Insurance Orientation Student Health and Counseling Services
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1 Health Insurance Orientation Student Health and Counseling Services
2 Presenters: Karla Abrantes Coordinator, Student Health & Counseling Immunization Student Health Insurance Plan Fred B. Hollick, Jr. Vice President of National Sales & Marketing Student Resources United Healthcare Slide 2 of 36
3 Services offered by Student Health and Counseling 1. Licensed therapists and a part-time psychiatrist who provide short-term psychotherapy for a variety of mental health issues. 2. A registered nurse is available for health education and suggestions for additional health resources (e.g. locating medical services off campus, understanding the different types of health care professionals, questions on illnesses, women s health, men s health, sexual health, etc.). 3. General assistance with the student injury and sickness insurance plan. Appointments are necessary for all visits. Students can call or visit the office to make an appointment. Slide 3 of 36
4 Services offered by Student Health and Counseling IMPORTANT: Services provided by our office are free and confidential. Students can take advantage of our services whether they are enrolled in the SVA student insurance plan, or maintain insurance coverage on their own. Medical services are NOT available on-site: Students needing medical attention should seek assistance from a doctor or hospital. Students do not need to visit the office for referrals before visiting a doctor or hospital. For emergencies, please dial 911 and contact Security. Slide 4 of 36
5 SVA-Sponsored Health Insurance Students are automatically enrolled in the UnitedHealthcare StudentResources Injury and Sickness Insurance Plan Dental or Vision coverage not available except for pediatric dental and vision (students 18 yrs & younger). Please see Brochure for details at, $1,035 per semester; Deductible $100; Physician Visit Copay $10 Fall Coverage - August 25, 2014 until January 7, 2015 Spring Coverage - January 8, 2015 until August 24, 2015 Please review the Insurance Tab on sva.edu/health for important general information about the insurance plan. Refer to the United Healthcare Getting Started and the Summary PDF s at for more information. Slide 5 of 36
6 Waiving the Health Insurance Fee Students are automatically enrolled in the student insurance plan each semester. However, students who already have comparable health insurance coverage coming into SVA, can waive the per semester Health Insurance Fee of $1,035, and be removed from enrollment. An online waiver form must be completed by the deadline, October 2, 2014, and can be accessed at > The waiver form must be completed each year, by each fall semester. It can also be completed in the spring should a student miss the fall deadline. > Bookmark for updates each semester. Slide 6 of 36
7 Waiver Form Deadlines The Fall Waiver Form deadline is October 2, > Completing the waiver form will remove you from the Insurance Plan and remove the Health Insurance Fee for both Fall 14 and Spring 15 semesters. The Spring Waiver Form deadline is February 12, > Should you miss the fall waiver deadline, or now have your own insurance coverage for the spring, you can complete the spring waiver form by this date. Slide 7 of 36
8 Getting Started with UnitedHealthcare StudentResources Slide 8 of 36 August 2014: First insurance sent to students SVA account. Subject: IMPORTANT You re Enrollment in United Healthcare Fall 2014: Reminder that you re enrolled in the UnitedHealthcare StudentResources administered plan. Contains information on creating an online account, printing out your insurance ID card, reviewing the benefits, and finding local doctors. Reminder to complete online waiver form by the deadline. If you did not receive this , please visit us at and click on the United Healthcare Getting Started pdf.
9 Going Off Campus for Health Care Since SVA does not provide medical services on campus, you must visit a doctor off-campus. You have several choices: Private Doctors and/or Specialists treat non-emergency patients by appointment during regular office hours, typically 9:00AM until 5:00PM. Some of these doctors may have weekend hours, but can vary. Minor Emergency Clinics or Urgent Care do not require appointments and are usually open on weekends and holidays. You can simply walk in for medical services. (For example, City MD, NY Doctors Urgent Care, Beth Israel, etc. These locations can be found online at sva.edu/health under the Downloads section.) Hospital Emergency Rooms provide serious emergency care. Go to the nearest, hospital by ambulance if necessary. Hospital emergency rooms are designed to treat life-threatening ailments. This is typically the most expensive place to receive care. If you need to use a medical facility but are uncomfortable with your English skills, ask a friend who speaks English to go with you. Proper communication is very important! Slide 9 of 36
10 Find a Doctor Slide 10 of 36
11 for Plan Information Slide 11 of 36
12 School of Visual Arts Student Injury and Sickness Insurance Plan Slide 12 of 36 StudentResources
13 Points to Consider Prior to Waiving The SVA Student Injury & Sickness Insurance Plan includes coverage for preventive care services, has a low up-front deductible, and a prescription medication plan. If your current coverage is through an HMO or PPO, local services in New York City may be limited or may be charged to you at a higher, non-preferred rate. Your current insurance plan may only cover urgent or emergency care outside of their network. Your current plan may not include coverage worldwide. The SVA Student Plan provides worldwide coverage and includes Medical Evacuation and Repatriation. Slide 13 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
14 Rates Annual 8/25/14 8/24/15 2 nd Semi-Annual 1/8/15 8/24/15 Student $2,070 $1,035 This plan is underwritten by UnitedHealthcare Insurance Company of New York and is based on Policy # For a full description of coverage, including costs, benefits, exclusions, any reductions or limitations and terms under which the policy may be continued in force, log on to Slide 14 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
15 Plan/Benefit Highlights Unlimited Maximum Per Insured Person, Per Policy Year for Covered Medical Expenses. $100 Deductible Per Insured Person, Per Policy Year. What s a deductible? A deductible is the amount of money you must pay towards covered medical expenses before the insurance company pays. Slide 15 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
16 Plan/Benefit Highlights Covered Medical Expenses for Preferred Providers are payable at 90% of Preferred Allowance and Out-of-Network benefits are payable at 60% of Usual and Customary charges (all benefits are subject to satisfaction of the deductible, specific benefit limitations, maximums, and copays as described in the policy). Slide 16 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
17 Plan/Benefit Highlights Benefits Preferred Providers Out-of-Network Hospitalization 90% 60% Surgery 90% 60% Outpatient Services 90% 60% Emergency Room 90% 90% Physician s Office Visit $10 copay, 100% $10 deductible, 70% Preventive Care and Immunizations Dental Injury (to sound, natural teeth only) 100%, no cost sharing No Coverage $10 copay, 100% $10 deductible, 100% Slide 17 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
18 Plan/Benefit Highlights Benefits Preferred Providers Out-of-Network Inpatient Mental Health 90% 60% Outpatient Mental Health $10 copay, 100% $10 deductible, 70% Inpatient Substance Abuse Outpatient Substance Abuse 90% 60% $10 copay, 100% $10 deductible, 70% Ambulance Expense 100% 100% Slide 18 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
19 Plan/Benefit Highlights Prescription Drug Benefits: $10 copay for Tier 1; $20 copay for Tier 2; up to a 31-day supply per prescription. Prescriptions must be filled at a UnitedHealthcare Pharmacy. Mail order at 2.5 times the retail copay, up to a 90-day supply. Slide 19 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
20 Plan/Benefit Highlights The Preferred Provider Network for this plan is UnitedHealthcare Options PPO. Preferred Providers can be found using the following link: Region Providers Hospitals Central 221,305 2,133 Northeast 198, Southeast 136,104 1,243 West 139, Leased 43, Total 738,720 5,600 Slide 20 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
21 Plan/Benefit Highlights FrontierMEDEX: Global Emergency Services Domestic students are covered when they re 100 miles or more away from their campus or home address. International students are covered worldwide except in their home country. Slide 21 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
22 Plan/Benefit Highlights UnitedHealth Allies Included with every policy, the UnitedHealth Allies discount program typically saves members 5 50% on many health and wellness products and services. Members save on dental and vision care, fitness club memberships, weight management programs, smoking cessation, massage therapy, and much more. The UnitedHealth Allies Discount Program is administered by HealthAllies, Inc., a discount medical plan organization. This discount program is not a qualified health plan under the Affordable Care Act. UnitedHealth Allies discount plan is NOT insurance. Slide 22 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
23 Plan/Benefit Highlights Collegiate Assistance Program (CAP) Nurseline Services Experienced registered nurses can help with nearly any health or medical concern, 24/7. Call Toll-Free: Telephonic/Online Counseling Students facing stressful or emotional issues have 24/7 access to prompt counseling services. Innovative Web-based Services Our website for students, offers a wealth of information on a full range of topics. Slide 23 of 36 Legal and Financial Services Non-clinical issues such as mounting credit card debt, divorce, child custody matters, and shelter from abusive relationships. Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
24 Plan/Benefit Highlights My Account With My Account, available through or insured students can securely: Review plan coverage details online Print an ID card and/or request a replacement ID card Check claim status and review EOB (Explanation of Benefits) Find a Preferred Provider Update personal information Contact UHCSR with a question/comment Access helpful resources and forms Slide 24 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
25 Plan/Benefit Highlights Create your secure My Account page: From click on Login to My Account, then Create Your Online Account. Type in your first name, last name, date of birth (as shown) and for your SVA account. Click CONTINUE Slide 25 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
26 Plan/Benefit Highlights UHCSR Mobile App With the free UHCSR Mobile App, available at GooglePlay and Apple s AppStore, you ll have access to the most popular self-service features like: Viewing and sharing your ID card. You can even or fax it to your provider. Viewing claims received within the prior 60 days. Searching for a Preferred Provider. Accessing your custom My Account page. Slide 26 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
27 Plan/Benefit Highlights Understanding your ID Card Member ID# This is the Member Identification number your provider will need to confirm your benefits. Group Name This is the Group Identifier your provider will need to confirm your benefits. Plan Name This is the plan name you need to provide to physicians or when online. Slide 27 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
28 Plan/Benefit Highlights Health Insurance 101 Located at Health Insurance 101 defines and clarifies the often confusing world of health insurance and its jargon from an overview of health care to a glossary of common terms available in English, French, Spanish, Chinese, Korean, and Arabic. Slide 28 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
29 Plan/Benefit Highlights Submitting a Medical Claim Providers will typically file claims on your behalf. You don t need a company claim form to file a claim. If you receive services from a provider who would like payment upfront, simply send (within 90 days of sickness or injury) all medical and hospital bills, along with the patient s name, address, social security number, or school ID number to this address. If you prefer to fax your claim, the number is Send claims to: UnitedHealthcare StudentResources PO Box Dallas, TX Slide 29 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
30 Plan/Benefit Highlights Submitting a Prescription Claim Visit and click on Helpful Resources and Forms. Under FORMS, Click on the Prescription Reimbursement Request Form. Keep all receipts and send with request form. Make note of the different claim address Send claims to: OptumRx Claims Department, P.O. Box 29044, Hot Springs AR 71903
31 Getting Started with UnitedHealthcare StudentResources Review United Healthcare Getting Started PDF Take time to review the information on including the Brochure Create an Online Account (through your secure My Account page) by going to Familiarize yourself with the benefits and discount programs Familiarize yourself with how to find health care providers (doctors), Medical & Mental Health Print out your insurance ID card immediately and carry it with you at ALL TIMES OR Download the UHCSR app to your iphone or Android phone Use your account to review benefits statements AND add to your SVA contacts to receive important s from United Healthcare Slide 31 of 36
32 Quiz Time How do you obtain your Insurance ID card? Can you see a doctor who is out of the network? Where can you find information on insurance benefits and/or creating an online account? Where can you find the UnitedHealthcare pdf s containing information on getting started with the student insurance? What are some ways you can locate a doctor? If you re feeling sick, what are some of the steps you should take? What type of services can SH&CS offer students? Slide 32 of 36
33 Quiz Time What is your co-pay cost? Do you need to contact SH&CS first before going to the doctor or hospital? How will you be able to receive your insurance statements and view the information concerning your account? When should you carry your Insurance ID Card? What account should you be checking for notifications from Student Health Services and United Healthcare? Slide 33 of 36
34 Questions? UnitedHealthcare StudentResources Phone: Student Health & Counseling Services Phone: Fall Hours: Monday Friday, 9:00AM 5:00PM Slide 34 of 36
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