Mandatory Health Insurance

Overview | Why the Requirement | Quality, Cost & Coverage | International Students | Enrollment | Dates of Coverage | Student Health Services | Optional Coverage |
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Quality, Cost & Coverage

The quality and cost of the Emory/Aetna Student Health Insurance Plan and Scope of Coverage

• Is the Emory student insurance plan any good?
  
  
• What are the annual premium rates of the 2007-08 Emory/Aetna plan?
  
  
• Why is this student insurance plan so expensive? My spouse/partner pays a lot less for his/her health insurance.
  
  
• Aren’t there cheaper insurance policies available that meet the minimum waiver criteria?
  
  
• 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?
  
  
• When I leave Emory, will I automatically lose my insurance coverage?
  
  
• I will be going abroad in the Spring Semester.  Will the Emory plan give me coverage while I am away from the United States?
  
  
• Are there reasons that I might not want to enroll in the Emory student plan?
  
  

Is the Emory student insurance plan any good?
There was a time several years ago when many students were dissatisfied with the coverage under the Emory-sponsored student health insurance plan.  However, significant improvements have been made in the plan over the past five years.  We now feel strongly that our student health insurance plan is among the best student plans in the nation.  The 2007-08 Emory/Aetna plan will feature the following:

• A national preferred provider network of over 610,000 providers and over 3,700 hospitals, which includes all Emory outpatient and hospital facilities.  
• Students do not have to personally complete and submit claim forms for care received.  The provider submits bills directly to Aetna. 
• There are no pre-existing condition exclusions under the Emory/Aetna student plan and no waiting period for coverage to begin. 
• The plan covers 100% of covered medical expenses at Emory Student Health Services, including the on-site EUSHS Dermatology and Gynecology/ Colposcopy clinics (after specialist $25 co-payment), immunizations, TB skin tests and Travel Clinic. 
• The plan covers 80% of negotiated charges outside Emory University Student Health Services (EUSHS) and within the Aetna network (which, once again, includes all Emory facilities).  There is a $100 total annual deductible in-network and a $25 co-pay for physician visits outside EUSHS.  Outside the Aetna network, coverage is 60% with a $200 annual deductible.
• All non-emergency specialist care must first have a written referral from the Student Health Service, unless you are more than 50 miles away from Emory or the EUSHS is closed. 
• The plan offers outpatient prescription pharmacy coverage up to $1,500 (after co-pays) and $500 of coverage at EUSHS (which includes oral contraceptives).
• Mental health outpatient and inpatient coverage has no cap on coverage, including treatment for alcohol and substance abuse.
• Coverage is also available for student’s spouse, qualified domestic partner and children.

We strongly encourage you to read the plan brochure before you draw conclusions about the quality of coverage.

What are the 2007-08 premium rates of the Emory/Aetna plan?”
The premium rates for Spring-Summer coverage for students under the 2007-08 plan are:

For Domestic students, from January 8 to August 14, 2008:

• Student $ 1,137
• Spouse/domestic partner $ 2,707
• Child(ren) $ 1,126

For International students, from January 8 to July 31, 2008:

• Student $ 1,065
• Spouse/domestic partner $ 2,536
• Child(ren) $ 1,043

This comes out to approximately $158 per month for students.

 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 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.  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 mandatory health insurance requirement with a “hard waiver.”  Under this proposal, 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 the November 27th for Spring Semester 2008, 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 Spring Semester classes (January 16, 2008) 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. If you graduate at the end of Spring Semester, you will continue to be covered for the duration of your policy (you will graduate in May and your policy is good through August). In fact, 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, 6, or 9 months. That should give you time to get settled at your new job, school or the like. Arrangements for continuation coverage must be made while your current policy is still in effect. Please be aware that the continuation plan is significantly more expensive than coverage for enrolled students, which is true of all COBRA-type coverage.

Effective 2007-08, 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. Once again, 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, 6, or 9 months. Arrangements for continuation coverage must be made while your current policy is still in effect. Please be aware that the continuation plan is significantly more expensive than coverage for enrolled students, which is true of all COBRA-type coverage.

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.

Are there reasons that I might not want to enroll in the Emory student plan?

Yes, possibly. The Emory student plan is designed to meet the insurance needs of the vast majority of Emory students while keeping premium costs in mind (since cost is a big issue for many/most students). As a result, there are at least two features of the plan of which students should be aware:

• The Pharmacy Cap: The plan offers outpatient prescription pharmacy coverage up to $1,500 (after co-pays) and $500 of coverage at EUSHS (which includes oral contraceptives). If you have a condition that will require prescription medications that far exceed this cap, you may want to consider another insurance plan.
• The $250,000 Lifetime Aggregate Maximum: Although the plan has no pre-existing condition exclusion (which is great), it features a $250,000 aggregate lifetime maximum for each covered illness or injury. It also only provides coverage while you are a student at Emory. If you have a severe pre-existing illness (cancer, a complex cardiac condition, etc.) and your physician feels that your expenses for that condition could exceed $250,000 during the time you are a student at Emory, you should consider another insurance plan.