Transcript Student Health Insurance

Quality health plans & benefits
Healthier living
Financial well-being
Intelligent solutions
Boston University
2016-17 Student Health Insurance Plan
Graduate School of Arts and Sciences
Fully insured student health insurance plans are underwritten by Aetna Life Insurance Company (Aetna) and administered by Aetna Life Insurance Company (ALIC). Self
insured plans are funded by the applicable school, with claims administration services provided by Aetna Life Insurance Company. Aetna Student HealthSM is the brand name
for products and services provided by Aetna Life Insurance Company and their applicable affiliated companies (Aetna).
2016-2017 Coverage Dates and Premiums
Boston University makes two plans available to students on the main campus.
The BASIC Plan provides benefits comparable to “Gold” plans offered through
the public Marketplace (e.g. Healthcare.gov). The PLUS plan provides a higher
level of benefits, comparable to “Platinum” plans offered through the public
Marketplace, at a higher premium than the BASIC Plan:
Program
Coverage Dates
Annual Premium
BASIC Plan
8/23/16 to 8/22/17
$2,014
PLUS Plan
8/23/16 to 8/22/17
$2,782
For premium rates and benefit description available to eligible dependents, please
visit www.aetnastudenthealth.com/bu.
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BASIC Plan benefits
Plan information
Policy Year Maximum
Policy Year Deductible
Preferred Care
Non-Preferred Care
Unlimited Medical & Prescription Drug
$150 per Covered Person
$500 per Covered Person
$5,500 per Covered Person
$5,500 per Covered Person
$40 Copay, then 100% of
Negotiated Charge
80% of Recognized Charge
100% of Negotiated Charge
80% of Recognized Charge
Emergency Room (Copay waived if admitted)
$150 Copay, then 80% of
Negotiated Charge
$150 Deductible, then 80% of
Recognized Charge
Inpatient Hospitalization
80% of Negotiated Charge
60% of Recognized Charge
$10 Generic Drug/
$40 Preferred-Brand Name Drug/
$60 Non-Preferred Brand Name
Drug
80% of Recognized Charge
Out-of-Pocket Maximum
Physician Office Visits
Preventive Care
Prescription Drug
The Plan will pay benefits in accordance with any applicable Massachusetts insurance law. The Boston University plan may not cover all your health care expenses. The plan
excludes coverage for certain services and contains limitations on the amounts it will pay. Please read the Boston University Plan Design and Benefits Summary carefully
before deciding whether this plan is right for you. While this document and the Boston University Plan Design and Benefits Summary tell you about some of the important
features of the plan, other features may be important to you and some further limit what the plan will pay. If you want to look at the full plan description, which is contained
in the Master Policy issued to Boston University, you may contact us at (800) 966-7772. Additional plan maximums may also apply. Some illnesses may cost more to treat
and health care providers may bill you for what the plan does not cover.
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PLUS Plan benefits
Plan information
Policy Year Maximum
Policy Year Deductible
Preferred Care
Non-Preferred Care
Unlimited Medical & Prescription Drug
None
$250 per Covered Person
$3,000 per Covered Person
$3,000 per Covered Person
$25 Copay, then 100% of
Negotiated Charge
80% of Recognized Charge
Preventive Care
100% of Negotiated Charge
80% of Recognized Charge
Emergency Room (Copay waived if admitted)
$100 Copay, then 100% of
Negotiated Charge
$100 Deductible, then 100% of
Recognized Charge
Inpatient Hospitalization
$250 Copay, then 100% of
Negotiated Charge
80% of Recognized Charge
$10 Generic Drug/
$35 Preferred-Brand Name Drug/
$50 Non-Preferred Brand Name
Drug
80% of Recognized Charge
Out-of-Pocket Maximum
Physician Office Visits
Prescription Drug
The Plan will pay benefits in accordance with any applicable Massachusetts insurance law. The Boston University plan may not cover all your health care expenses. The plan
excludes coverage for certain services and contains limitations on the amounts it will pay. Please read the Boston University Plan Design and Benefits Summary carefully
before deciding whether this plan is right for you. While this document and the Boston University Plan Design and Benefits Summary tell you about some of the important
features of the plan, other features may be important to you and some further limit what the plan will pay. If you want to look at the full plan description, which is contained
in the Master Policy issued to Boston University, you may contact us at (800) 966-7772. Additional plan maximums may also apply. Some illnesses may cost more to treat
and health care providers may bill you for what the plan does not cover.
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Student Connection www.aetnastudenthealth.com/bu
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Aetna Mobile - available from App Store and Play Store
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Aetna Student Health network
A national network
of more than
1.1 million providers* including:
More than
664,000 primary care
doctors and specialists*
More than
5,500 hospitals*
Access to the Aetna Preferred Provider
Network.
Aetna Student Health has arranged for you to access a
Preferred Provider Network in your local community. Acute
care facilities and mental health networks are available
nationally if you require hospitalization outside the
immediate area of the Boston University campus.
To maximize your savings and reduce your out-of-pocket
expenses, select a Preferred Provider. It is to your
advantage to use a Preferred Provider because savings may
be achieved from the Negotiated Charges these providers
have agreed to accept as payment for their services.
To learn more about Preferred Providers, visit www.aetnastudenthealth.com
Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee
access to health services.
*http://www.aetna.com/about-aetna-insurance/aetna-corporate-profile/facts.html. As of September 30, 2014.
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Travel assistance services
Access to travel assistance services including emergency
assistance – available 24/7.
• 24/7 emergency travel arrangements
• Translation assistance
• Emergency travel funds and lost travel
documents assistance
• Natural Disaster & Political Evacuation
Services up to $100,000
in the event of either natural disaster
making current location uninhabitable
or governmental/social upheaval,
placing student in imminent bodily harm
• Unlimited emergency medical
evacuation and medical
repatriation
• Medical/dental/pharmacy referral
• Hospital deposit arrangements
• Prescription drug replacement
assistance
• Dispatch of physician
• Pre-trip plans
For more information visit www.aetnastudenthealth.com/bu
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Value added programs
Aetna VisionSM discount program
Informed Health® Line
Aetna Natural Products and ServicesSM
discount program
Aetna Weight Management discount program
Aetna FitnessSM discount program
Oral Health Care discount program
Boston University
These are not underwritten by Aetna and
are NOT insurance. The member is
responsible for the full cost of the
discounted services. Please note that these
programs are subject to change without
notice. To learn more about these additional
services and search for providers visit,
www.aetnastudenthealth.com.
Discount programs provide access to
discounted prices and are NOT insured
benefits. The member is responsible for the
full cost of the discounted services. Discount
programs may be offered by vendors who
are independent contractors and not
employees or agents of Aetna or their
affiliates. Aetna may receive a percentage
of the fee you pay to the discount vendor.
These services, programs or benefits
are offered by vendors who are independent
contractors and not employees or
agents of Chickering Claims Administrators,
Inc., Aetna Life Insurance Company or
their affiliates
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Vital Savings by Aetna® on Dental*
An optional dental discount program
helping you and your dependents save.
• One low annual fee of $25 per student
• In most instances, savings range from 15-50
percent on services from general dentistry
and cleanings to root canals, crowns, and
orthodontia (braces)
• No claims to file
• Price: $25 Student only
$44 Student +1 Dependent
$63 Student +2or more Dependents
*Actual costs and savings vary by provider and geographic area.
Enroll online at www.aetnastudenthealth.com/bu
Boston University
The Vital Savings by Aetna® program
(the “Program”) is not insurance. The
Program does not meet the Minimum
Creditable Coverage requirements in
Massachusetts. It provides Members
with access to discounted fees
according to schedules negotiated by
Aetna Life Insurance Company for the
Vital Savings by Aetna discount
program. The range of discounts
provided under the Program will vary
depending on the type of provider and
type of service received. The Program
does not make payments directly to the
participating providers. Each Member
must pay for all services or products
but will receive a discount from the
providers who have contracted with the
Discount Medical Plan Organization to
participate in the Program. Aetna Life
Insurance Company, 151 Farmington
Avenue, Hartford, CT 06156, 1-888BeVital, is the Discount Medical
Plan Organization.
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Contacts for assistance
We offer helpful tools and resources.
Aetna Student Health
Customer Service: (800) 966-7772
Aetna Pharmacy Management: (888) 792-3862
www.aetnastudenthealth.com/bu
For assistance with waivers and enrollment:
Boston University Student Accounting Services
phone: (617) 353-2264
email: [email protected]
www.bu.edu/studentlink
Client name
Boston
University
here, change on master page
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Thank you
This material is for information only and is not an offer or invitation to
contract. Health insurance plans contain exclusions, limitations and benefit
maximums. Health information programs provide general health
information and are not a substitute for diagnosis or treatment by a
physician or other health care professional. Information is believed to be
accurate as of the production date; however, it is subject to change.
©2014
Aetna
Inc.
Boston
University
15.25.118.1 (12/14)
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