SUNY Mandatory Health and Accident Insurance for International Students and Scholars 2007-2008 Information
WHY MANDATORY INSURANCE?
In 1985, the SUNY Board of Trustees passed a resolution mandating that all individuals participating in SUNY programs of international exchange possess health and accident insurance through a policy contracted by the University. This was to protect international students from the exceptionally high cost of medical care in the United States, and to fulfill U.S. federal government regulatory requirements. The insurance program commenced with the fall 1986 semester.
IF I HAVE OTHER HEALTH AND ACCIDENT INSURANCE WILL THE SUNY HEALTH AND ACCIDENT INSURANCE BE WAIVED?
Waivers can be given only if your current insurance is comparable to the SUNY policy. This means that your insurance must, at minimum, cover pre‑existing conditions, maternity, repatriation, and medical evacuation, as well as carry a $0 deductible per illness/accident/injury and a $100,000.00 maximum reimbursement rate per illness. Very few policies fulfill these requirements. Health insurance policies that are NOT comparable are policies offered by LASPAU, AAI, AmidEast, the Chinese (People's Republic) government, U.N. Blue Cross/Blue Shield, and IIE (including Fulbright). If you think you are eligible for a waiver, you must present a copy of your policy, in English, and proof of current dates of coverage to Diane Sliwinski, Special Programs Coordinator at the Office of International Student and Scholar Services.
HOW MUCH DOES THE SUNY POLICY COST?
The annual fee for the SUNY health insurance policy is $951.00 for the 2007-2008 academic year. The annual cost is made through two semester tuition payments: $396.25 for the fall semester (August 15, 2007 to January 14, 2008) and $554.75 for the spring semester and summer (January 15, 2008 to August 14, 2008). The payment is made, along with your tuition and other fees, to the Student Accounts Office at Binghamton University.
IS COVERAGE ALSO AVAILABLE FOR MY SPOUSE AND/OR CHILDREN?
Yes. Students in J-1 status should note that the US government REQUIRES that J-1 sponsored dependents have insurance. Printed material describing the health insurance policy benefits, the cost and enrollment information for dependent health insurance coverage is available from Diane Sliwinski at the Office of International Student and Scholar Services.
WHO CAN I TALK TO IF I HAVE ANY QUESTIONS REGARDING MY INSURANCE, OR IF I NEED CLAIMS ASSISTANCE?
Any questions, concerns or problems regarding insurance should be directed to Ms. Diane Sliwinski at the Office of International Student and Scholar Services. You may also contact HTH Worldwide Insurance Services, Inc. in Tampa, FL for questions about coverage and claims. The toll free number is (888) 350-2002.
IS THERE A DEDUCTIBLE WHICH I MUST PAY BEFORE THE INSURANCE COMPANY WILL PAY MY MEDICAL BILLS?
There is no deductible for health care as long as you visit University Health Service first. However, you will pay a deductible of $100.00 per illness/accident/injury if you fail to use University Health Service first when their services are available. The $100.00 deductible is waived if University Health Services is closed when you need emergency medical care.
The health insurance policy covers 100% of the first $4,000.00 of allowable expenses for one “event” (accident/illness/injury), 80% of expenses from $4,000.01 to $7,000.00, and back to 100% of your expenses from $7,000.01 to the limit of $100,000 per illness/accident/injury. The majority of student bills are below the $2,000.00 level.
WHAT IF THE HEALTH SERVICE IS CLOSED?
If your situation is such that you cannot wait until University Health Services re‑opens (e.g., acute illness, severe injury, extreme pain), you have the option of going to a doctor, a “walk-in clinic” or an Emergency Room* in the community. When you file a claim with the insurance company for payment of your care, you are responsible for obtaining a stamped claim form (called a Health Center Authorization & Referral Form) from the University Health Service so that you will not be charged the $100.00 deductible. The stamped claim form verifies that you sought medical care when University Health Service was closed.
*Please note: Emergency Room services are very expensive. You should allow a minimum of as least 2 hours to be seen and treated. For non-emergencies, we recommend that you use one of the numerous “walk-in” clinics in the area that offer comparable, faster and not as cost prohibitive care.
WHAT IF THE HEALTH SERVICE IS OPEN, BUT I WOULD PREFER TO BE SEEN BY A DOCTOR IN THE COMMUNITY?
Go to the University Health Service first anyway for an evaluation, so that they can stamp your claim form so that your doctor visit will be considered to be a referral. With a referral from University Health Services to an off‑campus health provider, you will not have to pay the $100.00 deductible.
WHY SHOULD I VISIT THE UNIVERSITY HEALTH SERVICE FIRST?
By visiting the University Health Service first, you will not be required to pay the $100.00 deductible per “event” (illness/accident/injury). All basic services offered by University Health Services, including office visits, medication, and common medical supplies, are pre‑paid by the separate Health Fee that is included in the tuition bill that you pay at the beginning of each semester. Using University Health Services offers you the convenience of receiving health care and medications right here on campus, rather than having to go off campus to a doctor or pharmacy. Also, you will not need to submit claim forms or wait for reimbursement of your medication expenses when you use University Health Services.
AM I STILL COVERED BY THE INSURANCE EVEN WHEN I TRAVEL?
Yes, you are covered everywhere in the world except in your country of citizenship.
WHAT IS THE PROCEDURE FOR FILING A CLAIM?
If you are referred off-campus for health care, obtain a health insurance claim form (Health Center Authorization & Referral Form) at University Health Service and ask that they stamp it for you. Without the University Health Service stamp on your claim form you will have to pay a $100 deductible. (This step applies to students only. Dependents, non-student and children, are not eligible to use the University Health Service.)
Directions for completing the claim form are on the back of the claim form. Answer all questions that apply to your situation and be sure to sign your name and date at the bottom of the page. For your personal records, make copies of your completed claim form, medical bills and receipts for payments already made by you. If you receive additional bills or receipts for the same illness/accident/injury (“event”), do not send additional claim forms for the same “event”. Send only one claim form per illness/accident/injury. Remember to keep copies of what you send to the insurance company. Mail claim form, bills and receipts to HTH Worldwide, P.O. Box 30259, Tampa FL 33630. Their telephone number is 1-888-350-2002.
The insurance company will make payments directly to the health care provider, NOT to you, UNLESS you include a paid receipt that indicates that you already paid the bill. Allow three to four weeks for processing of claims.
HOW DO I KNOW WHAT HEALTH CARE PROVIDERS TO USE IF I AM REFERRED OFF CAMPUS?
If you are referred off-campus for health care, be sure to use a provider who participates in the Aetna US Network System. Aetna is a private company that negotiates reduced health care rates between hospitals, physicians, health care providers and numerous health insurance companies around the world to offer patients more affordable health care. University Health Services will give you names of off-campus providers, but you do not have to use them those providers because they may not be participating Aetna providers.
To use a “preferred or participating provider” off-campus, go to Aetna’s website (http://www.aetna.com) and on the rights side of the screen under “shortcuts” click on “Find a Doctor.” On next screen, Click on “Go to DocFind” and choose “standard search.” By using a “preferred or participating provider”, you will avoid having to pay the deductible or any cost difference between what a “non-participating provider” charges (e.g., $200.00) and what the insurance company contracts to pay a “participating provider” (e.g. $150.00).
SINCE THIS INSURANCE POLICY DOES NOT COVER DENTAL CARE, WHERE CAN I GO FOR INEXPENSIVE DENTAL TREATMENT?
Broome Community College, on upper Front Street in Binghamton, operates a Dental Hygiene Clinic through their Dental Hygiene Program that is open to the public, by appointment, during the academic year. The hygienists at the clinic are students who are supervised by a dentist and professional hygienists. Services offered include fluoride treatments, plaque control, X‑rays, teeth cleaning, and pit and fissure sealants. Please call 778-5015 for information and/or an appointment. Please note: The clinic cannot diagnose a dental condition, only a dentist can do that.