About the Plan
Eastern Illinois University requires that all students who enroll in nine or more on-campus hours, all graduate assistants under contract to the University, and all international students enrolled in three or more on-campus hours, be covered by health insurance and provides a Plan of medical coverage for injury and illness for which the fee is automatically assessed along with tuition and fees. Students enrolled part-time with 6, 7 or 8 on-campus hours may apply to purchase coverage.
The Plan coordinates with the student's primary carrier and provides the student worldwide protection, 24 hours a day. Student Health Insurance is an economical way to reduce or eliminate out-of pocket expenses when family health plans do not cover 100% of medical costs because of deductibles, co-payment amounts, limitations on specific benefits, and out-of network penalties.
The plan has a $50 deductible per diagnosis, per Plan year and pays up to 80% of eligible expenses for physician and hospital expenses, lab and x-ray, surgery, ambulance transport, physical therapy, maternity expenses, mental health and substance abuse issues.
In the event of a non-emergency injury or illness, the Covered Student should report to the Health Service for proper medical treatment or referral. If away from the University, consult a Physician. Emergency Room visits to Sarah Bush Lincoln Health Center for non-emergency treatment available from the Health Service will not be considered without a referral from a physician.
The Plan is secondary if the student is entitled to benefits by any other policy.
Students should familiarize themselves with the proper procedures to utilize the benefits available.
Coverage for each Term is based on enrolled hours as of Count Day as per the University Academic Calendar.
| Term | Cost | Coverage Period | Count Day |
|---|---|---|---|
| Fall | $109.95 | 8/15/2012 - 1/01/2013 | 8/31/2012 |
| Spring | $109.95 | 1/02/2013 - 6/09/2013 | 1/18/2013 |
| Summer | $87.45 | 6/10/2013 - 8/13/2013 | 6/17/2013 |
Lifetime Maximum for any one bodily injury or illness - $25,000
Combined Lifetime Maximum for Mental illness and Substance Abuse - $5,000
A $50 deductible will be taken per injury or illness per Plan (academic) year. All related conditions and recurrent symptoms, or injuries as a result of the same accident, will be considered one illness or one injury.
| Schedule of Benefits* | |
|---|---|
| Hospital Outpatient/Inpatient | 80% |
| Lab and X-Ray | 80% |
| Anesthesia | 80% |
| Surgery | 80% Usual and Customary |
| Physician Inpatient | 80% up to $100 (1st day), 80% up to $50 (thereafter) |
| Physician Outpatient | 80% |
| Ambulance | 80% up to $300 |
| Dental | $100 per injured tooth |
| Maternity | 80% |
| Mental Health and/or Substance Abuse | 80% |
*All benefits are subject to all Plan Limitations and Exclusions.
What you need to know...
The family health plan may only cover the student while in the home area, or may reduce benefits when the student is treated away from home. When this happens, the student might be covered for medical emergencies only. This could leave the family with a large amount of out-of-pocket expense for non-emergency or non-covered treatment. The student may even forego treatment rather than travel to a covered provider. Student Health Insurance follows the student worldwide.
The Student Health Insurance Plan can complement the family health plan. It may be beneficial to carry both, particularly if the family plan has a high deductible. Student Health Insurance has a $50.00 deductible per diagnosis, per academic year.
College years are usually physically health ones, but they are also a time of major developmental and social transitions during which physical and mental health problems have the potential to interfere with students' lives and ambitions. Student Health Insurance provides the additional coverage when needed.
The cost of Student Health Insurance is very reasonable compared to health care costs in general.
Students enrolled in a combination of Continuing Education courses and on-campus courses that total 6, 7, or 8 hours, with a minimum of 3 on-campus hours, are eligible to purchase coverage as part time students.
Students enrolled only in Continuing Education courses are not eligible for coverage.
Dependent coverage is not available.
How to Submit a Claim
Contact the Student Health Insurance Office for verification of coverage.
Complete the Student Health Insurance Claim Form (pdf) and submit it to our office. If the form is not completed, the claim will be denied.
It is the Covered Student's responsibility to provide primary and secondary (if applicable) insurance information to all medical providers.
If the Covered Student is entitled to benefits under any other insurance policy, that policy is primary. An Explanation of Benefits (EOB) documenting payment/denial from the primary carrier is required before benefits are payable by the Plan.
The completed claim form and all required documentation, and any additional information requested by the Student Health Insurance Office must be received within 52 weeks from the date of the first medical expense.
This is only a summary of Plan benefits. Consult a Medical Insurance Specialist in the Student Health Insurance Office to request a brochure or for complete detailed information regarding eligibility and enrollment, benefits, limitations or exclusions.
