University of Rochester


Questions

If you have questions about health insurance for families offered through the University Health Service, contact the UHS Insurance Advisor at insurance@uhs.rochester.edu.

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Last modified: Monday, 14-May-2012 15:51:24 EDT

University Health Service (UHS)

Guidelines for
Choosing Health Insurance

Students are financially responsible for the cost of services not covered by their health insurance. It is important to know what your insurance covers and does not cover. You do not want to be surprised to find out a charge you thought was covered is not covered. Familiarize yourself with your plan, noting any restrictions (e.g., prior referrals needed, limits on number of visits, deductibles, out-of-the-area coverage, co-payments, etc.). Keep information about your insurance plan for reference as long as you are on the plan. There may be times you need to call your insurance company for clarification about your coverage before receiving a service.

Deciding which insurance plan to choose can be a difficult decision. As you consider which insurance to purchase, look carefully at the plan's benefits and restrictions to be sure the plan provides adequate coverage. A plan that costs less may not be the best plan if the coverage is poor. Insurance plans with a lower cost usually have fewer benefits and more out-of-the-pocket expenses when you use the plan.

Before you waive the Aetna Student Health insurance:

Students who have insurance coverage that meets University criteria can waive the Aetna Student Health insurance plan if the insurance plan is with a U.S.-based company. Generally, insurance from international-based companies does not meet the University criteria. For this reason, a request to waive the University-sponsored insurance with an international-based insurance will be denied. Students can appeal this denial by submitting the Insurance Waiver Appeal Form if their plan meets all of the University criteria. For information about submitting an appeal, check "Health Insurance for Full-time Students."

When you complete the waiver process, you will be asked to verify that your insurance plan meets all of the University criteria. If you do not know if your plan meets the University criteria (listed below), you may need to call your insurance company to verify your plan meets the criteria. You will also be asked to provide information about your insurance company (e.g., address, phone number, contract number, etc.). This information can be found on your insurance card.

University Criteria for Insurance – For 2012-2013

To be eligible for waiver of the University-sponsored insurance, the student's insurance plan must be from a U.S. based company. International-based companies are not eligible for waiver. (See below.)

To be eligible for waiver:

  1. The plan must cover a minimum of $500,000 US in medical benefits due to illness, accident, or injury per plan year.
  2. The plan must have a deductible of no more than $5,000 US per covered person per plan year. (Note: Plans without a deductible meet this requirement.)
  3. The plan must cover prescription medications both in the hospital and out of the hospital to a minimum of $100,000 US per plan year.
  4. The plan must have no restrictions for coverage of any pre-existing health condition.
  5. The plan must cover biologically-based mental health conditions at the same level as other medical conditions.
  6. The plan must cover care related to pregnancy and delivery, including newborn care for the first 30 days of life.
  7. The plan must not exclude care for self-inflicted injury, intercollegiate athletics, and recreational activities.
  8. The plan must be in force for the duration of the academic year, or through the end of the month in which graduation occurs or the student's academic program ends.

If you are insured by an insurance plan outside of the Rochester area

Check your coverage for care received in the Rochester area. Some insurance plans provide only emergency coverage for out-of-area care and/or require a prior referral from the primary care physician at home. It is your responsibility to know about your health insurance plan and to contact your physician when appropriate.

When selecting health insurance, we suggest you consider the following:


If you have questions about health insurance, contact the UHS Insurance Advisor at insurance@uhs.rochester.edu