Required Student Health Insurance Program
Basic Information
The Student Senate at MSUM this past year adopted a policy that allows domestic students to have access to a very affordable insurance plan if you don't have access to other coverage or wish to supplement your existing coverage. (perhaps because your existing plan is an HMO from out of the area or if your plan has a high deductible). MSUM will be a pilot MnSCU institution in 2008-09 for this type of coverage; the only MnSCU institution to offer this benefit to students. The plan selected by the University, when compared to the existing plan, has better benefits and is more affordable than the plan previously offered to domestic students. The following information reflects a high level comparison of the previous domestic plan and the new 2008-09 domestic plan. The brochure and plan policy that has all of the exclusions and limitations will be provided to you shortly, unless you decide to waive this benefit. The exclusions are the same as the existing plan, which is available at www.uhcsr.com.
This plan is only available to those students that are enrolled for a minimum of 6 on-campus undergraduate credits. The cost of the plan for fall semester is $389 and will be charged to your tuition and fees statement unless you elect not to participate in the plan and complete the attached electronic waiver. If you elect not to participate in the plan, the next opportunity to participate will be when you register for the spring semester. If you do elect to participate, you will also have the option of enrolling your dependents directly with the company.
OPT OUT
Please review the information below carefully and make your election. If you wish to waive this benefit, please opt out no later than September 30, 2008. If you do decide to participate, do not complete the waiver. You are automatically billed and are covered by the plan. The cost of the insurance may be eligible for financial aid.
For additional assistance with this feel free to contact:
Karen Lester at 218-477-2177 or at lesterka@mnstate.edu
Carol Grimm at 218-477-2327 or at grimm@mnstate.edu
Both are located in Hendrix Health Center
Comparison of 2008 Voluntary Domestic Student Insurance Plan
vs. Proposed 2009 Waiver Domestic Student Insurance Plan
| 2007-08 Plan | 2008-09 Plan | ||||||
| Total Annual Premium Cost (12 months) | $1,152 | $975 |
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| Fall Semester Coverage 8/25/08-1/11/09 | $389 | ||||||
| Policy Maximum Benefit | $25,000 | $100,000 |
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| Deductible | $50 | $50 | |||||
| Coinsurance up to $2500 | 80% | 100% | |||||
| Coinsurance after $2500 | 80% | 80% | |||||
| Prescription Drugs | $500 Limit | $2000 Limit | |||||
| Day Surgery Miscellaneous (This is the facility charge in the case of an outpatient surgery) |
$1200 Limit | No Limit | |||||
| Outpatient Miscellaneous Includes: Physician visits Medical Emergency Diagnostic X-Ray and Lab Injections Tests and Procedures Chemotherapy and Radiation Therapy Physiotherapy |
$500 Limit | No Limit No Limit No Limit No Limit No Limit No Limit No Limit No Limit |
|||||
| Ambulance – Ground | $400 Limit | No Limit | |||||
| Consultant Physician Fees | $100 Limit | No Limit |
Deductible is $0 for office visits to the MSUM Hendrix Health Center
Note:The reference to “No Limit” refers to the plan not having a limit on the coverage of these services other than the Policy Maximum Benefit which is $100,000 per sickness or injury.
The above comparison only reflects specific benefits of the plan, and doesn't reflect all of the policy benefits, definitions, exclusions, and other limitations. Some services are available only at the Hendrix Health Center, and the plan does require a referral from the student health service in order to receive the maximum benefits under the plan. Please review your plan materials carefully when you receive them and advise the company immediately if you wish to cancel your enrollment. Any cancellations must occur within 30 days of enrolling in the plan.
I wish to Opt Out of Insurance
International Students
All international students and their accompanying dependents are required to carry Health Insurance through the MNSCU designated carrier, United Health Care.
For coverage and premium information contact the MSUM International Programs at 218-477-2956.
Tips for accessing and using health insurance:
Health insurance can be a complicated and confusing subject. Many health insurance plans are available with all sorts of varying coverage, exclusions, deductibles, co-pays, and so on. The following are generally accepted tips for accessing and utilizing any health insurance plan.
- Carry your insurance plan card(s) with you at all times. You may have more than one card for your medical plan, prescription plan, dental plan, and so forth.
- Carry some form of photo identification with you at all times.
- Review your health insurance benefits before you need them. By doing so, you will know what to expect at the time of need
- Review your health insurance plan limitations and exclusions before you need the coverage. Again, this will help you know what to expect at the time of need.
- Know your deductable amount.
- Know your co-pay amount
- Know your stop loss amount
- Check with your health insurance company to determine if it considers the University Health Center to be "In-Network" or "Out-of-Network" for reimbursement purposes
Health Insurance Plan Categories
Indemnity Plan
With an indemnity plan (sometimes called fee-for-service), you can use any medical provider (such as a doctor and hospital). You or they send the bill to the insurance company, which pays part of it. Usually, you have a deductible (such as $200) to pay each year before the insurer starts paying.
Once you meet the deductible, most indemnity plans pay a percentage of what they consider the "Usual and Customary" charge for covered services. The insurer generally pays 80% of the Usual and Customary costs and you pay the other 20%, which is known as co-insurance. If the provider charges more than the Usual and Customary rates, you will have to pay both the co-insurance and the difference.
The plan will pay for charges for medical tests and prescriptions as well as from doctors and hospitals. It may not pay for some preventive care, like checkups.
Preferred Provider Organization (PPO)
A PPO is a form of managed care closest to an indemnity plan. A PPO has arrangements with doctors, hospitals, and other providers of care who have agreed to accept lower fees from the insurer for their services. As a result, your cost sharing should be lower than if you go outside the network. In addition to the PPO doctors making referrals, plan members can refer themselves to other doctors, including ones outside the plan.
If you go to a doctor within the PPO network, you will pay a co-payment (a set amount you pay for certain services: say $20 for a doctor or $15 for a prescription). Your co-insurance will be based on lower charges for PPO members. If you choose to go outside the network, you will have to meet the deductible and pay co-insurance based on higher charges. In addition, you may have to pay the difference between what the provider charges and what the plan will pay.
Health Maintenance Organization (HMO)
HMO's are the oldest form of managed care plan. HMO's offer members a range of health benefits, including preventive care, for a set monthly fee. There are many kinds of HMO's, if doctors are employees of the health plan and you visit them at central medical offices or clinics, it's a staff or group model HMO. Other HMO's contract with physician groups or individual doctors who have private offices. These are called individual practice associations (IPA's) or networks.
HMO's will give you a list of doctors from which to choose a primary care doctor. This doctor coordinates your care, which means that generally you must contact him or her to be referred to a specialist. With some HMO's, you will pay nothing when you visit doctors. With other HMO's there may be a co-payment, like $5 or $10, for various services. If you belong to an HMO, the plan only covers the cost of charges for doctors in that HMO. If you go outside the HMO, you will pay the bill. This is not the case with point-of-service plans.
Medicare
Americans age 65 or older and people with certain disabilities can be covered under Medicare, a Federal health insurance program. In many parts of the country, people covered under Medicare now have a choice between managed care and indemnity plans. They also can switch their plans for any reason. However they must officially tell the plan or the local Social Security Office, and the change may not take effect for up to 30 days. Call your local Social Security office or the State office on aging to find out what is available in your area.
Medicaid
Medicaid covers some low-income people (especially children and pregnant women), and disabled people. Medicaid is a joint Federal-State health insurance program that is run by the States. In some cases, states require people covered under Medicaid to join managed care plans. Insurance plans and State regulations differ, so check with your state Medicaid office to learn more.
Source: The Agency for Healthcare Research and Quality (ARHQ), a unit of the United States Department of Health and Human Services. (www.ahrq.gov)
