1. An Introduction to Healthcare
& Insurance at
The University of Chicago
STUDENT HEALTH AND COUNSELING SERVICES
2. • Student Health Service (SHS)
860 E. 59th St. (at Drexel, Goldblatt Pavilion Entrance), R-100
(773) 702-4156
healthcare.uchicago.edu
• Student Counseling Service (SCS)
5555 S. Woodlawn Avenue
(773) 702-9800
counseling.uchicago.edu
• Health Promotion & Wellness (HPW)
Woodlawn Social Services Center, 950 E. 61st St., 3rd floor
(773) 702-8247
wellness.uchicago.edu
Accessing Healthcare at UC
3.
4. • All registered students* pay a quarterly Student Life
Fee
– Provides access to primary medical and mental health care at
Student Health Service and Student Counseling Service
• Health services covered by the Student Life Fee:
e.g., acute/chronic primary care, routine physicals, short-term
psychotherapy, academic/study skills counseling, etc.
• Private insurance / U-SHIP covers:
– Prescriptions, lab tests, hospitalizations, ER care, long-term
psychotherapy, consultation and treatment by specialists, etc.
*applies to students enrolled in insurance-eligible programs
Student Life Fee vs. Health Insurance
5. Primary medical and mental health care, wellness
programming:
• Covered by Student Life Fee & provided by SHS, SCS, HPW
Referrals provided to specialists / for tests
• If on U-SHIP, referral required from SHS/SCS; if referral is not
obtained in advance, $50 penalty is assessed
Is it an Emergency?
• If SHS closed, call 24-hour Nurse Advice Line – 773.702.1915 –
to determine if ER services are required (otherwise, claim
may be denied)
Where to Go for Services
6. Graham programs providing U-SHIP coverage:
• GSAL
• Returning Scholar
• UTEP
Graham programs exempt from U-SHIP (must opt-in for coverage)
• MLA
• Master of Science, Analytics
• Master of Science, Threat & Response Management
• Returning Scholar, Graham in GSB
• Masters in Biomedical Infomatics
Insurance Eligibility at The Graham School
7. • UC requires ALL students to have good health insurance
• All registered students* enrolled annually in University
Student Health Insurance Plan (U-SHIP)
• Deadline: by 4th Friday of one’s first registered quarter, each
year, students must either:
– Waive out of U-SHIP (comparable coverage required) or
– Enroll dependents
Autumn 2015 deadline – 5pm Central time, Friday, Oct. 23rd
• Students’ insurance selection applies for entire academic year
Confirm or waive U-SHIP enrollment at:
http://studentinsurance.uchicago.edu
*applies to students enrolled in insurance-eligible programs
University Annual Insurance Requirements
8. • Enrollment in U-SHIP is on an annual basis: plan year runs
from Sept. 1, 2015 – August 31, 2016
• U-SHIP coverage is tied to students’ registration status
• If a U-SHIP-enrolled student does not have an active
registration status in a specific quarter, their coverage is not
active that quarter
• Please note: coverage returns to active status in subsequent
quarter if student returns to UC registered status, in current
plan year
• Spring registration impacts summer enrollment status
U-SHIP Coverage & UC Enrollment
9. Insurance Terminology
• Premium – The amount of money – generally paid on a monthly,
quarterly or annual basis – that you pay to cover the cost of your health
insurance.
• Deductible – The amount you need to pay before your insurance plan
starts to cover your medical costs.
• Annual out-of-pocket maximum – The maximum amount of money you
are expected to pay annually for medical costs before your plan starts to
cover expenses at 100%.
• Co-insurance – A percentage of the cost of your treatment that you are
required to pay (i.e., 10%, 20%, or 30% typically), after your plan’s
deductible has been fully paid.
For additional help, see the “Health Insurance Glossary” at https://studenthealth.uchicago.edu/insurance
Navigating Health Insurance
10. • 2015-2016 Premium – $3,432 (billed in 3 installments of $1,144)
• Deductible – $500 (in-network); $1,000 (out-of-network)
• Annual out-of-pocket maximum –
$1,500 (in-network); $2,500 (out-of-network)
• Co-insurance – 10%; plan pays 90% after deductible has
been met
• Prescriptions paid by co-pay, 3 tiers ($10, $25, $40)
• $20 co-pay for doctor/specialist visits
• $10 co-pay for psychotherapy with SCS community providers
(SCS referral required)
Navigating Health Insurance: U-SHIP
11. • These costs are interconnected
• Consider how changes in one
impacts the others
• Consider YOUR individual health
needs in assessing plans
Understanding Health Insurance Costs
12. Here’s a comparison of U-SHIP and two alternate plans:
And here’s what it would look like if you faced a $5,000 medical bill:
Assessing Health Insurance: A Comparison
U-SHIP
Land of Lincoln PPO
Silver
ISO-Care ("ACA
Comparable")
Premium $3,432 $1,524 $2,148
Deductible $500 $1,500 $500
Annual Out-of-Pocket $1,500 $6,450 $6,350
Co-insurance 90% 70% 80%
U-SHIP
Land of Lincoln
PPO Silver
ISO-Care ("ACA
Comparable")
Total billed amount $5,000 $5,000 $5,000
Deductible owed $500 $1,500 $500
Co-insurance owed $450 $1,050 $900
Total amount due $950 $2,550 $1,400
% of O-O-P covered 63% 40% 22%
13. 2015-16 Comparable Coverage Requirements
To qualify to waive U-SHIP, all alternate insurance plans must provide the following:
Routine and emergency care provided in the Chicago area (or local area where student will be residing and studying for the academic
year)
Treatment for pre-existing conditions (with no waiting periods or exclusions)
Essential health benefits as defined by the Affordable Care Act (ACA):
Outpatient care (ambulatory patient services)
Emergency Services
Hospitalization (treatment for inpatient care)
Mental health services and addiction treatment
Prescription drugs
Maternity and newborn care
Rehabilitative services and devices
Laboratory services
Inpatient mental health care
Preventive services, wellness services, and chronic disease treatment
Pediatric services
Plan has a claims administrator based in the U.S., a U.S. telephone number and address for submission of claims, and the insurance policy
was issued in the U.S.
Coverage for medical evacuation and repatriation expenses:
Required for all F1 / J1 students
Required for all other students ONLY when they will be studying / traveling / doing research out of the United States during the
current academic year (otherwise exempt and can check “yes”)
Active coverage from the day student arrives on campus through either August 31, 2016 OR the end of their academic program
(whichever comes first)
14. Plans must have a U.S.-based claims administrator and be
issued in the U.S.
• Plans issued outside U.S. require students to pay up front for medical
costs
• Costs for medical care in U.S. can be very expensive prior to insurance
Adjustment to medical evacuation / repatriation
requirement
• Coverage required for all students in F1 / J1 status
• Coverage required for al other students only when they will be
studying / traveling out of U.S. during current academic year
Remember: a random subset of waiver applications will be
audited to ensure compliance with requirements!
Comparable Coverage Changes for 2015-2016
15. U-SHIP “My Account”
• Create or log into your account at www.uhcsr.com/uchicago
UnitedHealthcare Student Resources
On-campus Insurance Coordinators:
• Hours: Mon-Fri: 8:30am – 4:30pm
• Woodlawn Social Services Center,
950 E. 61st Street, rooms 368/370
• 773-834-4543 (press option #2) or
uchicagoadvocates@uhcsr.com
Home Office:
• Customer Service: 866-348-8472
• customerservice@uhcsr.com
U-SHIP Contact Information
16. U-SHIP MyAccount access information:
www.uhcsr.com/uchicago
Create or log into My Account to:
• Download an insurance I.D. card
• Check benefits status and policy details
• Check claims status and EOBs
• Locate network providers
• Access pharmacy benefit information
24/7 Access To U-SHIP “ MY ACCOUNT”
17. Benefit Highlights Cigna DHMO Delta PPO
UHC "Low
Plan"*
Cleanings (2 annually) 100% 100% 100% / 60%
Fillings Co-pay per procedure 80% 100% / 60%
Oral Surgery Co-pay per procedure 80% 0% / 0%
Maximum annual benefit None
$2,000 (12-mos plan);
$750 (6-mos plan) $500
*indicates in-network/out-of-network rates that plan pays
OPTIONAL DENTAL PLANS
For additional information on optional dental coverage, see:
https://studenthealth.uchicago.edu/2015-2016-dental
18. OPTIONAL VISION PLANS
For additional information on optional vision coverage, see:
https://studenthealth.uchicago.edu/2015-2016-vision
19. Health care access:
• SHS / SCS – covered by Student Life Fee
• Add’l testing, specialists, etc. – covered by insurance
Comparing alternate insurance plans:
• Consider impact of all costs: premium, deductible, out-of-pocket
max, co-insurance, co-pays
• Look at value when faced with actual medical expenses
• Must meet UC requirements for comparable coverage
• Consider how your course schedule impacts your health needs!
Summing Up – Health Care at UC
