Undergrad & Grad Insurance FAQ's
Find answers below to your most frequently asked questions...
Eligibility
Costs
Medical Services
Prescription Medications
Covered Benefits
Waiving the Insurance
Renewing the Insurance
Claims Procedure
Referral to Specialists
Women's Health Services
For general health information and disease-specific information, please visit
Health
Related Links
What period of time does the Student Insurance Plan cover ?
The policy period is from August 15, 2008 through August 14, 2009.
How do I know if I will be enrolled in the Student Insurance Plan ?
All full-time, matriculated undergraduate students enrolled for 12 credits or more and all graduate students enrolled for 9 credits or more, will automatically be enrolled in the Student Insurance Plan and billed unless the student electronically submits a waiver form with information about other current health insurance coverage. An electronic waiver form must be filed for each academic year an exemption is requested. Click here for the waiver form.
I am graduating in one semester or leaving school--can I get a policy for one semester?
If you are not enrolled for the next semester or leave by September 12, 2007 in the Fall semester or January 15, 2008 in the Spring semester, your insurance coverage will terminate, and you will not be billed. Students who leave mid-semester (e.g., sudden medical leave of absence) have already been billed and will have the policy in effect until the end of the policy period.
I have been a full-time student, but this last semester I am taking fewer credits in my degree program. Can I enroll in the Student Insurance Plan?
Yes, you may enroll in the Student Insurance Plan if you are
registered for a part-time load and this is your last semester in your degree
program. However, you must complete the "Request for
Student Health Insurance"
form
and return the form and payment for the
premium to Enrollment Services. They will review your status in the degree
program and contact you with any questions about the request. If approved,
Enrollment Services will manually change your bill to add the charge for the
insurance for the semester. There is no pro-ration of the premium if you elect
coverage in mid-semester.
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What does the insurance cost and how do I pay ?
The South Orange Campus policy is $618 per calendar year. The bill for the Student Insurance Plan is included in your usual bill from Student Accounts. Half the annual cost [$309] is billed in the Fall semester; the second half [$309] is billed in the Spring semester.
Can my financial aid package be changed to cover the cost of the Student Insurance ?
You may meet with an Enrollment Services staff member to
re-package your financial aid to cover this year's insurance cost. In most
cases, this will mean extending a loan to include the cost of the insurance.
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What types of medical services are covered by the Student Insurance ?
There is limited coverage according to a schedule of benefits for the following services: inpatient care, outpatient care, laboratory tests and X-rays, prescriptions, emergency dental care for accidental injuries, physiotherapy, mental health services; immunizations are not covered (Health Services offers immunizations at moderate costs).
Do I have to be seen in Health Services before using off-campus medical providers or emergency services ?
Student health insurance coverage begins from the first visit to an off-campus health care provider if you have an urgent health situation and cannot reasonably come to Health Services. If you choose to contact an off-campus health provider instead of coming to Health Services first, and your health situation is not urgent or an emergency, the insurance coverage will begin at the second visit.
What if I need medical care when Health Services is closed ?
Depending on the severity of your medical need, please do the following:
1. Call 911 if you need immediate assistance for an
emergency
2. Go to a local medical walk-in clinic (See
After Hours Care)
3. If unable to get services at a walk-in clinic, go to the nearest
hospital for an urgent problem.
4. For a minor problem, Self
Care Guide for helpful self-treatment.
5. Consider contacting a private health care provider. See
Devonhealth for
list of providers or cal 1-800-431-2273.
What free medical services are available through Health
Services?
Health & Counseling Services provide free, strictly
confidential primary medical care and psychological assessment and
counseling. For details about services, staffing and hours, please click
here.
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Does the insurance pay for prescription medications?
Your insurance plan offers up to a $500 benefit for the policy period for prescription medications. When you get a prescription filled at a pharmacy, you must pay for the medication and then submit a "Claim Form," with a copy of your bill to the Insurance company to receive reimbursement. [See "Claims Procedure," below]. Your plan includes a "prescription drug discount card," which may reduce your out-of-pocket costs for prescriptions that are filled at a participating Scrip Pharmacy Solutions Pharmacy.
Where do I find the prescription discount card and where can I find participating pharmacies?
The prescription benefit ID card is found on the last page of your Insurance brochure. Cut it out and carry it with you and present it when you fill a prescription from a participating pharmacy in order to receive your discount. Participating pharmacies include: Wal-Mart, Walgreens, Phar-Mor, Target, Safeway, Winn-Dixie, Drug Emporium, K-Mart, Rite-Aid, Kroger, Publix, Sam's Club, Giant Foods, and Eckerds.
Where can I call with questions about the pharmacy benefit?
Information about additional network pharmacy locations may be found by calling Scrip Pharmacy Solutions Pharmacy Helpline toll-free at 1-888,299,5383. Pharmacists are on call, in case of emergency, 24/7.
How do I know if the treatment I am receiving is a covered benefit?
For questions about coverage, read the insurance brochure that is mailed to you or download the brochure. If you still have questions, call the broker, T.L. Groseclose (866/769-3084).
Can I enroll my spouse and dependent children in the Student Health Insurance Plan ?
Yes, for an additional fee, you can enroll dependents for coverage in the insurance
plan, as long as you [the student] are enrolled in the insurance plan.
Please click
here
for the
Dependent Enrollment Form.
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I have other health insurance---how do I waive out of the Student Insurance Plan ?
You must electronically submit a waiver form to have the cost of the Student Insurance Plan deducted from your Student Accounts bill. Waivers may only be submitted on-line and must be received by no later than the end of the add/drop period for the Fall semester [September 10, 2008] and no later than the end of the add/drop period for the Spring semester [January 19, 2009]. Click here to electronically submit your waiver form.
Once I electronically submit a waiver form, am I automatically waived from the Student Insurance Plan as long as I'm enrolled at Seton Hall ?
No. You must electronically submit a waiver form for each academic year for which you are requesting an exemption. Eligibility status for other insurance plans can change as personal circumstances change (e.g., employment, age), so the University needs up-to-date information on your other insurance coverage.
I waived out of the Student Insurance Plan, but now I want the Student insurance coverage--what do I do ?
You may add the student insurance coverage midyear. However,
you must complete the "Request for Student Health Insurance"
form and return the form and payment for the premium to Enrollment
Services. They will review your status in the degree program and contact
you with any questions about the request. If approved, Enrollment Services
will manually change your bill to add the charge for the insurance for the
semester. There is no pro-ration of the premium if you elect coverage in
mid-semester.
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How do I renew my coverage ?
Your insurance coverage will automatically be renewed and billed
when you enroll for the next semester unless you electronically submit
a waiver form with Enrollment Services. When you graduate, your
coverage will terminate after August 14th.
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What is the claims procedure? Whom do I speak with about claims issues? Where do I get claim forms ?
To file a claim, complete a claim form, attach the
medical bills, and mail it to the address at the top of the form. Be sure
to include your current local address; otherwise, correspondence from the
insurance company will be sent to your permanent home address. Questions
regarding filed claims should be directed to T.L. Groseclose
(866/769-3084). Claim forms are available at Health Services, T.L. Groseclose, or you can download a
claim form
here.
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How do I get referred to a specialist ?
Call Health Services (973/761-9175) to verify that an outside referral is needed. It may be necessary to have an appointment at Health Services for confirmation. If Health Services determines it is not necessary for you to come in, a notation about the referral will be made in your confidential health record, and insurance coverage begins from the first visit. Claim forms are available in Health Services or you may download there here.
Do I have to pay the off-campus doctor or specialist at the time of the office visit ?
Most health care providers will request payment at the time of
the visit. Confirm this with their office prior to your appointment.
You should obtain a receipt of services provided, attach it to a completed
insurance claim form and send them to T.L. Groseclose (address is on the claim
form).
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Does Health Services provide birth control prescriptions ?
Health Services provides medical care consistent with Seton Hall's Catholic Mission. Women's health care is provided, including gynecological exams, Pap smears, STD/HIV and pregnancy testing and counseling. Prescriptions for birth control or the "morning after pill," are not available. Any student who reports having been raped is referred to a local Rape Crisis Center for assessment and medical treatment.
Are maternity services covered ?
Yes, maternity service benefits are provided for expenses
incurred as a result of pregnancy and childbirth. The benefit amount for
expenses for pregnancy and childbirth will be provided to the same extent as the
hospitalization benefit is provided in the policy for any other sickness.
Conception must occur on or after the insured person's effective date of
coverage under the plan.
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