Eligible Emergency Room visits defined as Medical Emergency apply towards deductible then covered at 80% for in network and 80% or Reasonable and Customary out-of-network if admitted inpatient.
Medical Emergency means the occurrence of a sudden, serious and unexpected Sickness or Injury. In the absence for immediate medical attention, a reasonable person could believe the condition would result in:
- Placement of the Insured's health in jeopardy;
- Serious impairment of bodily functions;
- Serious dysfunction of any body organ or part; or
- In the case of a pregnant woman, serious jeopardy to the health of the fetus.
Information below is for the 15-16 plan year.
This is current list of some of the Urgent Care Facilities in network as of 8/14/15 please confirm with the facility if they are still in network urgent.pdf. If you do not fall under the defination for medical emergency it is best to try to locate an urgent care facility for care if possible.
Insured Students have access Care Management, designed to help manage the care of patients who have a catastrophic or extended care Accident or Sickness. Please contact 1-855-639-8679.
The master policy on file at the university contains all the provisions, limitations, exclusions, and qualifications of the plans, which may not be included on the web pages. The master policy is the contract and will govern and control the payment of benefits.
The information on this website is intended to provide guidance to the benefits of the insurance and how to utilize its services. It in no way constitutes a guarantee of payment for claims submitted to the insurance company.