Aetna Student Health can always be used without a referral anywhere in the United States if you are within 56 miles of UMBC, and during the remote instruction period, the need for a referral from RIH has been waived. Please remember to use in-network providers to avoid additional charges.
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Once enrolling in the plan the basic benefits are as follows:
- The insurance policy term runs from August to August each year.
- The policy has a deductible of $350 in-network and a $550 deductible out of network.
- The insurance plan pays at 80% with a co-insurance of 20% in-network and the plan pays at 60% with a co-insurance of 40% out of network.
- A deductible is the amount of money you must pay out of pocket before any monies are paid by the insurance company. This is a fee paid once a policy year.
- Co-insurance is the amount you must pay each time to go to an outside provider based on your charges.
- In-network is when you stay within the listing of providers who participate with Aetna Student Health.
- Out of network is when you go to a provider that does not participate with Aetna Student Health.
- There is a listing on Aetna Student Health that will help you navigate through providers to make sure you choose a provider that is in-network.
- Aetna Student Health also has co-pays for office visits, urgent care, emergency room, pharmacy, massage, and acupuncture.
- The co-pays for RIH are listed below:
- Office visit co-pay at RIH: $10
- Massage co-pay at RIH: $20
- Acupuncture co-pay at RIH: $20
- Pharmacy co-pays: $10 for generic drugs and $50 for name-brand drugs.
- Acupuncture and massage are only covered if the services are performed at RIH.
- The co-pays for outside providers are listed below:
- Office visit co-pay at an urgent care provider is: $25
- Emergency room co-pay: $100.00
- Pharmacy co-pays for an outside pharmacy: generic drugs $15 and preferred name-brand $50
- Non-preferred name brand: $60 and specialty drugs $60
Co-pays are the fixed amount of monies you must pay when receiving services from a provider.
There are no co-pays for any type of physical. Each person enrolled in Aetna student health receives one covered physical each year and women are also allowed one well-woman physical each year.
Aetna Student Health also includes a discount vision plan under the medical benefits. The coverage gives discounts on services offered by a vision care provider.
There are no dental benefits under the medical policy for Aetna Student Health. If a student wishes to have dental coverage there is a dental discount plan that a student can enroll in on the Aetna Student Health website for a small fee.
If a replacement card is needed due to loss, the student can call Aetna Student Health directly at 1-877-437-6535 and speak to a customer service representative to get a new card sent to their mailing address. You can also print your insurance card from the Aetna Student Health website. If a student enrolls in the Aetna Student Health plan offered by UMBC, RIH becomes the student’s primary care provider. Students must first see an RIH provider for a referral to be able to see an outside provider for care. If a student does not have a referral for outside care, the deductible for Aetna Student Health increases to $550.