About the Plan
Eastern Illinois University requires that all students who enroll in nine or more on-campus hours, all graduate assistants under contract to the University, and all international students enrolled in three or more on-campus hours, be covered by health insurance and provides a supplemental Plan of medical coverage for injury and illness for which the fee is automatically assessed along with tuition and fees. Students enrolled part-time with 5 or more hours may apply to purchase coverage.
The Plan coordinates with the student’s primary carrier and provides the student worldwide protection, 24 hours a day. Student Insurance is an economical way to reduce or eliminate out-of-pocket expenses when family health plans do not cover 100% of medical costs because of deductibles, co-payment amounts, limitations on specific benefits, and out-of-network penalties.
The Plan has a $50 deductible per diagnosis and pays up to 80% of eligible expenses for physician and hospital expenses, lab and x-ray, surgery, ambulance transport, physical therapy, maternity expenses, mental health and substance abuse issues.
In the event of a non-emergency injury or illness, the Covered Student should report to the Health Service for proper medical treatment or referral. If away from the University, consult a physician. Emergency Room visits to Sarah Bush Lincoln Health Center for non-emergency treatment available from the Health Service will not be considered without a referral from a physician.
The Plan is secondary if the student is entitled to benefits by any other policy.
Students should familiarize themselves with the proper procedures to utilize the benefits available.
Coverage for each Term is based on enrolled hours as of Count Day per the University Academic Calendar.
Annual Maximum - $20,000
A $50 deductible will be taken per injury or illness. All related conditions and recurrent symptoms, or injuries as a result of the same accident, will be considered one illness or one injury.
|Schedule of Benefits*|
|Lab and X-Ray||80%|
|CT and MRI||50%|
|Surgery||80% Usual and Customary|
|Ambulance||80% up to $300|
|Dental||$100 per injured tooth|
|Mental Health and/or Substance Abuse||80%|
|Health Service Schedule of Benefits*|
Tier I - Neb Treatment, Ear Wash, Dressing/Debridement/Burns, Wound Care, Destruction of Lesions, Foreign Body Removal - Cost $15.00
Tier II - Repairs, Nails, Incision and Drainage, Injection/Aspiration of Joint, Excision of Lesion - Cost $45.00
Hepatitis B, MMR (Limit 1), Tdap/Td (Limit 1), Hepatitis A, Meningitis, Gardasil, Typhoid
Health Service Pharmacy Benefit
Tier I -(Cost $15, Plan pays (savings)$10. Student pays $5, Without Student Insurance coverage, student would pay $15)
Tier II - (Cost $25, Plan pays (savings) $15, Student pays $10. Without Student Insurance coverage, student would pay $25)
Tier III - (Cost $50, Plan pays (savings) $30, Student pays $20. Without Student Insurance coverage, student would pay $50)
*All benefits are subject to all Plan Limitations and Exclusions.
What you need to know...
The family health plan may only cover the student while in the home area, or may reduce benefits when the student is treated away from home. When this happens, the student might be covered for medical emergencies only. This could leave the family with a large amount of out-of-pocket expenses for non-emergency or non-covered treatment. The student may even forego treatment rather than travel to a covered provider. Student Insurance follows the student worldwide.
The Student Insurance Plan can complement the family health plan. It may be beneficial to carry both, particularly if the family plan has a high deductible. Student Insurance has a $50 deductible per diagnosis.
College years are usually physically healthy ones, but they are also a time of major developmental and social transitions during which physical and mental health problems have the potential to interfere with students’ lives and ambitions. Student Insurance provides the additional coverage when needed.
Students enrolled in a combination of Continuing Education courses and on-campus courses that total 5 or more hours, are eligible to purchase coverage as part-time students. Students will need to complete the appropriate Enrollment Form.
Dependent coverage is not available.
How to Submit a Claim
Contact the Student Insurance Office for verification of coverage.
Complete the Student Insurance Claim Form (pdf) and submit it to our office. If the form is not completed, the claim will be denied.
It is the Covered Student's responsibility to provide primary and secondary (if applicable) insurance information to all medical providers.
If the Covered Student is entitled to benefits under any other insurance policy, that policy is primary. An Explanation of Benefits (EOB) documenting payment/denial from the primary carrier is required before benefits are payable by the Plan.
The completed claim form and all required documentation, and any additional information requested by the Student Insurance Office must be received within 52 weeks from the date of the first medical expense.
This is only a summary of Plan benefits. Consult a Medical Insurance Specialist in the Student Insurance Office to request a brochure or for complete detailed information regarding eligibility and enrollment, benefits, limitations or exclusions.