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Eastern Illinois University requires that all students who enroll in 9 or more on-campus hours, all Graduate As­sistants under contract to the University, and all Inter­national students enrolled in 3 or more on-campus hours, be covered by health insurance and provide 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 coverage, 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 $100 deductible per diagnosis and pays up to 70% 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.  It has an annual maximum of $15,000.

The Plan covers most services at the Health Service at 100% including labs, x-rays, procedures, TB tests, and supplies.  The Plan has a 50% benefit for immunizations at the Health Service and provides prescription benefits at the Health Service Pharmacy. 

Unlike an HMO or PPO, the Plan does not have a network.  This gives students a choice in their care and provides coverage for treatment they receive at home, at school, or wherever they may travel.

If the student has other coverage, the Plan coordinates with your primary carrier.  It 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. Most students find it beneficial to carry both, particularly if the family plan has a deductible/coinsurance. 

While the student is insured, they can print off their Student Insurance Card from their PAWS account.  Click on the "My Health" tab.  From here, they will find a link for Student Insurance that will take them to their new Student Insurance Card.

Coverage for each Term is based on enrolled hours as of Count Day per the University Academic Calendar.  Dependent coverage is not available.

Annual Maximum - $15,000

A $100 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* 
Hospital Outpatient/Inpatient 70%
Lab and X-Ray 70%
CT and MRI 50%
Anesthesia 70%
Surgery 70% Usual and Customary
Physician Inpatient 50% 
Physician Outpatient 70%
Ambulance 70% up to $300
Dental $100 per injured tooth
Maternity 70%
Mental Health and/or Substance Abuse 70%

 

Health Service Schedule of Benefits* 

Procedures

100%
In-house Lab 100%
X-Ray/ECG 100%

Immunizations (Limit 1)

50%
Supplies 100%
TB Testing (Limit 1) 100%

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)

 

Contraceptives

Savings

 $10.00

 

 $15.00

 

 $30.00

 

$10.00/month

 *All benefits are subject to all Plan Limitations and Exclusions. 

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.