Frequently Asked Questions
Questions about the Health Insurance Marketplace
Beginning October 1, the new Health Insurance Marketplace will be open to enroll for health coverage beginning in 2014. The Marketplace was created to provide an option to purchase health insurance especially for those who have not had access to health insurance in the past.
For students currently covered under OSU Student Health Insurance:
Do I need to do anything now? No, your Student Health Insurance coverage will continue through August 19th, 2014.
How do my student health insurance benefits compare to the Health Insurance Marketplace plans? Ohio State's Comprehensive Student Health Insurance plan is equivalent to a platinum level plan in the Marketplace. Additionally, OSU SHI includes benefits for:
- A $10,000 accidental death and dismemberment benefit
- Emergency medical and political assistance and evacuation when traveling in the U.S. or abroad.
You can visit the OSU Student Health Insurance web site for an interactive benefit plan comparison tool. Remember, when comparing benefits, be aware of the out of pocket costs you are responsible for paying for your care. Things like deductible, copayments, coinsurance and the out of pocket annual can vary significantly from plan to plan. It is also important to understand what providers and facilities are considered "network."
If I want to buy a plan in the Health Insurance Marketplace, can I opt out of the Student Health Insurance plan for Spring term? No, your enrollment into the Student Health Insurance plan is an annual selection.
Can I apply my graduate Associate health insurance fee authorization toward a plan purchased in the Health Insurance Marketplace? No, the fee authorization only applies to plans offered by Ohio State.
For students not currently covered under Student Health Insurance:
Do I need to do anything now? No, the waiver selection you made for this term will continue through August 19th, 2014.
What if I lose coverage during the school year? You can enroll in the OSU Comprehensive Student Health Insurance plan with a qualifying event or go to https://www.healthcare.gov/ for information about the Health Insurance Market place plans available.
What if my current coverage expires December 31 of this year?
You can enroll in the OSU Comprehensive Student Health Insurance plan through your Student Service Center by December 30th. The Health Insurance Market Place open enrollment period is until December 31st for January 2014 coverage. Visit https://www.healthcare.gov/ for more information about the Health Insurance Market place plans available.
Questions about eligibility for OSU Student Health Insurance
Who is required to carry insurance?
Students who are enrolled at least half-time* ( 6 eligible credit hours for undergrads, 4 eligible credit hours for grad students, and 3 eligible credit hours for post-candidacy doctoral students) in a degree-seeking program and are attending any campus of The Ohio State University .
All international students enrolled in courses at The Ohio State University are required to enroll in the Comprehensive Student Health Insurance Plan. (Exception: Students enrolled only in Distance Learning classes will not be enrolled in the Plan.)
Who is eligible to purchase coverage under the Student Health Insurance Program?
Students who are enrolled at least half-time(6 eligible credit hours for undergrads, 4 eligible credit hours for grad students, and 3 eligible credit hours for post-candidacy doctoral students )) in a degree-seeking program. Exceptions apply to enrolled students taking one of the approved exception course numbers representing: co-ops, internship, study abroad, and thesis or dissertation research. These students will be automatically enrolled regardless of the number of credits.
What if I am not taking classes and still need to purchase Student Health Insurance?
1) choose the Continuation Plan by specific deadlines or
2) remain covered on your parent's plan or
3) explore other private insurance options
Am I required to have health insurance in order to maintain my immigration status? Are my dependents?
J-1 students and J-2 dependents are required to have health insurance to maintain legal immigration status in the US.
F-1 students are not required to have health insurance to maintain immigration status, but are required to have health insurance to study at Ohio State.
F-2 dependents are not required to have health insurance to maintain status, but you are strongly encouraged to purchase insurance for any F-2 dependents on your record.
Can I add my parents as dependents onto my plan? Who can I add as dependents?
Parents or siblings are not eligible. Your Spouse/Domestic Partner and or your eligible children.
If I need to take a leave of absence from the University for Medical Reasons, can I keep my health insurance if I'm not enrolled in classes?
If you were enrolled in the Comprehensive Student Health Insurance plan the previous term, then you have the option of keeping your health insurance. You will need to submit to the Student Health Insurance Office a completed " Petition to Enroll" form with supporting documentation including the beginning and return dates from your college by the posted term deadline.
Please visit shi.osu.edu "Important Forms" tab and select the appropriate policy year.
What if I lose my health insurance coverage either from my parents or spouse/partner's plan?
If a student experiences a qualifying event, the student must complete and submit a Coverage Status Change Form along with supporting documentation to the Student Health Insurance office within 31 days of the qualifying event. Please visit shi.osu.edu " Important Forms" tab and select the appropriate policy year.
What is a qualifying event?
- marriage, divorce or initially meeting requirements of domestic partnership,
- child birth or adoption
- dependent reaching the age limit of another health insurance plan,
- first time arrival of dependent to the United States from a foreign homeland,
- gain of coverage as result of the student becoming employed,
- open enrollment of the student, parent or spouse's employer plan,
- a change in the student, parent or spouse's employment resulting in eligibility for benefits or the involuntary loss of coverage
- attainment of minimum eligibility requirements after the 2nd Friday of the term.
*** Please note that the loss of a university subsidy or a change in personal financial circumstance are not qualifying events.
Is my spouse/partner eligible for coverage?
Yes, a legal spouse and or same or opposite sex domestic partner are eligible for coverage
Are my children eligible for coverage?
Yes, unmarried child(ren) under age 26. The term "children" includes a student's biological children, stepchildren, foster children, adopted children from the date of placement in the student's home and who depend on the student for their support; children for whom the student has been granted legal custody; children for whom the student has legal obligation to provide coverage due to a court order; and children of the student's domestic partner.
Can I remove my dependents from my plan if they return to our home country in the middle of the semester?
No. If the Coverage Status Change Form to terminate coverage is made in accordance with the Plan and approved, the termination will be effective the first day of the following term and there will be no pro-rata refund of premium (during the term of the qualifying event).
I am a new student and will arrive on campus three weeks before classes start. How can I make sure I am covered before the semester begins?
Complete the "Interim Insurance Request" form for Early Arriving Domestic or International Student Form if you meet one of these requirements:
- International, graduate or professional student new to Ohio State
- Undergraduate students required to arrive early by an Ohio State program
- Private insurance expired between specific interim dates (usually 1 month before school term).
Please visit shi.osu.edu "Important Forms" tab and select the appropriate policy year.
I am graduating soon, and will be remaining in the US. Can I extend my coverage under Student Health Insurance?
If you have the OSU Comprehensive Plan Spring Semester, you are eligible to purchase a continuation plan through Aetna Student Health. Tier 2, Tier 3, and Tier 4 benefits are included. (Eligible services provided at Student Health Services are covered at the Tier 2 level. Tier 1 benefits, the eye-wear allowance, and dental benefits through Delta Dental of Ohio are not included. )
The Continuation Plan may be purchased for a 3-month or 6-month coverage period and you must enroll within 31 days of the end of your OSU Comprehensive Plan coverage. Payment is made directly to Aetna Student Health. The Continuation Plan is non-renewable and non-refundable.
The on-line site to request the Continuation Plan is at aetnastudenthealth.com, where you can find current information about enrollment deadlines and procedures.
Students whose coverage terminates under the Continuation Plan are eligible to purchase an Aetna Conversion Plan.
How will the university enforce the insurance requirement?
By submitting the waiver request, you agree that your current insurance plan may be contacted for confirmation that your coverage is in force for the applicable policy year and that it meets the school's waiver requirements.
What if I already have health insurance and I do not need the insurance offered by The Ohio State University?
Every year, you must either select or waive the Student Health Insurance coverage from their online Student Center at http://www.buckeyelink.osu.edu by the published deadline of Autumn term (or the first term of enrollment during that policy year).
Questions about choosing or waiving coverage
How do I enroll for coverage- either the Comprehensive Plan or Wilce Care?
Students select Student Health Insurance coverage from their online Student Center at http://www.buckeyelink.osu.edu every year by the published deadline of Autumn term (or the first term of enrollment during that policy year). Students who do not make a selection from their online Student Center by the deadline each year will be defaulted into Comprehensive Student Health Insurance if they meet the eligibility requirements.
What are the deadlines for enrollment?
Please visit shi.osu.edu for current rates, dates and deadlines to enroll.
When does my coverage begin and end?
Coverage begins 1 week in advance of the term and ends the last day of the plan year. Please visit shi.osu.edu for current rates, dates and deadlines to enroll.
How long is the coverage effective?
For the entire plan year as long as student remains eligible (meets the minimum credit hour requirement.
How much does the coverage cost?
Please visit shi.osu.edu for current rates, dates and deadlines to enroll.
How do I pay for the OSU Comprehensive Plan?
Your student health insurance premium appears on your Statement of Account and you pay for it just as you do your other school fees. Ohio State's Tuition Option Payment Plan (TOPP) allows students and their families to divide the cost of tuition, housing, and fees into installment payments for autumn and spring semesters.
How do I enroll my dependents or change dependent coverage selections?
To enroll an eligible dependent, the student must elect coverage online through their Student Center at http://www.buckeyelink.osu.edu by the posted deadline.
What are the issues to consider before waiving out of the University-plan?
The OSU Comprehensive Student Health Insurance Plan benefits have been designed for students, by students. The plan offers medical, dental and vision benefits combined in one low cost plan that covers you year round when you are on campus, home or abroad. For on campus care, there are no copays, co-insurance or deductible for office visit fees, diagnostic tests and medical procedures at the Wilce Student Health Center
How do I waive coverage?
Eligible domestic students who do not wish to enroll must waive coverage by providing proof of adequate insurance coverage by the posted deadline date. This process must be completed online at your SIS Student Center Page at www.buckeyelink.osu.edu.
International Students cannot waive on the SIS Student Center Page. International students who meet certain criteria must complete an electronic petition to waive. [add link]
What are the deadlines to waive coverage?
Students can only waive coverage during the first academic term of enrollment each policy year. Please visit shi.osu.edu for current rates, dates and deadlines to enroll.
Can I drop the Student Health Insurance Plan in the middle of the year?
If you have a qualifying event to terminate coverage during the middle of a term, you will need to submit a "Coverage Status Change" form within 31 days from when you gained coverage. If approved, the termination will be effective the first day of the following term and there will be no pro-rata refund of premium (during the term of the qualifying event) in accordance with the Plan.
What if I already have health insurance or am covered under my parent's plan?
Eligible students who do not wish to enroll must still waive coverage by providing proof of adequate insurance coverage by the posted deadline date. This process must be completed online at your Student Center at www.buckeyelink.osu.edu.
Do I have to submit a separate waiver every semester?
No, the election you make in the Autumn is binding for the remainder of that policy year.
I have a problem with my waiver and need additional information. Who can I talk to about it?
A representative at Student Health Insurance can assist you with your insurance questions by calling 614-688-7979 or you can send an email to: firstname.lastname@example.org .
I submitted a waiver but now I no longer have other insurance. How can I get covered under the Student Health Insurance Plan?
If a student needs to change their selection after the deadline due to a Qualifying Event (an involuntary loss or gain of coverage under another plan due to marriage, divorce, birth, death, change in employment, etc.), they must submit a "Coverage Status Change" form within 31 days of the date of the Qualifying Event. Please visit shi.osu.edu "Important Forms" tab and select the appropriate policy year.
I submitted a waiver, but the charge for Student Health Insurance appears on my fee statement.
Students must allow 1-2 business days for a transaction to process on their account.
What is the deadline for submitting a waiver?
It is the published deadline of your initial term of enrollment each academic year. Please visit shi.osu.edu for Rates, Dates, & Deadlines.
What kind of information must be supplied to prove comparable coverage by another health insurance plan?
The Insurance company name, addresses, and telephone #; the subscriber's name and telephone #; and the subscriber's ID#.
What options do I have if my waiver is denied?
Remain in the student health insurance plan until the academic year is completed, then seek private health insurance and have in place prior to the next academic year
Where can I get a waiver form?
Please visit shi.osu.edu "Important Forms" tab and select the appropriate policy year.
Why did I get charged for a health insurance fee on my account statement?
Students who do not make a selection from their online Student Center by the deadline each year will be defaulted into Comprehensive Student Health Insurance
I am graduating in Spring Semester, in May. Why do I have to buy health insurance that goes all the way through the middle of August?
Feedback from OSU students indicated a need for continuous coverage through the summer months. The annual premium is divided by 2 semesters equally. When you enroll for the Spring semester coverage, the Spring premium rate includes Summer coverage.
Questions about WilceCare
What is WilceCare?
WilceCare is not an insurance policy. It is designed to supplement the health insurance that a student already has by providing prepaid coverage for medical care delivered exclusively at the Wilce Student Health Center.
Who is eligible for WilceCare?
Any student who has met the credit hour requirements and has private health insurance coverage.
Why choose WilceCare?
WilceCare has been designed to meet the needs of students with other health insurance plans that only provide regional coverage for basic care services, or provide coverage subject to high deductibles and/or co-pays.
What does WilceCare cover?
WilceCare provides for outpatient primary care benefits for students seen at the Wilce Student Health Center. WilceCare pays for routine x-rays, laboratory tests, physical therapy, minor office procedures, prescribed medical supplies in stock, office visits for the treatment of illness or injury, and prescriptions. There is a $2000 covered medical expenses maximum and $500 prescription maximum per policy year.
How do I enroll in WilceCare?
To enroll, the student must select the coverage online through their Student Center at http://www.buckeyelink.osu.edu.
Can I enroll in WilceCare at any time? What are the deadlines to enroll in WilceCare?
Students may enroll at the beginning of Autumn and Spring term, but the cost will remain the same regardless of which term is purchased, including Summer only term for new students. If you miss the deadline, you must wait until the next term. Please visit shi.osu.edu for Rates, Dates, & Deadlines.
How do I pay for WilceCare?
Your WilceCare supplement premium appears on your statement of account and you pay for it just as you do your other school fees.
Does WilceCare cover preventive services?
No, it only covers medical illness and injury expenses.
How do I file my own insurance claim once WilceCare has paid?
If you would like a claim form to file with your primary insurance, they can be obtained at the Wilce Student Health Center Cashier counter located on the first floor in the Pharmacy, or at the Patient Accounts/Billing desk located on the third floor.
Questions about using your insurance coverage
Will I receive an ID card and list of benefits?
Yes, you will receive your ID card and benefit overview booklet in the mail. The Summary Plan Description is on our website and can be viewed at your leisure. Your packet should arrive 2-4 weeks after the semester begins.
What is the ID card for?
An ID card from the health insurance company identifies to providers that you (and your dependents) have coverage. It includes basic coverage information, a unique member identification number and a toll-free phone number to contact member services for the member and provider. IT IS VERY IMPORTANT THAT YOU HAVE YOUR STUDENT HEALTH INSURANCE CARD WITH YOU WHEN YOU SEEK MEDICAL CARE.
Who is Aetna Student Health?
The Ohio State University has partnered with Aetna Student Health to offer the OSU Comprehensive Insurance Plan. Aetna Student Health is an insurance administrator that provides health insurance programs for college and university students.
Is mental health treatment covered by the SHIP?
Yes. Detailed benefit information is at: www.shi.osu.edu
If I waive SHIP can I still use Student Health Services at the Wilce Student Health Center?
Yes. All students enrolled at OSU are eligible to use the health service, regardless of health insurance coverage.
What is a pre-existing condition and how is it covered?
A pre-existing condition is any sickness, injury, or related condition for which the insured person received medical treatment (including prescription drugs) or advice, or which was diagnosed by a doctor or other healthcare provider during a designated period of time immediately preceding the effective date of the insured person's coverage. The OSU Student Health Plan does not have a pre-existing condition waiting period due to the healthcare reform.
Can I see the physician of my choice under the Comprehensive Student Health Insurance Plan?
Yes, but you may have less out of pocket costs if you choose a provider from the OSU Health Plan Network inside Franklin County and the Aetna network outside of Franklin County
Will this plan cover me when I'm out of state and/or out of the country?
Yes, if you are enrolled in the OSU Comprehensive Student Health Insurance Plan. You will have a separate ID card from On Call International. Please carry this with you when you travel, as well as your Aetna Student Health Insurance card. If you have an emergency while traveling at least 100 miles from your primary residence or when traveling in a foreign country, call On Call International as soon as possible by dialing 866-525-1956 (within the United States) 603-328-1956 (outside the United States). On Call International can provide the travel and medical assistance services.
Where can I find a list of providers?
Do I have dental benefits under the SHI?
Yes, under the Comprehensive Student Health Insurance. The insurance vendor is Delta Dental of Ohio.
Will I get a Delta Dental ID card?
No, all you have to do is present your student number to the dental office and let them know you have dental coverage with Delta Dental.
What is pre-certification?
Pre-certification simply means calling our insurance vendor, Aetna Student Health, prior to treatment to obtain approval for a medical procedure or service. Pre-certification may be done by you, your doctor, a hospital administrator, or one of your relatives. All requests for pre- certification must be obtained by contacting Aetna Student Health at (855) 546-5413
Do I have to get a pre-certification for inpatient hospitalization, outpatient mental health services and home health care services? If yes, what is the time frame to do this?
Yes, three (3) business days prior to the planned admission or prior to the date the services are scheduled to begin or within one (1) business day following emergency inpatient (or partial hospitalization) admission.
Do I have coverage in my home country when I return home during the breaks between terms?
Do I have vision benefits under the SHI?
Yes. Please visit shi.osu.edu for benefit detail. Be sure to select the appropriate policy year.
What is the difference between going to the doctor's office, urgent care, the emergency room, and being treated as an out-patient?
- Care from a doctor's office is usually scheduled in advance.
- An urgent care facility is used for an unexpected illness or injury that is not life threatening but requires immediate outpatient medical care. An urgent situation requires prompt medical attention to avoid problems and unnecessary or severe pain, such as a high fever.
- A person would go to an emergency room if they have an emergency medical condition having symptoms that are severe enough (including sharp pain) that it causes a careful person, who has an average knowledge of health and medicine, to reasonably expect the absence of immediate medical attention to result in: placing the health of the individual in serious jeopardy; serious harm to bodily functions; serious dysfunction of any body organ or part.
What is a provider?
A provider is a doctor, hospital, or facility.
What is a network? Why is it important to use a network provider?
A network provider is doctors, hospitals, and other healthcare providers who have contracted to provide specific medical care at negotiated prices. Use of a network provider results in better benefits and lowers out of pocket costs.
Can I go to any doctor I want?
Yes, however choosing a network provider will maximize your savings and reduce your out-of-pocket expenses. For network providers, select an OSU Health Plan network provider (Designated Care Provider) or an Aetna In-Network Provider if you need care outside of Franklin County (Designated Care Provider).
What is a "premium"?
The amount of money charged by an insurance company for coverage
What is a "deductible?"
The amount of Covered Medical Expenses that are paid by each covered person during the policy year before benefits are paid.
What is a"co-pay"?
A specified dollar amount an insured person must pay for specified charges. The co-pay is separate from and not part of the deductible or coinsurance.
What is an "EOB"? Explanation of Benefits?
An EOB (explanation of benefits) is a form that explains how the payment amount for a health benefit/health insurance claim was calculated. It also may explain the claims appeal process and provide other information
What is an insurance "claim," and how does the claims process work?
An insurance claim is a request for benefits payment to an insured employee or beneficiary (the claimant). The claim is generally submitted to the insurance company by the provider, the claim is processed based on the benefits, and payment is made to the provider.