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Frequently Asked Questions

Enrollment

Q: Can I enroll myself or a dependent after the deadline?

A: You may enroll yourself (or a dependent) after the deadline date only if there has been a significant life change:

  • Marriage*
  • Birth*
  • Loss of prior coverage
  • Arrival in the United States

If the completed Enrollment Form is submitted within 30 days of the qualifying event, coverage will be backdated to the date of the qualifying event. If the completed Enrollment Form is submitted after the 30 days of the qualifying event, it will not be accepted, and the dependent(s) will have to wait until the next annual open enrollment period to enroll.

*The Voluntary Basic Plan does not include dependent coverage

Q: Are monthly payments an option for dependents?

IU Postdoctoral Fellow and Professional Students Plan All premiums must be paid at the time of purchase. Monthly payments are not an option.

Fellowship & International All premiums must be paid at the time of purchase. Quarterly payments for dependents can be made but must be initiated in the Fall. Monthly payments are not an option.

ID Cards

Q: When should I expect my ID card to arrive in the mail?

A: Voluntary plan students should receive their ID card within 2-3 weeks of enrollment. Mandatory plan students should receive their ID card within 2-3 weeks after the waiver deadline.

Q: What should I do if I don’t get an ID card or lose my ID card?

A: You can request an ID card directly from Aetna Student Health. Call 877-375-4243 to make the request, or request one online through Aetna Navigator®. Please make sure all address information is up to date in Onestart so that ID cards are addressed to the correct location.

Aetna Navigator

Q: What is Aetna Navigator?

A: Aetna Navigator®. is your members-only website. It's secure, so your information is protected. View your personalized claims and health information. You can do it all right here — 24 hours a day, 7 days a week.

By logging into Aetna Navigator®. you can:

  • Review who is covered under your plan.
  • Request, view and print member ID cards.
  • View Claim Explanation of Benefits. (Sample EOB)
  • Access Health Discounts & Resources.
  • Look up costs and other health related information before you seek care and to better plan your expenses.
  • Research the price of a brand name drug and learn if there are generic alternatives.
  • Find health care professionals and facilities that participate in your plan.
  • Send an e-mail to Customer Service.

Q: What should I do if I cannot log-in to Aetna Navigator®.?

A: If you are a first time user, make sure you register first. If you are already registered and have logged in before please contact technical support at (800) 225-3375. Please also allow Aetna Navigator®. 3-5 business days to update their system after you have enrolled in the insurance plan.

Claims

Q: Where should I mail claims?

A:  Aetna Claims Contact Information:
Aetna Student Health
PO Box 981106
El Paso, TX 79998
(877) 437-6512

Q: Where should I mail appeals?

A:  Aetna Appeals Address:
Aetna Student Health
P.O. Box 14464
Lexington, KY 40512

Q: I went to the doctor several months ago and they submitted a claim to our insurance, but I have not heard anything from Aetna. What should I do?

A: At this point you should make sure that the insurance has received the claim. A common problem with insurances is that they mysteriously "lose" several claims every month. If two months or so has passed with no payment or rejection from the insurance, you should log onto the Aetna website to check the claim status via the online system, or call the insurance to see if they have received the bill. It is important that you keep up with the claims you submit, because our insurance has a 90-day filing deadline. If the insurance doesn't receive the bill for the first time within 90 days (even if it's their fault for "not receiving" a bill you sent in), they will reject it as being beyond the filing deadline and it is very hard to get them to pay at that point. If they claim to have lost or never received the claim, ask the doctor's office to resend or fax the claim, verifying the address to which they are sending the claim and patient ID number.

Q: Is there a way that I can view my claim online?

A: You can view all of your claims online at Aetna Navigator®.

Q: Where can I find claim forms?

A: Claim forms can be found on the main page of our website under “resources”.

Prescriptions

Q: Where can I find the claim form for prescriptions?

A: Aetna Prescription Claim Form (PDF)

 

Q: Are there any medications that I cannot get?

A: Medications not covered by this benefit include, but are not limited to: drugs to promote or to stimulate hair growth, appetite suppressants, smoking deterrents, and non-self injectables. Prior authorization is required for growth hormones and drugs which are used for the treatment of malaria. For assistance, or for a complete list of excluded medications and drugs available with prior authorization, please contact (800) 238-6279 (available 24 hours).

Q: How do I know if a prescription is covered on my plan?

A: You can look up prescription information and cost by going to Aetna Navigator®. You can also refer to Aetna's Pharmacy Tier Listing (PDF) which lists some of the medications that are covered.

Maternity

Q: What can I expect to be covered during and after pregnancy?

A: Maternity is covered as any other medical condition. Labor and delivery expenses include inpatient care of the covered person and any newborn child for a minimum of 48 hours after a vaginal delivery and for a minimum of 96 hours after a cesarean delivery.

If a person is discharged earlier, benefits will be payable for one at-home post-delivery care visit by a health care provider. The at-home post-delivery care visit shall be conducted not later than 48 hours following the discharge of the woman and her newborn child from a licensed hospital. However, at the mother's discretion, the visit may occur at the facility of the provider subject to the terms of the Policy or group contract.

Q: My wife is pregnant; Can I add her to my insurance plan?

A: Yes, you can add your spouse to your plan during open enrollment or if she has lost coverage you can contact .

*Please Note: Spouses and Dependents cannot be added to the Voluntary Plan.

Vision

Q: Does Aetna cover eye exams?

A: Aetna does not cover vision.

Postdoctoral Fellows & Professional Students, Fellowship Recipient, International, and Voluntary Plans – Enrollees in these plans have access to an Aetna Vision Discount Program as part of their medical insurance plan. Members are eligible for vision discounts with participating providers (see Health Discounts). Please see the chart listed below for a summary of vision discounts and register for the program at Aetna Navigator®.

Aetna Vision Savings Summary
This chart is a summary of the Aetna Vision Discount Program.  For the full chart please register at Aetna Navigator and view Health Discounts.
Product or Service Reduced Fee/member Cost*
Frames
Eyeglass Frames (retail prices) 40% off retail prices
Lenses per Pair (uncoated plastic)
Single Vision $40
Bifocal $60
Lens Options per Pair (add to lens price above)
Standard Polycarbonate (includes UV and scratch-resistant coating) $40
Glass 20% discount
Standard anti-reflective coating $45
Eye Exams for ALL Managed Medical Plans* that Do Not Cover Eye Exams
For eyeglasses $42
For standard contact lenses $82
Contact Lenses
Conventional lenses 15% discount
Disposable lenses 5% discount
Additional Vision-Related Items
LASIK procedures 15% off the standard prices or 5% off promotional prices through the U.S. Laser Network
Dental

Q: Is dental included on my medical insurance plan?

A: No,* you must purchase dental separately. We have linked the Dental brochure and summary of benefits under each plans website link. Please select your plan from above for more information.

*Dental premiums for qualifying Fellowship Recipients are fully paid by the University or external granting agency. No Enrollment Form is required for students on the Fellowship Recipients Plan. Note: This does not apply to qualifying dependents.

Q: Can I use a dental provider at IU School of Dentistry?

A: Yes, it is in network as long as you see a licensed professional.

Continuation Insurance

Q: What do I need to know about continuation insurance?

A: When you enroll in Continuation Coverage, you are continuing your medical benefits. The Indiana University Aetna dental policies do not offer continuation.

Your original ID number and group number will remain the same on Continuation as they were during your standard coverage.

You may not add dependents to continuation plans unless they were already on the previous semester plan with you.

Payment is due at enrollment, for the total number of months you desire coverage.

Forms should be mailed directly to Aetna, at the address provided on the form, or sent to student insurance coordinator for help with submission.

The 30-day open enrollment period, after your standard coverage terminates, is the only opportunity to enroll in Continuation.

You may not shorten or extend your Continuation Coverage period, once you have enrolled.

There are no refunds for Continuation Coverage.

Rates and Enrollment forms are available on your plan-specific web page, accessible from the Indiana University Student Insurance Home Page.

Getting Help when Traveling Internationally

Q: Who do I call in an emergency away from campus?

A: If you have an emergency while traveling at least 100 miles from campus, call On Call International as soon as possible by dialing 1-866-525-1956.

Q: How do I find a qualified medical provider when I am traveling abroad?

A: You can call On Call International at any time, day or night to speak to a medical professional and receive information on medical providers in your travel location.

Q: Will I receive a separate ID card for the travel assistance services?

A: Yes. Once you are enrolled in an Indiana University student health insurance plan, you will receive an On Call International member card. You can also print a temporary card from the main page under ‘Resources’. The card may be used for services in the United States (anytime you are 100 miles or more from your home address) or in any other country. Always carry the card with you when you travel. The 24-hour help-line telephone number is printed on the card.

Q: Do I have to call On Call International before I leave on a trip?

A: If you will be traveling for more than one semester, please contact On Call International to receive valuable pre-trip and extended travel information. Also, remember to take your On Call International card with you and call if you need medical advice or assistance.

Q: If I have an accident or illness, and the hospital or I arrange all the necessary transportation, will On Call International reimburse me for the expenses involved?

A: No. On Call International is a service provider, not an insurance company; therefore On Call International must make the arrangements for all services. On Call International cannot reimburse participants for any assistance expenses not arranged and provided by On Call International.

Q: What if the foreign hospital refuses to accept my insurance and requires me to pay in full at the time of services?

A: You will need to pay the provider and then file a claim for foreign medical assistance with Aetna Student Health (See: Filing a Foreign Claim). If you do not have the funds available to pay the hospital, On Call International can help you make financial arrangements with the provider. The source of the funds is your responsibility.

Q: Will On Call International transport a family member or friend to be at my side?

A: Yes. If an eligible participant is traveling alone and it seems likely that they will be hospitalized for more than seven days, On Call International will transport a family member or friend to that location.

Q: What happens when I'm ready to be discharged but I still need assistance?

A: If you still need assistance at the point of discharge from the hospital, On Call International will arrange for you to come home with a medical/non-medical escort.

Q: I don't travel internationally. How does this service benefit me?

A: On Call International will help you with any medical situation if you are 100 miles or more from your campus address--this can mean your weekend trip home or your vacation plans. If you become ill or have an accident while traveling, you may not know how to access care, but with On Call International, you can call 24 hours a day, 365 days a year for assistance and advice.

Q: Why is it important to use your emergency assistance services?

A: By calling On Call International immediately, you can receive services before your medical condition becomes serious. Also, On Call International can protect you in the event of an emergency by getting you to appropriate medical care when there may not be good local medical facilities.

 

Page updated: 19 February 2014
UNIVERSITY HUMAN RESOURCES
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