- Aetna Emergency Room Payment Policy
- Does Aetna Cover Emergency Room
- Is There A Copay For The Emergency Room
Preventive care copay: $0: Primary care visit copay: $20: Specialist visit copay: $35: Maternity: Prenatal Care: $0: Hospital Care: $250 per day, $1000 max per stay: Inpatient hospital copay: $250/day, $1,000 max per stay: Outpatient surgery copay: $175: Emergency room copay: $125: Urgent care center copay: $50: Lab/X-ray/diagnostic services. Emergency Room Visit At Hospital $250 Copayment per visit (waived if admitted) Ambulance $100 Copayment per transport Urgent Care $75 Copayment per visit If the use of a Participating or Non-Participating Hospital Emergency Room is not due to an Emergency Medical Condition for a Condition covered by this Group Plan, the only payment made will. Aetna International Traditional Choice Plan Aetna Member Services 1-800-367-6276 www.nafhealthplans.com. $350 emergency room copay 50% after deductible plus separate $350 emergency room deductible Urgent care facility 100% after $30 copay 60% after deductible. Your Aetna health benefits or insurance plan may pay part of the doctor’s bill. But it pays less of the bill than it would if you got care from a network doctor. Also, some plans cover out-of-network care only in an emergency. Out-of-network rates are higher. An out-of-network doctor sets the rate to charge you.
Need coverage?
Aetna Emergency Room Payment Policy
If you are a student looking for coverage, Aetna Student Health℠ has a plan for you. Aetna Student Health℠ gives you access to care by working closely with your school and with a network of doctors, hospitals, pharmacies and specialists throughout the country.
The insurance waiver Information for Fall 2020-21 is available on the Emory University Student Health website at http://studenthealth.emory.edu/insurance/waive.html.
You can enroll your Dependents or in the Fall Continuation Plan by clicking on the Enroll button below.
What’s New This Year!
- Annual premium - $3,816
- 4-tier Pharmacy copay structure - $15 / $30 / $45/$150
- Preferred Care annual deductible: $400 per policy year
- Non-Preferred Care annual deductible: $600 per policy year
- Emergency Room copay: $150 per visit
- Urgent Care copay: $25 per visit
- Annual Preferred Care Out of Pocket Maximum: $7,000 individual/ Family $14,000
- Insurance Waiver Verification – Administered by Aetna Student Health
- Waiver deadline extended to September 15th (Appeals process no longer available)
- Once again, automatic annual Dental PPO coverage upon enrollment in the medical plan.
School of Medicine and Two-Year MBA Students
| Annual 07/15/2020 - 07/14/2021 | Spring/Summer 01/01/2021 - 07/14/2021 | Summer 05/18/2021 - 07/14/2021 | |
| Student Only | $3,816 | $2,038 | $607 |
| Spouse Only | $3,816 | $2,038 | $607 |
| Child | $3,816 | $2,038 | $607 |
| Children | $7,632 | $4,076 | $1,214 |
International Students and PA Students
| Annual 08/01/2020 - 07/31/2021 | Spring/Summer 01/01/2021 - 07/31/2021 | Summer 05/18/2021 - 07/31/2021 | |
| Student Only | $3,816 | $2,216 | $784 |
| Spouse Only | $3,816 | $2,216 | $784 |
| Child | $3,816 | $2,216 | $784 |
| Children | $7,632 | $4,432 | $1,568 |
All Other Schools
| Annual 08/15/2020 - 08/14/2021 | Spring/Summer 01/01/2021 - 08/14/2021 | Summer 05/18/2021 - 08/14/2021 | |
| Student Only | $3,816 | $2,362 | $930 |
| Spouse Only | $3,816 | $2,362 | $930 |
| Child | $3,816 | $2,362 | $930 |
| Children | $7,632 | $4,724 | $1,860 |
To obtain the terms of your Plan Design and Benefits Summary click on one of the links below. You also can contact us at the number on the back of your member ID card.
If you are not an existing member, for additional information on the terms of the Plan Design and Benefits Summary, please contact 877-261-8403.
The plans described in the below summary documents are pending approval by the state insurance department. If changes are made as a result of the approval process, revisions will be posted.
Summary of Coverage
The Northwestern University Student Health Insurance Plan (NU-SHIP) complies with all Patient Protection and Affordable Care Act (ACA) requirements for student health insurance plans. There are no exclusions for pre-existing conditions for this plan.
The plan year runs September 1–August 31. Annual benefits apply to services received during this period of time.
NU-SHIP: What's Covered at a Glance
Does Aetna Cover Emergency Room
| Type | Description | Preferred Care (In-Network Provider) | Non-Preferred Care (Out-of-Network Provider) |
|---|---|---|---|
| Plan Deductible | Amount you pay for medical costs, before NU-SHIP begins to pay for covered services. | $250 | $500 |
| Annual Out-of-Pocket Limit | Amount you pay out of pocket before NU-SHIP pays 100% for covered health benefits, subject to any benefit maximums or limits that may apply. (Applicable co-pays and deductibles will be applied to out-of-pocket maximum.) | $2,000 (individual) / $4,000 (family) | None (you are encouraged to use only in-network providers) |
| Co-insurance | The percentage of covered medical expenses that you are responsible for. | 20% of negotiated rate | 40% of allowable expenses |
| Co-payment | Specified dollar amount you pay for certain covered medical expenses. (Prescription Drugs ONLY!) | see below | see below |
Inpatient/Outpatient Medical Expenses | See Plan Guide for details | Aetna pays 80% of negotiated charge | Aetna pays 60% of recognized charge |
| Physician Office Visit | Note: $50 penalty incurred without referral from NUHS | Aetna pays 80% of negotiated charge | After $20 co-pay per visit, Aetna pays 60% of recognized charge |
| Outpatient Mental Health | 80% of the negotiated charge per visit. Maximum patient responsibility of $20 per visit. No policy year deductible applies. | $20 copayment then the plan pays 80% of the balance of the rrecognized ccharge per visit thereafter. No policy year dedeductible applies. (Please note if the recognized charge is less than the provider's full charge, the student may be responsible for additional costs.) | |
| Emergency Room | $100 co-pay (waived if admitted) then, Aetna pays 80% of negotiated charge | Aetna pays 80% of recognized charge | |
| Prescription Drugs | Each prescription fill: | Deductible per supply of 50% of recognized charge | |
| Routine Physical Exam | Includes routine vision and hearing screenings given as part of the routine physical exam | Aetna pays 100% of negotiated charge | After $20 deductible per visit, Aetna pays 60% of recognized charge |
Is There A Copay For The Emergency Room
For a brief summary of benefits, download a copy of 2021-21 NU-SHIP Pamphlet
For detailed medical coverage info, download a copy of the 2020-21 NU-SHIP Plan Design & Benefits Summary
Additional Benefits
Students enrolled in the NU-SHIP have access to the following benefits:
- International global emergency services, including medical consultation and evaluation, medical referrals, foreign hospital admission guarantee, prescription assistance, lost luggage assistance, legal and interpreter assistance, and travel information such as visa and passport requirements and travel advisories.
- Medical evacuation and repatriation coverage (this benefit meets the requirements of the U.S. State Department for international students and dependents on the J-1/J-2 visa).
- Access to Vital Savings for Dental® at a substantially reduced annual rate ($26). This program provides 10-30% discounts on selected services.
- Discounts on Vision services, including eye exams and glasses/contact lenses.