Residence Life and Student Leaders Guide - Health Insurance

To obtain insurance, an individual pays a predetermined sum, usually once a year. Most people who are employed in this country have their insurance paid all or partly through their employers, often for a monthly fee deducted from their paycheck. Rutgers University offers students some special health insurance benefits which are generally less expensive and more appropriate for students' needs than commercial insurance plans. 

International students studying at Rutgers are required to obtain complete insurance. Listed below are commonly asked questions regarding health insurance for Rutgers University students.

Who is covered by the Rutgers Student Health Insurance plan?

All full-time students (registered for 11.5 or more credits who have paid full-time student fees) are automatically covered for "basic" health insurance benefits. Part-time students and University College students may purchase this health coverage. Students who are graduate or teaching assistants receive a different health insurance package from the university which includes the option of having your health care provided by a health maintenance organization (HMO) or by a comprehensive health insurance coverage, such as "Blue Cross/Blue Shield." With most HMOs, you receive all health care at one location, pay a monthly or annual fee (often directly from your paycheck) and pay nothing or a small fee at each visit to the clinic. With comprehensive insurance, you usually go to a specific doctor, pay him/her, then submit the bills to the insurance company to be reimbursed later. If you are a TA of a GA, check with your department benefits coordinator to find out more about these options.

As a student, what type of insurance do I receive?

All eligible students are covered by the BASIC plan. The basic plan in additional coverage beyond any other insurance you have. What this means is that if you have other health insurance, you submit medical bills to those companies first for payment. If you have no other insurance, the BASIC plan is your primary coverage. The Rutgers Student Health Service strongly recommends having additional insurance in the event of a major illness or injury (see "additional insurance"), if the BASIC is your only coverage. Rutgers students having basic insurance are entitled to receive their health care at the student health centers on campus.

When does coverage begin and end under the BASIC plan?

Coverage begins with the start of the fall semester, and continues until just before the spring semester (about January 20). Coverage for the spring term is effective just after the fall coverage ends and continues through the end of August.

How much am I covered for under the BASIC plan?

The maximum coverage for expenses incurred due to injury is $5,000 per injury provided that treatment is received within 90 days of the initial accident. The maximum benefit for sickness is $5,000, provided that treatment is received within 12 months from the date of the first treatment for the sickness.

If I have to go to a community hospital, am I covered?

Many of your hospital expenses will be covered by your insurance including room and board, hospital miscellaneous expenses such as pre-admission testing, surgical expenses, anesthetist expenses, etc. (Note that the basic plan will only reimburse you up to $5,000 per illness.) There also are limits on various policy coverage.

If I feel sick (and it is not a medical emergency), where should I go for treatment?

Students should seek treatment first at one of the health centers. If you are uncertain what to do, call (732) 932-7401 to talk with a clinician about the most appropriate care.

How do I obtain the additional insurance?

The Rutgers University Student Health Services offers two MAJOR MEDICAL PLANS for those students who have the basic plan and want to be insured in case of a major illness or injury. It is very important that all students have this plan or one with similar coverage for $50,000 or $100,000 of coverage, covering you from September until the following August. Payment of bills submitted to this plan begins after you have used the maximum benefit per service from your basic insurance. Then, you must pay $250 of your bill (this fee is called a "deductible") after which the insurance company then pays 80% of usual and customary fees.

What is NOT paid for by the BASIC insurance plan?

While you should check a copy of the policy for a more specific list, some of the more common things that the BASIC plan does NOT cover are :

• Dental treatment, except as a result of an accident.
• Routine eye examinations, preventative medicines, serums or vaccines, and allergy testing.
• Injury or sickness resulting from the use of a narcotic unless administered on the advice of a doctor.

Are spouses/domestic partners, and children of students covered under the policies?

Insured students may also insure their dependents for an additional fee.  Eligible dependents are the spouse or domestic partner and unmarried children under 19 years of age, who are not self-supporting.  For a spouse/domestic partner and any eligible dependents to obtain coverage, the student must first be enrolled in the insurance plan.

Basic coverage is available for service rendered at the Rutgers University Health Centers.  If you purchase the Basic Coverage, Major Medical is also available for an additional premium for the spouse/domestic partner and any eligible dependents.  Spouses/domestic partners are able to utilize the services at the health centers; coverage is very limited for children of insured students.  Children are not eligible to use the health centers' clinical services at this time.

For detailed information on coverage for students, spouse/domestic partners, and any eligible dependents, please contact the insurance office at (732) 932-8285. 

BASIC health coverage costs $580/year for a spouse/domestic partner and $245 for each child. MAJOR MEDICAL insurance costs $190/year ($50,000 coverage) for either a spouse/domestic partner or a dependent. Premiums can also be paid by semester at an additional cost.

How and when do I submit bills to be reimbursed for my medical expenses?

A student can obtain a insurance "claim form" at any student health center, or from the student health insurance office (Hurtado health Center, third floor). Fill out the claim form, attach a copy of the medical bill to it, and give them to the Student Health Insurance Office within 30 days of the injury or treatment.

Health Care and Health Insurance is important, and it can be confusing, but don't worry. Call the Office of Student Health Insurance at (732) 932-8285 to get all of your insurance questions answered. Janet Wisniewski can be contacted at this number to help you with any of your insurance problems. Insurance packets and further information can be found in Hurtado at the Office of Student Health Insurance.