Family Premium Costs	Year	Term
Student & Spouse	$3032	$1010
Student & 1 Child	$2357	$ 785
Student, Spouse & 1 Child	$4342	$1447
Student & 2 or more children	$2988	$ 995
Student, Spouse and Children	$4973	$1657

Coverage Periods	Begins	Ends
Annual	9/11/2008	9/10/2009
Fall Term	9/11/2008	1/04/2009
Winter Term	1/05/2009	3/29/2009
Spring/Summer Term (Covers Summer)	3/30/2009	9/10/2009
Summer Term Only	6/22/2009	9/10/2009

Eligibility

Spouses, domestic partners and unmarried children under the age of 19 are eligible for coverage on the UO insurance plan. The student must be covered by this insurance in order to insure family members.

Enrollment Periods

There are established health insurance periods during the first 3 weeks of each term. International students may enroll their dependents during these open enrollment periods only or within 30 days of the family member’s arrival in the United States.

Enrollment Process - The enrollment process for students insuring family members is handled through the Student Health Insurance office on campus. The student will need to provide dependents’ names and birthdays, complete an enrollment form and pay the premium.

Benefit Schedule

The following listing of benefits is a partial listing only and applies to dependents only.

Additional Services

Exclusions

The following listing of exclusions is a partial listing only.

Pre-existing Conditions - IMPORTANT - PLEASE READ

Covered medical expenses for a pre-existing condition are limited to a maximum of $2,000 during the first 6 months of coverage on the UO student insurance plan. Pre-existing conditions are any injury, sickness or condition that was diagnosed or treated within 6 months prior to beginning coverage on the UO student insurance plan. Treatment includes prescriptions for treatment of injury, sickness or a condition.

Deductible

There is a $50 deductible per accident/sickness. If an insured dependent sees a physician once or 3 times for the same medical problem, there will be only one $50 deductible. However, if an insured dependent sees a physician 3 times for 3 different illnesses/injuries, there will be a $50 deductible each time.

Type of Coverage

This plan provides coverage for treatment for illness and injury. The plan provides year round coverage including coverage during school breaks and over the summer. The plan does not include vision or dental coverage.

This plan attempts to balance benefit levels and premium affordability. Out-of-pocket expenses should be anticipated. The plan does not cover preventative or elective health care except as specifically noted in benefit details.

Area of Coverage

The plan provides coverage for treatment at the Health Center. Covers eligible medical expenses in the United States and abroad EXCEPT IN THE DEPENDENT’S COUNTRY.

Preferred Providers

A Preferred Provider Organization (PPO) is a network of physicians, hospitals and other health care professionals who have contracted with an insurance company to provide care at a set reimbursement rate in an effort to reduce costs to patients. The Preferred Provider Organization for the UO Student Health Insurance plan is Aetna. It is always to your advantage to use Aetna Preferred Providers whenever you receive medical care. The discounts granted by Preferred Providers saves you money. Click here to find Aetna Preferred Providers.

Student family members need to select a Primary Care Provider in the community to coordinate their medical care. There are many Primary Care Providers in the Eugene area who are Preferred Providers for this plan.

If your Primary Care Provider decides that you need specialized care not available in his/her office, your Primary Care Provider will refer you to a specialist. There are many specialists in the Eugene area that are Preferred Providers for this plan. You need to request that your Primary Care Provider refer you to a specialist you is a Preferred Provider for this plan.

Medical Care outside the Eugene Area

Physicians - When a dependent is outside the Eugene area, they may receive care from ANY licensed practitioner and payment for covered medical expenses will be made at 100% of the reasonable charge (after the deductible has been met). However, it is always to your advantage to use Preferred Providers when you receive care because it will save you money.

Hospitals/Surgery - If a dependent is going to have a non-emergency hospital stay or an elective surgery, they do need to find the hospitals or outpatient facilities in their area that are Preferred Providers. Benefits will be reduced to 75% of the reasonable charge if the student does not use Preferred Provider facilities.

Lab/x-rays/CT scans, MRIs, etc. - Dependents do need to find the hospitals, outpatient facilities, labs, imaging facilities, etc., in their area are Preferred Providers. Benefits will be reduced to 75% of the reasonable charge if the student does not use Preferred Provider facilities.

Medical Bills & Filing Insurance Claims

It is the responsibility of the insured person to provide insurance information to medical providers when receiving medical care. Show the insurance ID card whenever receiving medical care. The insurance card lists the policy number and billing address.

If an insured dependent pays cash for any medical services, you will need to provide the Health Insurance Office with receipts.

Insured dependents must pay cash for all prescriptions. Outside pharmacies CANNOT bill the student health insurance for your prescriptions. You will need to provide the Health Insurance Office with the receipts from the pharmacy in order to be reimbursed.

All charges incurred with a medical provider are owed to that provider. It is the responsibility of the insured to make arrangement to pay the deductible and copayment to the medical provider who provided the medical care.

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