Student health insurance is a fact of student life at Portland State, and the following information will give you the basics to understand your plan or to opt out in order to avoid unwanted charges to your student account.
All PSU students registered for five or more in-person credits (or one credit for international students) are automatically enrolled in PSU’s student health insurance plan through the Aetna Network. The cost of the plan is charged to each student’s account unless the student opts out of the plan by submitting an application for a waiver. International students can also choose to add spouses and children to their plans with a higher upfront payment.
What does it cost?
The cost of the insurance is $694 per term during fall, winter and spring, or $2,082 for the academic year. For students enrolled in the plan during spring 2015, coverage is added for summer 2015 at no additional cost. Students who need coverage for summer 2015 and are not enrolled in the plan during spring 2015 would pay $514 for summer term.
If you had PSU’s student health insurance during the last academic year, you’ll probably notice the cost exceeds that of the previous year by $100 a term. The Center for Student Health and Counseling’s website states that the rates and other changes are “impacted by Affordable Care Act (ACA) requirements including no medical maximum, no more pre-existing condition exclusions, ACA taxes, along with high utilization by students during both the 2012–13 and 2013–14 Academic Years.”
What is covered by my student health insurance?
Coverage includes, but is not limited to: emergency room care, physician visits, counseling, hospital stays and surgeries, diagnostic procedures, physical therapy and chiropractic care, prescriptions including birth control, transgender surgery, abortion and maternity expenses. Coverage for most types of care is 80–100 percent of the total cost after varying co-pays. Co-pays for routine visits to in-network physicians are $20 a visit.
Where can I use my insurance benefits?
When you receive your insurance information and medical ID card in the mail from Aetna, it will contain directions to locating network providers to fit your needs. You can also contact the insurance team at SHAC for assistance finding a provider, and you can visit SHAC and use any of their services. Most services at SHAC are covered by your student health fees and/or insurance.
How do I opt out of the plan?
To opt out of the plan, you must meet the eligibility requirements and complete a waiver by the deadline. For fall term 2014, the deadline is October 12. The eligibility requirements for domestic students are that you have a comparable insurance plan that has mental health coverage, prescription drug coverage, no more than a $2,500 deductible and at least 80 percent in-patient hospitalization coverage. If you have the Oregon Health Plan, your insurance makes you eligible to opt out. If you are an international student you must either have health insurance purchased prior to arrival in the U.S., insurance paid for by your government or embassy through an outside company or insurance through a family member’s U.S. employer.
Can I still use SHAC if I waive out of the insurance plan?
Yes. All students enrolled in five or more in-load, non-restricted differential tuition credits pay a student health fee associated with the costs of services you can receive at SHAC, which include physician visits, individual and group counseling, vaccinations, prescriptions, smoking cessation, acupuncture and more. Some services provided at SHAC may incur an additional fee.
How can I learn more about the student insurance?
Upcoming fall term 2014 insurance education events:
Sept. 25: Workshops and one-on-one drop-ins for questions and waiver assistance, at SHAC (Time to be decided, see website for updates.)
Sept. 29 through Oct. 10: SHAC insurance team help desk in SHAC, 10 a.m. to 4 p.m. weekdays for questions and waiver assistance. No appointment necessary.
Oct. 7 and Nov. 13: Insurance 101 workshop. 1 p.m. to 2 p.m. at SHAC.
For the fine print and detailed list of coverage, students can view the Student Health Brochure. Students can also contact SHAC’s insurance team with questions about their policy, waivers or claims at insurancehelp@pdx.edu or by calling (503) 725‑2495.