Health Insurance FAQs for Students

Health Insurance FAQs for Students

General Insurance Questions

Since there is a Student Health Center on campus, when/why would I need to see an outside provider?

The campus health center has nurses and counselors. The nurses do assessments and treatment for minor injuries or illnesses. However, if symptoms indicate the possibility of something more serious or something that may require a prescription for medication, you will be referred off-campus.

The counseling offered at SHACS is designed for short-term care. If you have need for more long-term care, we often refer off-campus. It is also possible you prefer an off-campus provider. You can meet with our mental health nurse to discuss your options as she works closely with all of the local providers.

When am I supposed to present my health insurance coverage to a medical provider?

You will need your insurance information with you when you go to your appointment with any off-campus medical provider. This includes rehab, pharmacy, emergency room, doctor’s office, chiropractor, etc.

What is co-pay? A deductible?

A deductible is usually a fix dollar amount that you have to pay out of your own pocket before the insurance will cover the remaining eligible expenses. The amount can vary depending on if your provider is in the insurance network.

Example: in 2017 the student health insurance had a deductible of $100 for in-network providers. That means you would need to pay $100 of a bill before insurance would cover anything.

A co-pay is a fixed amount of money you have to pay each time you need to use your insurance plan.

Example: Physician’s visits required a $10 copay for each visit.

What is the difference between and EOB and a bill?

The Explanation of Benefits (EOB) is a statement of charges created by your insurance company, usually after you have seen a provider. It includes:

  • details of services,
  • healthcare provider’s charges, and
  • how charges are processed by your insurance company.

A medical bill is a statement created by your healthcare provider of the amount that is owed by the patient. It can take over 30 days for you to receive the bill due to processing time and whether or not the provider had to send an appeal or documentation to the insurance carrier. The medical bill should show:

  • payments made at the time of service,
  • how much your insurance company paid, and
  • how much you owe.

I received a bill. I thought insurance covered this?

There are many possibilities.

  • Did you give the provider your insurance information?
  • Did the cost of the visit go to your deductible?
  • Was there a co-pay for the visit?

If you wish to discuss this, feel free to make an appointment with someone at SHACS to discuss it.

Where can I go for help understanding this paperwork?

Dustin Smith at Ramsey Weeks Insurance, 641-236-3141, can help Grinnell College students. You can also schedule an appointment with a nurse at SHACS. You can book an appointment online or at 641-236-3141.

After college, you can always call your insurance company and your medical provider with any questions.

Do I need to enroll each year?

Yes, you must enroll in health insurance every year. This is true for when you are in college and after you leave.

Grinnell College Student Health Insurance Plan Questions

I need my insurance card.

You must go online to access your card. See Instructions for using the Gallagher site.

Does Grinnell College profit financially from students who enroll in the Grinnell plan?

No, Grinnell College goes through a student insurance broker who negotiates with the insurance company. The plans are at cost for students.

Can I “waive” the Grinnell Health Insurance plan? What are the risks of doing so?

Yes, you can waive out of the Grinnell College Student Insurance Plan. You can find complete waive instructions on the cashier’s webpage.

You must have coverage by a U.S.-based insurance company and you must complete the online waiver process before August 14, 2018. If you do not waive, you will automatically be enrolled.

If you do waive it, please be sure that Grinnell providers are in-network. You can do this by calling the number on the back of your card or going to your insurer’s website. Please note that the Urgent Care in Grinnell bills insurance like a primary care provider. If your insurance only covers Urgent Care or ER visits, it will only cover ER visits in Grinnell.

 I tried to waive the Grinnell College Student Health Plan, but was denied. What does that mean? What do I do now?

The alternate coverage you provided is not sufficient coverage to qualify for a waiver. This is most likely due to out-of-state Medicaid or a plan outside the U.S. These plans will not cover you while in Grinnell. If you are not able to waive the insurance, you will remain enrolled in the Student Health Insurance through the College. If you have out-of-state Medicaid and would like to stay on Medicaid, you will need to apply to Iowa Medicaid. Please contact the Director of SHACS for more information at 641-269-3230.

What does the plan cover? (and what doesn’t it cover?)

You can access a plan summary or full copy of the health plan online.

What if I need the student insurance but can’t afford to pay for it?

You may contact Financial Aid at 641-269-3250 to see if you are eligible to receive assistance with this charge. The Cashier Office also provides monthly payment plans for students who would like to split their balance into smaller payments over time.

Does the health insurance plan apply over breaks? Does is apply outside of Grinnell, Iowa?

Yes. Coverage starts August 14, 2018, and ends August 13, 2019. Any medical events that happen between those dates can be submitted to the insurance company.

Yes, the student insurance plan is a national plan. You will need to check to see if your provider is in-network for United Healthcare.