www.NUGSA.com
Healthcare Information
The following information serves as an introduction to resources at Northwestern and does
not necessarily reflect the official policies of your department or The Graduate School.
Please refer to your program’s handbook for additional information and direct your questions
to the representatives at the websites and email addresses listed here. Let us know if you
have questions or if your need additional direction!
Updated 8/4/2010
www.NUGSA.com
THE MOST IMPORANT SLIDE
• If you have a serious or life-threatening emergency, call 911
and go immediately to the Emergency Room.
• If you are sick, need a TB test, bloodwork, etc.
• GO TO THE STUDENT HEALTH SERVICES!
– Evanston campus: www.nuhs.northwestern.edu/evanston/default.aspx
– Chicago campus: www-chicago.nuhs.northwestern.edu
• Don’t go anywhere else. Call and make a same-day
appointment. Examinations are typically free of charge to
those enrolled in the Northwestern Plan (they are your
“primary care provider”). Go elsewhere and you’ll pay a pretty
penny.
www.NUGSA.com
Student Health Services: Urgent Care
• If the situation is not life-threatening but urgent (you are sick and
cannot wait until the next appointment), let Health Services know
when you call them, or just go there directly and ask to see a nurse.
• Do not wait long to get treatment just because you are afraid it’s
going to be too expensive.
• If you have the NU Plan, Student Health Services can take care of
many things for free (cold, flu, urinary tract infections, food
poisoning, muscle strains, X-rays, lab tests, women’s health, and
others).
• If you are more than 100 miles from campus, call the On Call
Operation Center for assistance:
• Inside the U.S.: 866-525-1956
• Outside the U.S.: 603-328-1956
www.NUGSA.com
Student Health Services: Women’s Health
• Student Health Services provides annual women’s
health exams free of charge for students at the NU
Plan.
• Counseling is available through the Women’s Center.
• http://www.northwestern.edu/womencenter/counseling.html
www.NUGSA.com
Counseling and Psychological Services (CAPS)
• CAPS is staffed by a variety of dedicated
professionals devoted to providing the highest quality
mental health care and service to the Northwestern
University community.
• Get help with anger management, depression,
stress, self-esteem, substance abuse, and much
more.
• http://www.northwestern.edu/counseling/
www.NUGSA.com
Northwestern Plan
• All students are required to have health insurance
as a condition of class registration
• http://www.tgs.northwestern.edu/studentlife/health/
healthinsurance/
• Northwestern currently partners with Aetna to offer
subsidized insurance to graduate students
• Aetna has staff at the Evanston Student Health
Services who can help you with any questions
• N.B. It is always a good idea to carry your
insurance card with you at all times!
www.NUGSA.com
Basic Health Insurance Glossary
• Co-payment: a predetermined (flat) fee that you pay for health
services, in addition to what the insurance covers (e.g., $20.00 for
each office visit).
• Deductible: the yearly amount you must pay for health care
expenses before the insurance cover their portion of the costs.
• Premium: the cost of health insurance, i.e., the yearly amount you
pay a health care company to provide you with health insurance.
• Primary care provider: a health care professional who monitors
your all of your health care needs. If you are in the Northwestern
plan, the Student Health Services is your primary care provider.
• Referral: a document that your “primary care provider” provides you
when you need to seek additional / external care (e.g., physical
therapy, long-term mental health care, MRI).
www.NUGSA.com
Cost (2010-2011 Academic Year)
Student Premium: $2466
– TGS subsidizes premium for all PhD and MFA
students at 100%
– Masters students are subsidized at 50% or 65%
by TGS
– McCormick engineering students are subsidized
at either 100% by TGS (1st year students) or 65%
(2nd through 5th year students)
– Remaining amount is expected to be covered by
the student’s department, program, or advisor
www.NUGSA.com
Important Numbers
The current deductible is $250. That means you
need to pay $250 of your own money before Aetna
will pay for medical services on your behalf.
After the deductible is met, Aetna will cover 80% of
all costs for providers in their network.
You pay the remaining 20% of the costs, up to a total
of $1,000 a year.
That means the most you will pay out of pocket in any
given year is $1,250, which includes the deductible.
In addition, each visit to a healthcare provider has a
$20 copay.
www.NUGSA.com
Deductible
Examples of services that count toward the deductible:
Referrals outside of Student Health Services
Some lab tests
Physical therapy
Inpatient / outpatient hospital care
Specialized care (dermatologists, allergists, etc)
Services that do not count toward the deductible:
Prescriptions
Mental health care
Copays
Visits to Student Health Services
www.NUGSA.com
Aetna Website
• You can register your account on the Aetna
website:
• https://member.aetna.com/MbrLanding/login.fcc
?TYPE=33554433
• There you can check claim information, if you’ve
met your deductible, and update your profile.
• You can also use DocFind to search for doctors
that are in Aetna’s network of preferred
providers.
www.NUGSA.com
Referrals
• You need referrals to seek treatment for injuries, ailments,
etc.
• Aetna will likely NOT pay for treatments such as
rehabilition, chiropractic care, etc. if you do not have a
referral.
• Thus, go to Health Services, tell them what is wrong with
you, and get a referral.
• Check with DocFind to find an in-network provider
• Show them the referral and get treatment (which then
should be covered by Aetna, subject to the deductible and
80% coverage as described earlier).
www.NUGSA.com
Student Health Services / Health Portal
• http://www.nuhs.northwestern.edu/
• There are websites for both campuses.
• They have lists of free services and more insurance
information.
• You can call for an appointment or make it online:
https://www-
healthy.nuhs.northwestern.edu/login_directory.aspx
• This is your Personal Health Portal, where you can
make appointments, send messages to doctors, etc.
www.NUGSA.com
Hours of Operation
• Evanston:
• http://www.nuhs.northwestern.edu/evanston/appointm
ents.aspx
• Chicago:
• http://www-
chicago.nuhs.northwestern.edu/hourslocation.aspx
www.NUGSA.com
Pharmacy
• In Evanston, Northwestern has a pharmacy which
subsidizes common over-the-counter (OTC) and
prescription drugs to students.
• It’s also convenient if you’ve just had an examination
and need to pick up a prescription.
• Check out the list of subsidized OTC items:
• http://www.nuhs.northwestern.edu/evanston/otcitems.
aspx
www.NUGSA.com
NU Health Insurance Flow Chart
You need medical
attention.
Go to NU Student Health
Services
Go to sick call at local hospital or
emergency room depending on
severity of condition.
No charge
Prescription
Referral
Full charge
up to $ 250$20 copay, plus
20% of total charges up to $1000
Deductible
already met?
Go to external
care / clinic
Copay only:
$10 generic
$25 name brand
YES NO
You are on campus
during business hours
You are out of town or
it’s not business hours
www.NUGSA.com
Examples – Use Cases
Bob is an imaginary graduate student who uses his Northwestern Health
Insurance. He starts a new academic year with a new $250 deductible. The
fees exemplified below are fictitious and do not reflect real values.
www.NUGSA.com
1. Bob gets strep throat
– He goes to Student Health Services and sees a doctor (FREE)
– The doctor does a throat culture on Bob (FREE)
– The doctor prescribes antibiotics for Bob. He fills the (generic)
prescription at the Student Health Services Pharmacy ($10 copay, not
subject to deductible) *
– Total cost to Bob: $10
– Bob still has $250 left of his deductible
* Or at a participating pharmacy (a pharmacist can look at your Aetna ID card and tell
you if they honor our insurance). If Bob had filled his prescription at a non-participating
pharmacy, he would have had to pay for the full prescription cost when he filled it.
Then he would be able to submit a reimbursement form for 50% of the cost of the
drug, minus the co-pay. So if the full price of the prescription was $50, Bob would be
able to file a reimbursement for $20 (1/2 of $50-$10). Moral of this story: make sure
you fill your prescriptions at a participating pharmacy, it is a much better deal!!
Examples – Continued
www.NUGSA.com
Examples – Continued
2. Bob’s girlfriend gets a cat and Bob gets allergies
– He goes to Student Health Services and sees a doctor (FREE)
– The doctor gives Bob a referral to see an (in network) allergist* and makes a visit
• Cost of visit: $150 negotiated fee between doctor and Aetna; to be paid when
Bob gets billed by the doctor; $20 copay (does not count toward deductible)
– The allergist tests Bob’s allergies
• Cost of tests: $50 negotiated fee between doctor and Aetna
– Bob fills a prescription for a name brand allergy medication at a participating
pharmacy
• $25 copay (paid at time of purchase, does not count toward deductible)
– Total cost to Bob: $245 ($200 toward deductible; $50 left of deductible)
* It is very important that you make sure that you see an in network provider! It is
not the responsibility of health services to check this. You can check it through the
DocFind on the Aetna website, or when you call to make an appointment just ask the
doctor if they are in the network. If they are not, you may use the same referral form to
make an appointment with any equivalent doctor (same specialty) that is in the
network.
www.NUGSA.com
Examples – Continued
3. Bob gets stressed over his qualifier and decides to seek help
for his anxiety
– Bob visits CAPS for a mental health referral (FREE)
– Bob is referred to a psychologist that he meets with weekly
• Cost of visit: $100 / cost to Bob: $25 per visit (Aetna covers 75% of mental health
visits; an unlimited number of visits are covered; no copays are charged)
• Mental health visits do not count toward the deductible
– Bob still has $50 left of his $250 deductible
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4. Bob has a surfing accident over spring break and ends
up breaking his arm and needing stitches … in California
– Bob visits the local emergency room for stitches and a cast
• Cost of treatment: $2000 – negotiated fee between hospital and Aetna
• Cost to Bob: $50 (remaining of his deductible), plus $390 (20% of the $1950
remaining cost)
• Bob may not need to pay this right away, he will probably receive a bill from
the hospital later
• Bob calls Aetna within 1 business day to alert them of his emergency room
visit
• When returning to campus, Bob schedules follow up care with Student
Health Services
– Now that Bob has exhausted his deductible for the year, he will
only have to pay 20% of other medical charges he incurs (up to
$1,000 total) plus copays
Examples – Continued
www.NUGSA.com
Dependent Care
You can enroll spouses or children in your Northwestern plan
(NOT subsidized, unlike student plans).
Spouse Premium: $4,932 per year
Child Premium: $3,085 per child per year
Northwestern does not prorate these for the academic year, so
if you wish to only have coverage for two quarters, you will
need to pay the entire annual premium.
Notice too that spouses cost twice as much as students.
For children, consider the All Kids Covered Program offered
through the state of Illinois: http://www.allkids.com/
Keep in mind that spouses and children are also subject to the
deductible and 80% coverage
www.NUGSA.com
Dental Insurance (Optional)
• You can register for dental insurance on Aetna’s
website:
• http://www.aetnastudenthealth.com/stu_conn/stu
dent_connection.aspx?groupID=812845
• The cost for the 2010-2011 academic year is
$171 per student.
www.NUGSA.com
Summary of Information
• We didn’t cover everything, so turn to this
website for more information or clarification.
• http://www.nuhs.northwestern.edu/evanston/insu
rance-returning.aspx