2017-2018 Student Health Insurance plan for Wheaton College F1 Visa Students
Who is eligible to be enrolled in the plan?
All F1 visa students are eligible.
F1 students who have lived in the United States accumulatively for 5 years or more may be eligible to opt out of the insurance. Please see explanation below.
Why is the plan mandatory for F1 Wheaton College students?
The reason is twofold. Wheaton College administration received feedback from international students indicating that the burden of securing health insurance in the U.S. as non-residents was too difficult while also navigating the beginning, or continuation, of attending school. In addition, U.S. insurance companies construct coverage plans and determine premiums based on various factors all related to a guaranteed size of enrollment for the plan. The mandatory requirement is a determination for the good of the international student community and not based on any one individual’s circumstances.
How do I get enrolled?
Wheaton College staff will identify and enroll students based on F1 Visa information.
What if I am already insured through another plan?
You may choose to remain insured under a different plan in addition to the plan arranged by Wheaton.
How do I pay for the insurance?
The charge (premium) for the fall semester will be placed on your main student account in mid-July for the coverage period of August 1 – December 31, 2017. The charge (premium) for the spring semester will be placed on your main student account in mid-December for the coverage period of January 1 – July 31, 2018.
How much does it cost?
Fall Semester Premium $645
Spring Semester Premium $903
Will I be covered under the plan after I graduate?
Students who graduate in December will only be enrolled for the Fall Semester coverage terminating at midnight on December 31, 2017.
Students who graduate in May will be remain covered until the end of the policy year at midnight on July 31, 2018.
Can I continue coverage after the policy terminates?
No, there is no option to continue coverage after graduating or after this policy terminates.
What health insurance do I need if I am a "resident alien"? An open letter to F1 Visa international students:
Dear international students,
International students are considered “non-resident aliens,” a status that has implications for your U.S. tax status. In general, non-resident aliens do not need to purchase an U.S. Affordable Health Care Act (ACA) compliant health insurance plan. Wheaton College automatically bills all non-resident alien international students for a non ACA compliant health insurance product that provides coverage for F-1 students while also excluding the conscience-violating practices and procedures included in ACA compliant plans.
However, when an F-1 student has been in the US for a total of 5 years or more she/he may become a “resident alien” for U.S. tax purposes. This means that purchasing ACA compliant health insurance coverage is required from an insurance company outside Wheaton College. If within the 2017-2018 calendar year you will have lived in the U.S. a total of five years or more, please contact email@example.com to request an exemption from the current Wheaton College sponsored health insurance plan. You will be directed toward resources that will assist you in purchasing an ACA-compliant healthcare plan. If you do not submit an exemption form you will be automatically billed.
The IRS has an excellent reference page of the application of the various ways in which a foreign student or scholar may be subject to U.S. taxation, including a set of examples (the first such example is especially helpful). Because your U.S. tax status is very specific to your individual circumstances, Wheaton College cannot be the monitor but rather are providing you with tools you need to monitor for yourself how your status in the U.S. affects your health care obligations by the U.S. Government.
The Plan Benefits
Where can I read about the plan?
To read a summary of the plan benefits please see the Schedule of Benefits page. This summary is provided as a preview and does not guarantee specific coverage.
Does the plan cover charges at Student Health Services at Wheaton College?
Yes, the plan contains special coverage benefits for a variety of office visits, immunizations, and laboratory tests at Student Health Services without an annual deductible. Due to these special arrangements, it is highly recommended that students begin the process of seeking primary care needs such as entrance medical requirements, preventive care, and non-life threatening sickness at Student Health Services.
Can I go to any doctor or hospital?
Yes. You can go to any provider; however, you can save money by seeing providers that participate in PHCS network because providers participating in this network have agreed to accept a predetermined negotiated amount. Locate a PHCS network provider
What if I have a pre-existing condition, are they covered?
Yes, pre-existing conditions are covered as any other covered illness or injury according to the plan. A pre-existing condition is a medical condition that started before a person's health insurance went into effect.
Does the plan have a deductible? What is a deductible?
The annual deductible (the amount that you will pay before the coverage begins) is $100 per person per plan year. A deductible is different and separate from the premium. The deductible does not apply for charges at Student Health Services.
How do I get my prescriptions filled?
This plan offers pharmacy coverage through Express Scripts up to $2,000 per plan year. Express Scripts is accepted at most major retail pharmacies. Pharmacy co-pay amounts are required to be paid at the time of purchase. To read more about the prescription medication coverage please see the Schedule of Benefits page.
Does this plan cover me when I am off campus?
Yes, the benefits of the plan cover you regardless of where you are in the United States.
Who can I talk to if I have questions about the plan?
Wheaton College is not the insurance company and cannot provide answers to specific coverage questions. However, if you need assistance finding information about the plan you can email them to firstname.lastname@example.org. For other contact information please see the Schedule of Benefits page.
How do I show a hospital or clinic that I have insurance?
Insured students will receive two insurance I.D. cards in their college post office box containing billing information for medical services and pharmacy medications. One card pertains to services within the United States and the other card marked “Global” pertains to services outside of the United States. In order to utilize the insurance coverage to pay for medical services or pharmacy medications the appropriate card, or information contained on the I.D card must be given to the provider before the services are provided.
Claims and Payment Processing
What is a claim?
Providers of medical services and supplies such as doctors, hospitals, and pharmacies have the ability to submit the charges for the services and supplies you receive to your insurance company for payment. This is called a claim. Each claim will generate a report called an “Explanation of Benefits.”
What is an Explanation of Benefits (EOB?)
The Explanation of Benefits, referred to as an “EOB”, is a report provided to an insured student by the insurance company by mail or online. The EOB lists each charge that was submitted to the insurance company for a given date of service(s). The report shows which charges are covered and how much was paid to the provider. The EOB will show any remaining amount, if any, you are required to pay to the provider. The provider will send you a bill for any amount that the insurance company did not pay and is the student’s responsibility.
Claims for medical services at Student Health Services
Claims for charges at Wheaton College Student Health Services will vary from claims at an outside provider’s office or hospital. Student Health Services will submit the claim for the charges for you, however, all charges for services will appear on your main Wheaton College student account.
How are the Student Health Services charges on my Wheaton College Student Account paid?
A payment called a “reimbursement” will be applied to your student account when it is received from the claims company. There may be a portion of the charges that are not covered based on the predetermined benefits of the plan. Please monitor your student account so you know how much you are required to pay. You are responsible for amounts remaining on your account after the insurance has made a reimbursement payment.
Are there Online Services available for the plan?
Yes, you are encouraged to create a personal log-in for claim management online at www.helpwithmyplan.com. You will need your Wheaton College student ID number. You may call ASRM at 844-898-8944 to learn about your coverage. If you have questions about a current claim, call ASRM at 1-800-359-7475.
Is any other information needed in order to pay a claim?
If the treatment you received was a result of an accident, you may receive a letter from the claims administrator asking for information about the accident, i.e. was it the result of a car accident, from playing sports, etc. Your claim cannot be processed without this information, so please respond to the letter promptly. You may also receive a letter asking you if you are covered by any other health insurance plan. It is important to respond promptly to this as well.