Health Insurance in the US

Health insurance in the U. S *Health insurance in the U.S. is complex and difficult to understand — even U.S. citizens have a difficult time understanding it! In the US health insurance is any program that helps pay for medical expenses. Insurance provides protection against the costs of medical services. Healthcare in the US is extremely expensive.

Do I need Health Insurance? St. Olaf requires that all students enrolled at the College have health insurance coverage. Each student must complete the waiver or enrollment form by 11:59pm Wednesday September 20, 2017. If the form has not been completed at that time, the student will be automatically enrolled in the St. Olaf insurance policy and the non-refundable $1,588.00 fee will be applied to your student account . You may already see the charge on your account, but if you waive by September 20, the charge will go away.

Have you enrolled or waived the St. Olaf Health Insurance? To enroll in the St. Olaf plan complete the enrollment form online (can leave SSN blank)

Have you enrolled or waived the St. Olaf Health Insurance? To enroll in the St. Olaf plan

Have you enrolled or waived the St. Olaf Health Insurance? 24-48 hours later you need to create your account Print Out and KEEP THE INSURANCE CARD

Have you enrolled or waived the St. Olaf Health Insurance? If you would like to waive (not enroll) in the St. Olaf Health Insurance… You have two and a half weeks to find another health insurance option, enroll in that program as you will need proof of your other insurance before you can waive on the website. Do NOT wait until the last minute!

Emiko will E-mail a chart with some example options…

Thinking about using Health Insurance from your home country? Does your health insurance cover medical expenses in the U.S.? What kinds of medical expenses are covered? (ex. doctor’s visit, prescriptions, emergency room, etc.) Are there any limits to how much can be covered by your health insurance? Ex. You pay $600 at the emergency room because you injured your ankle. However, your home country insurance only reimburses you $100, because that is what it would have cost in your home country. Can you afford to pay for medical costs in full in the U.S.? Most likely you will have to pay 100% of the medical cost at the time of service, and then apply for reimbursement from your home country’s health insurance. This can take time and initial medical costs can be VERY high. Will your insurance cover Medical Evacuation and Repatriation of Remains?

Summary of Health Insurance in the US If you need medical care while you are in the US, you should be prepared to pay to see a doctor, for the services and tests performed, and for the medication. Depending on what your insurance is, there will be doctors and clinics you can visit that are 'in your network'. Any care you receive 'out of network' will be more expensive. Dental and vision are not covered under St. Olaf Health Insurance. If you want these services you will need to pay more for additional plans. The maximum amount of money you will pay for Healthcare is called your out of pocket maximum. Until you pay this amount, you will be paying a percentage of the bill. Sometimes you will have a copay, which is a cost you must pay before you receive any service or medication. Other times you will get a bill in the mail which you can pay or submit a claim, to get the insurance to cover a portion. Health Insurance also covers Medical Evacuation and Repatriation of Remains.

Not feeling so good... Where should you go? Campus Health Services Doctor's Office Urgent Care Hospital Emergency Room If you have an emergency, choose any hospital. If you can, call the hospital and explain your problem. If the emergency is very serious, call 911 and the person who answers will tell you exactly what to do.

Handout from your handbook!

How to find a Doctor or Clinic -To find a doctor, call the number listed on your insurance card or go to the insurance company's website -For St. Olaf Health Insurance visit https://connect.werally.com/ or call 1-800-505-4160 for assistance.

Making a Doctor’s Appointment In order to visit a doctor, except for in emergency situations, you must make an appointment first. You may have difficulties scheduling an appoint. They will ask you detailed personal questions and questions about your insurance. You should be ready with answers to the following types of questions... -Reason for visit -Emergency Contact phone number -Date of Birth -Last 4 digits of SSN -Name of Heath Insurance -Policy number You must arrive for the appointment on time. If you cannot arrive on time or if you must change the appointment, inform the doctor’s office. You must bring a Photo ID and proof of Health Insurance to the appointment.

Prescription Medication If the doctor writes you a prescription for medication, you can't always get the medication at the doctor’s office/hospital. Often the doctor will send the request to the pharmacy you choose and you will have to pick it up. Students can pick-up medication at the Target or Cub Pharmacy (bus) or walk to Walgreen's. Please be prepared to pay a copay for your medication.

Prescription vs Over the Counter Prescription drugs: Over the Counter (OTC) drugs: Prescribed / requested by a doctor Bought at a pharmacy Prescribed for and intended to be used by one person Prescription drugs may help with severe symptoms. There are some prescription medicines that are available as OTC medicines in lower dosages. Drugs / medicine that do NOT require a doctor’s approval Bought off-the-shelf in a pharmacy and in stores such as supermarkets or small convenience stores Some products are legally classified as OTC medications, although they are available only in a pharmacy “behind the counter.” Over-the-counter medications are fine for mild, occasional symptoms.

You get a HUGE bill. Now what? The first you will receive an explanation of costs. This will show all the charges for your visit. Please do not panic-it should clearly say, "This is not a bill.“ Next you will receive an Explanation of Benefits (EOB) in the mail. This will be from your health insurance provider, which will outline how much you owe. The insurance company will be paying a percentage of your expenses from doctor visits or medicine. Then, you will receive your bill. It should match the EOB. You must pay the doctor or pharmacy this amount. Please pay on or before the due date, otherwise you will be charged a late fee which will only increase the amount you owe. If you pay the entire bill before the EOB, if you see an out of network doctor, or if you get injured while playing sports you will need to file a claim. You must file a claim within 60 days of treatment. Mail all medical and hospital bills and the claim form.

Scenario You are on the St. Olaf International Student intramural soccer team. As you make the game winning goal, you collide with another player and hurt your ankle. You try to walk it off but decide you will need some medical care. What should you do? Where could you go? What if its 8pm and you don’t want to wait until tomorrow? What if your bone is sticking out your leg/foot?

You see a doctor and the fee just to meet the doctor is $600 and he gives you a prescription for pain medication that costs $80. Your Insurance Plan: In-Network Deductible: $100 Coinsurance: 20% Prescriptions: 50% How much will you have to pay?

Questions…