Medical Care at WKU and Insurance Presented by: Linda Heady, MBA Benefits Administrator

Things you should know about the US Health Care System: The system is privately funded, not government sponsored or socialized Payment is the responsibility of the individual, with or without health insurance Even with health insurance, medical treatment in the US can be very expensive. Without health insurance medical treatment can be extremely expensive Before you visit a doctor, hospital or facility, always check to see if your insurance will be accepted.

More info about US Health Care Keep copies of all bills and papers for at least one year. You can ask a second doctor for an opinion before getting treated Inform your doctor about the conditions and medications you have had in the past You can ask the doctor questions about your conditions and medications you have had in the past

What do I do if I get sick? Monday: 8:00am – 6:00pm Tuesday: 8:00am – 6:00pm Wednesday: 8:00am – 6:00pm Thursday: 8:00am – 6:00pm Friday: 8:00am – 12:00pm Saturday: 8:00am – 12:00pm Call 270-745-CARE [2273] for Appointment or Walk in Documentation of your visit can be provided upon request.

What if WKU Health Services is closed? Go to: Urgent Care: 8AM – 8PM everyday Phone: 270-781-3910 Cost is $50 Greenwood Clinic: 8AM-6PM Mon-Fri, 8AM-2PM Sat Phone: 270-843-5662 Cost is $50

What to do in an EMERGENCY? Call 911 Go to the Hospital: Greenview Emergency Room (Hospital): Phone 270-793-1000 Medical Center Emergency Room (Hospital): Phone 270-745-1000 Cost is at least $250 or more depending on the number of services required.

Welcome Lobby

Laboratory

Patient Exam Room

X-Ray

Services Provided Men’s and Women’s Health Wellness Examinations Immunizations Laboratory Tests Medications Psychiatric Mental Health Birth Control/Contraceptives STD Testing Women – Yearly Exams Allergy injections X-Rays

Counseling Services offered at WKU Monday thru Friday from 8 a.m. – 4:30 p.m. Potter Hall, Room 409 Phone 270-745-3159 There is a ONE-TIME $20.00 fee for paperwork and documentation. After the one-time fee, students have unlimited access. Services are confidential and NO information is released without the student’s written permission, unless in an emergency situation. Individual and group counseling services are offered to help with coping strategies, conflict resolution, and crisis situations related to: College Adjustment Eating Disorder Decision Making Bipolar Disorder Problem Behaviors Stress Management Grief/Loss Depression/Anxiety Relationship Issues Suicide Prevention Sexual Assault/Abuse

I need to see the Doctor what should I do? Call 745-2273 to schedule an appointment with Graves Gilbert Clinic at WKU – if urgent, come directly to Graves Gilbert Clinic at WKU At appointment time, have a copy of your insurance card and photo identification.

United Healthcare Student Health Insurance – Major Medical Insurance Plan You will need to pay $840 in August for Fall 2015 Semester (coverage dates are August 1st through December 31st 2015. You will need to pay for health insurance AGAIN each semester.

United Healthcare Student Resources To access your account, go to www.uhcsr.com to “Create Your Account”. On this site, you can: Request an ID Card View/Print an insurance card Locate a Doctor View/Print proof of coverage

Insurance Terms Deductible – Dollar ($) amount you will need to pay before the insurance will pay. Co-Payment (Copay) – Specific dollar ($) amount you must pay at the time of service. Co-Insurance - Dollar ($) amount based on a percentage you must pay for services.

Insurance pays 100% at Graves Gilbert Clinic at WKU Preventative Care Annual Examinations Tobacco use screening and cessation Depression screening for adults Well women Exams Contraceptives/Birth control Immunizations/Vaccines Hepatitis, HPV, Flu, MMR, Meningitis, Pneumonia, Tdap, Varicella

Physician Office In-Network Provider (United Health Care) Health Services In-Network Provider (United Health Care) Out-of-Network Provider You pay $0 Insurance pays 100% (Except if you see the Psychiatrist, it will be a $50 copay) You pay $50 (copay) Insurance pays 75% and you pay 25%

Urgent Care or Emergency Room In-Network Provider (United Health Care) Out-of-Network Provider Urgent Care You pay $50 AHP pays 100% AHP pays 75% and you pay 25% Emergency Room (Hospital) You pay $250 AHP pays 75% - you pay 25%

Laboratory Health Services IN NETWORK United Health Care (If a complex Lab, Graves Gilbert Clinic it to Quest) OUT-OF-NETWORK You pay $0 AHP pays 100% Some of these include: UA, Glucose, CBC, Flu, Strep, Mono, Pregnancy Test, Wet Prep Stain, prep for fungal elements on skin $50 copay Some of these include: Pap Smears, Lipid Panel, Liver Tests, Comp Metabolic Panel, Gonorrhea & Chlamydia testing AHP pays 75% - you pay 25%

Hospital and Surgery Coverage IN NETWORK United Health Care OUT-OF-NETWORK Hospital Expenses AHP pays 80% of Preferred Allowance (You must first pay $250 deductible, then 20%) 60% of Usual and Customary Charges (You must first pay $600 deductible, then 40%) Surgery

Immunizations and Prescription Drugs Health Services IN NETWORK United Health Care Prescription Drugs Some medications available You pay $15 for generic You pay $30 for brand name

What happens after you go to the doctor? You will receive an EOB (Explanation of Benefits) from HealthSmart (THIS IS NOT A BILL)

Dental Care For those under age 21: Most services paid at 50% after meeting a $500 deductible. Pre-authorization is required for orthodontic services or any procedures over $300. FOR EVERYONE ON CAMPUS - Dental Hygiene Program operates a clinic on the 2nd floor of Academic Complex – Room 223 Services offered include: X-Rays, Sealants and Prophylaxis (Cleaning) Fee: $15 student, $20 non-student Call 270-745-2426 for appointment

Vision Care Services (for those under age 21) Spectra Eyecare Networks – these can be found by going to www.myuhcvision.com or call 1-800-638- 3120 Routine Vision Examination or refraction only in lieu of a complete exam – one per year Eyeglasses Lenses – Once per year Eyeglass Frames – Once per year Contact Lenses – Limited to a 12 month supply

Need assistance? Go to www.wku.myahpcare.com. Contact Linda Heady, at 270-745-5034 or by email at linda.heady@wku.edu. Call 855-247-2273 for assistance with your insurance questions.