Aetna Student Health Insurance International Students Student Health Insurance Coordinators

What you need to know about Aetna Student Health Insurance Enrollment/Waiver Process Coverage of Dependents Summary of Benefits Prescription Coverage Traveling Abroad Optional Health Discounts Aetna Navigator

Medical Coverage

Enrollment/Waiver Process Students are automatically enrolled in the medical insurance plans each semester and the cost of the student premium is billed to the Bursar account. Should you need to waive coverage, waiver forms can be submitted through iStart within 10 days of the start of classes at your campus. Student Medical Premium Fall $623 Spring/ Summer $921

Coverage of Dependents If you are covered by the International Student Insurance Plan, you may also enroll your spouse/same sex domestic partner (residing with the insured member) and dependent children under age 26. Dependent Enrollment Deadline Fall: September 15, 2015 Spring: January 31, 2016 Medical Premiums Spouse Child Children Fall $623 $1,246 Spring/ Summer $921 $1,842

Summary of Benefits Preferred Non-Preferred Annual Deductible $500 per Person $750 per Person IUPUI Health Services No Deductible - 100% after a $15 copay IUB Health Center Office Visit 100% after a $25 copay 50% Urgent Care 100% after a $50 copay Hospital Room and Board 100% after a $200 copay Emergency Room 100% after a $100 copay Diagnostic Services X-Rays and Labs X-Rays: 100% after a $20 copay Labs: 100% after a $10 copay Ambulance Expenses 100% of actual charge for the services of a professional ambulance to or from a hospital, when required due to the emergency nature of a covered accident or illness.

Prescription Coverage Prescription Drug Expenses Preferred Non-Preferred Generic $10 Copay N/A Preferred Brand $40 Copay Non-Preferred Brand $60 Copay Need to contact Aetna Pharmacy Management? Call 1-800-AETNA-RX (1-800-238-6279)

Mail Order and Specialty Medications Aetna Rx Home Delivery is the prescription mail service for Aetna pharmacy benefit members. Use it to order your maintenance medicines by mail. These types of drugs treat chronic conditions such as arthritis, asthma, diabetes, high cholesterol, heart conditions, hypertension and others. For more information, contact Aetna Pharmacy Management. Aetna Specialty Pharmacy provides specialty medications and support to members living with chronic conditions. Visit www.AetnaSpecialtyRx.com for more information on how to order or talk with a pharmacist 24 hours a day, 7 days a week. Contact Aetna Pharmacy Management (APM) with questions at 1-800-AETNA-RX.

Additional Services and Discounts

Aetna Navigator Aetna Navigator is your member website to view personal claims and health information. It's secure, so your information is protected once you create an account. By logging into Aetna Navigator you can: Review who is covered under your plan. Request, view and print member ID cards. View Claim Explanation of Benefits (EOB) statements. Lookup the cost of common health care services and procedures to better plan your expenses. Research the price of a brand name drug and learn if there are generic alternatives. Find health care professionals and facilities that participate in your plan. Send an e-mail to Customer Service.

OnCall International Coverage While Traveling 24/7 Worldwide Emergency Travel Assistance 24/7 Emergency Travel Arrangements Translation Assistance Emergency Travel Funds Assistance Lost Luggage and Travel Documents Assistance Assistance with Replacement of Credit Card/Travelers Checks Medical/Dental/Pharmacy Referral Hospital Deposit Arrangements Prescription Drug Replacement Assistance Dispatch of Physician Emergency Medical Record Assistance Legal Consultation and Referral Bail Bonds Assistance Additional Benefits Unlimited Medical Evacuation and Repatriation Visit by Family Member/Friend during hospitalization $2,500 Emergency Return Home in the event of death or life threatening illness of a parent, sibling or spouse Up to $10,000 for Accidental Death and Dismemberment Benefits If you require medical assistance and are more than 100 miles from home call: Within the United States: 866-525-1956 Outside the United States: 603-328-1956

Aetna Discounts and Programs Aetna Vision Discount Program provides access to discounts on vision exams, lenses and frames when a member utilizes a provider participating in the EyeMed Select Network. Beginning Right Maternity Program provides you with information on how to make healthy choices for you and your baby. Aetna’s Beginning Right Maternity Program helps prepare you for the exciting changes pregnancy brings. Quit Tobacco Cessation Program helps you say good-bye to tobacco and hello to a healthier future! The one-year Quit Tobacco program is provided by Healthyroads, a leading provider of tobacco cessation programs. You’ll get personal attention from health professionals that can help find what works for you. Aetna’s Informed Health Line you can call toll free 1-800-556-1555 24 hours a day, 7 days a week. Get health answers 24/7. When you have a Aetna health insurance plan, you have instant access to the information you need. For more information about available discounts and programs register at Aetna Navigator.

Questions?

Contact Information Information about this plan and a copy of this presentation can be found at: http://hr.iu.edu/benefits/student-internat-2015-16.html Melissa Williams and Shana Wigington Email: studenhc@iu.edu Phone: 812-856-4650 Appointments can be made to speak with us at anytime during the year. Please contact us at the information above to make your appointment.