If you are an F-1 or J-1 international student or a J-1 scholar whose Form I-20 or DS-2019 was issued by the University of Michigan (Flint), you are required to have health insurance coverage for yourself and any F-2 or J-2 dependents while at the University of Michigan. Health insurance coverage is coordinated through the UM-Flint International Center. This section provides information on the UM health insurance requirement and the UM International Student/Scholar Health Insurance (IHI) Plan.
Under direction from the IRS, carriers must attempt to solicit an SSN for all covered members (students, and dependents) beginning with the 2015 tax year (anyone who, at the time of solicitation letter mailing, that has coverage from 1/1/15-12/31/15) in preparation of mailing in January 2016 for Minimum Essential Coverage (MEC) that individuals must use to file their 2015 tax returns. Unfortunately, the IRS gives no relief for carriers to exclude anyone that are truly not going to have an SSN from these mailings. For 2015, Aetna also could not alter the solicitation to make it clear to international students that the solicitations may not apply to them (Aetna believes that will be the case in 2016 by the inclusion of a cover letter Aetna may add, though it still requires us to send the mailing three times)
Any international student who absolutely does not have any need to file an income tax return to the IRS can ignore the requests, but Aetna will have to continue to send them.
Using Health Insurance
- Traveling Outside the U.S.
- Prescription Drugs
- Important Phone Numbers
- Insurance Card
- Doctor Visits
- Bill From Doctor
If you should need medical attention when you are outside of the United States, this policy will cover the costs for those medical expenses, but you may have to pay for treatment when you receive it and submit a claim to the insurance company afterward. When filing a claim for medical treatment received outside the U.S., remember to keep all receipts of any bills paid and make copies of those receipts. You must send the original receipts to the insurance company, with the information listed under Bill From Doctor in order to be reimbursed.
- Prescription drugs are covered at 90%. If you purchase the medication at the University Health Services (UHS) or any other Aetna Pharmacy Management participating pharmacy, you will only be required to pay 10% at the time you buy your medication.
- Simply show your current insurance card or certificate to the pharmacist and they will bill Aetna directly, asking you only for 10 % or less of the cost. If for any reason your card is not accepted by the pharmacist, you will need to pay the entire amount and then submit a prescription drug claim.
- If you purchase medication at a pharmacy other than UHS or an Aetna Pharmacy Management participating pharmacy --or the pharmacist cannot see your enrollment in Aetna Pharmacy Management -- you will need to pay the entire amount and then submit a claim
- Prescription drug claim forms are available online. You will need to complete the form, include a copy of your receipt and the information about your prescription, and mail it to Aetna Pharmacy Management.
|Urban Health and Wellness Center||800-239-9697|
|UM-Flint International Center||810-762-0867|
During the International Student/Scholar Mandatory Immigration Check-In you received a temporary insurance certificate. Within 6-8 weeks, you should receive a permanent insurance card in the mail
- Keep your insurance ID card or certificate with you at all times. If you visit the doctor or the hospital, you will basked to show your ID card before receiving services
- You are still insured whether or not you have a permanent card, so your temporary insurance certificate will always work. The insurance company should send out "permanent" plastic insurance cards within 6-8 weeks of starting your plan. If you have not received your permanent card, you can call the insurance company at the number on the temporary insurance certificate (1-800-239-9697) to request a card and make sure they have your correct address on file. Press "1", then "2" at the prompts to talk to a customer service representative.
You can also print a temporary card immediately by registering at Aetna Student Health. Click on For Members > Aetna Navigator Member Website > Register for Aetna Navigator. You will be asked to enter your member ID number, which is "75" plus your U-M ID number.
- If you need to go to the doctor or the hospital before you receive your permanent ID card, simply use the temporary insurance certificate. If the provider has any questions about your coverage, the insurance company will verify your coverage over the phone. If you are not yet in the insurance company's records, you may refer the provider to the U-M International Center Health Insurance Office at 734.647.2303. We will be glad to verify your coverage over the phone.
This section provides information needed when you, your spouse, or your child must visit the doctor or hospital, or are referred to a specialist
If it is NOT AN EMERGECY, your least costly options depend on your status and age.
- For an inpatient non-emergency hospital admission, where you will be in the hospital admission, where you will be in the hospital for 18 hours or longer, you must notify the insurance company at least three (3) working days prior to admission in order to obtain Pre-Certification for the hospitalization. You, your doctor or the hospital must call the insurance company at 1-800-239-9697. The insurance company will ask you why you are planning to go into the hospital and will certify your visit over the phone.
- For an inpatient emergency admission, you must notify the insurance company by phone within one (1) working day of admission to the hospital. You, your representative, your doctor, or the hospital must call the insurance company at 1-800-239-9697.
- Pre-Certification or Notification for hospitalization is required by the insurance company. if you do not follow this procedure, the first $200 of the hospital bill will be your responsibility.
Preferred Provider Network
In all cases, it costs less to go to a hospital or doctor in the PREFERRED PROVIDER NETWORK (you can use any other hospital or doctor worldwide outside the Preferred Provider Network, at possibly slightly higher expense).The University of Michigan Health System in Ann Arbor is part of this network. To find other “Preferred Providers” and to find Aetna-network pharmacies, visit their web site Aetna or call 1.800.239.9697.
*In many cases, the doctor/hospital will bill the insurance company directly. If so, either you will not receive a bill at all or you will be billed for the portion of the services that the insurance company does not cover, such as the deductible.
Step 1: If you get something that looks like a hospital bill in the mail, make sure that it does not contain the words “insurance pending” or some other indication that the hospital has submitted the bill to the insurance company. If it does not, then move on to step 2.
Step 2: Call the hospital and ask them to bill your insurance company. You can give them the information on your insurance card/certificate. If the hospital refuses to send this bill or if it is not possible for them to do it, then move on to step 3.
Step3: Fill out an insurance claim following these instructions: Submit to the insurance company:
- All bills (make sure to keep copies of all bills for your own records)
- The patient's name and the insured student/scholar's name
- The ID number for the insured student/scholar
- The name of your university - The University of Michigan
- The policy number - 71146
After you have gathered the above information, send it to Aetna Student Health, and they will process the claim and determine the amount that the insurance will cover for your accident or sickness. The address is:
Aetna Student Health P.O. Box 981106 El Paso, TX 79998
If you have already paid for your treatment, the insurance company or the health care provider will then reimburse you for those services covered under your claim. If you have not paid for your treatment, the insurance company will pay the doctor/hospital directly. Be sure to make a copy of any documents that you send to the insurance company in case you have to follow up on the status of your claim.
For prescription drug claims, please refer to the Prescription Drugs section.
Coverage & Rates
- $1,000,000 per accident or illness
- 100% coverage up to $5,000 (after deductible)
- 80% coverage from $5,001 to $40,000
- 100% coverage from $40,001 to $1,000,000
*NOTE: The insurance company will pay these percentages of reasonable and customary costs. You will receive services at the lowest cost by going to a doctor or hospital in the Aetna Network, such as the University of Michigan Health System in Ann Arbor. You can find other doctors and hospitals in the network on the Aetna web site.
Deductibles are the minimum amount of money that you have to pay for a particular service
|If you are:||And you are first treated or referred by:||Deductible|
|International Student||Any other doctor/hospital or Emergency Room||$50|
Any other doctor/hospital or Emergency Room
|Spouse and Dependents age 10 or older||
Any other doctor/hospital or Emergency Room
|Dependents under age 10 (they cannot visit University Health Service)||
Any other doctor/hospital or Emergency Room
- 90% coverage for prescription drugs (excludes birth control, acne medicines)
- Costs of pregnancy and childbirth are covered. If the pregnancy began before enrollment in the IHI plan, some coverage limitations may apply. Please review the Pre-Existing conditions section What's Covered for more details
- Both inpatient and outpatient coverage (for example: hospital room and board, physician's fees, laboratory test, x-rays, ambulance, etc.)
- Some coverage for mental health problems and drug or alcohol abuse
- Routine eye exam once per policy year at University Health Service in Ann Arbor for $15. Visit UHS Eye Clinic in Ann Arbor for clinic hours and information about eye exam
- Medical evacuation and repatriation coverage
Insurance Premiums as of 8/6/2015
|Student or Scholar||$123.75||$1,485|
|Student or Scholar and One Dependent||$243.50||$2,922|
|Student or Scholar and two or more Dependents||$363.25||$4,359|
The rates above include both premiums for student health plan underwritten by Aetna Life Insurance Company, as well as University of Michigan's administrative fee.
The UM-Flint International Student/Scholar Health Insurance (IHI) plan only covers dental work needed as a result of an injury for a maximum of $250 per policy year. You can find more information on dental coverage on the “Outpatient Benefits” section of the “Summary of Benefits” table in the UM-Flint International Student/Scholar Health Insurance Plan Brochure. You can choose to enroll in the Vital Savings on Dental Plan. Click on “Dental Discount Program: Enroll” on the left. It is not insurance, but a discount plan that gives you a 15% to 50% discount if you go to a participating dentist. It only costs $25 per academic year, per person, and you can enroll in the plan online, using a credit card. You can find dentists in the network at Aetna DocFind. Complete the search fields using this information:
Provider Category: Dental Providers
Provider Type: All Providers
Plan: Vital Savings on Dental
Unfortunately, the UM-Ann Arbor Dental School doesn't participate in the discount plan.
Standards & Waivers
If you have insurance that is comparable to the UM-Flint International Student/Scholar Health Insurance (IHI), you can request a waiver of the health insurance requirement. If you plan to purchase insurance, please make sure your policy will meet these standards before you purchase it as many policies do not meet these requirements. Also, please remember that the IHI plan changes from time to time and so do the requirements for the approval of insurance waivers. Therefore, insurance that was acceptable in prior years may not be acceptable this year.
Applying for an Insurance Waiver
If you have another health insurance plan and you want to apply for a waiver, please make sure that your health insurance plan meets the standards below. Remember that coverage for all requirements must be available in the U.S.
UM-Flint Health Insurance Standards
- The following kinds of insurance plans are not considered to be comparable to the UM-Flint International Student/Scholar Insurance (IHI) and therefore are not acceptable:
- Travel Insurance is not acceptable. Travel insurance is in effect for a short period of time (60-90 days, for example) and is deigned for short trips. Insurance that you plan to substitute for the IHI Plan should be in effect at least through August 31 of the current academic year unless you plan to leave the University permanently before then
- Insurance that covers emergencies only is not acceptable.
- Insurance that pays for a patient's condition to be "stabilized" but then requires patient to be returned to the home country for treatment is not acceptable
- Coverage under MediShare (or other forms of cost sharing arrangements that are not true medical insurance) is not acceptable.
- Pregnancy must be treated as any other medical condition. Coverage for maternity/pregnancy must be provided regardless of your age or gender, or the age or gender of your dependents (this is to be in compliance with federal antidiscrimination laws, specifically Title IX of Education Amendments of 1972, as amended by the Civil Rights Restoration Act of 1987). Insurance plans that exclude pregnancy coverage or severely limit it will not be accepted.
- The insurance plan must provide medical benefits of $1,000,000 or more PER accident or illness. This amount must be available for each accident or illness. For example, a plan paying up to $500,000 for accident and $500,000 for illness would not be acceptable, or a plan that has a maximum benefit of $1,000,000 per policy year as opposed to per issue would not be acceptable either.
- The insurance plan must cover at least 80% of usual and customary charges in the Flint, Michigan area for hospital room, board, miscellaneous hospital expenses, physician expenses in and out of the hospital, ambulance service, outpatient labs, x-rays, and diagnostic tests. The plan may not contain specific limitations for the treatment of medical conditions relative to standard hospital or outpatient care. For example, an insurance plan that has limited coverage of hospital room and board to $500 or limited coverage of ambulance costs to $350 would not be accepted
- The insurance plan must cover at least 90% of usual and customary charges for prescription drugs
- The insurance plan must have a deductible of no more than $100 per accident or illness, or $150 per policy year.
- The insurance plan must cover both inpatient and outpatient mental health treatment and must cover treatment for substance abuse (both alcohol and drug abuse.) A specific level of coverage for mental health treatment is not required. However, coverage for mental health treatment should not be significantly lower than the coverage provided by the IHI Plan. The IHI Plan covers inpatient mental health treatment for up to 30 days per policy year per condition. 25 visits per year for outpatient mental health treatment are covered with a co-pay of $25 per visit (in network) or $50 per visit (not in network.
- The insurance plan must not contain major differences in coverage between the primary insured and dependents.
- There must be a U.S. phone number for the insurance claims agent.
- The plan must have a "medical evacuation to home country" benefit of at least $10,000 and a "repatriation of remains" benefit of at least $7,500.
NOTE: If your plan meets all other requirements you may purchase medical evacuation/repatriation coverage from University of Michigan-Flint for $30 per policy year (September 1 through August 31). Please contact the International Center.
If your insurance meets the requirements above and you can provide proof of this (such as your insurance plan's brochure), you can complete and submit a Health Insurance Standards and Waiver Form. If you are in Post-Completion Optional Practical Training (OPT), use the OPT Waiver Form. You can submit forms with supporting documents in person at the UM-Flint International Center. Please remember the insurance waiver requests cannot have a start date earlier than 30 days before the date you submit the form.
Special Note for Canadian Students: Health coverage provided by your Canadian province (OHIP, etc.) is not acceptable as a substitute for the UM-Flint International Student/Scholar Health Insurance Plan because it does not pay for the actual U.S. costs of health care.
Health insurance for international students and scholars is required at the University of Michigan, but here are situations where alternatives to the UM-Flint International Student/Scholar Health Insurance (IHI) Plan Coverage and Rates are accepted.
Insurance Provided as UM-Flint Benefit
You will be automatically enrolled in IHI when you attend the mandatory immigration check-in. If you have a job at the University of Michigan which provides insurance as a benefit or if you have a fellowship which offers GradCare, then you should enroll yourself and dependents in an insurance plan as soon as possible. If you have questions, ask your department administrator about enrollment procedures and health insurance plans that are available to you.
If your student account was charged for IHI, those charges will be reversed. However, you will need to notify the International Center about this change or submit a waiver form; it will not happen automatically.
If your other UM-Flint insurance becomes effective after the start date of the IHI plan, you will have to pay the whole month’s charge for IHI, and will be removed from IHI starting the next month.
Automatic Re-enrollment in IHI Plan
If your UM-Flint-paid insurance coverage ends before the end of your stay as an F-1 or J-1 student or scholar, you will be re-enrolled in and billed for the IHI plan. If you leave the University permanently before the end date of your I-20 or DS-2019, or leave the United States because you have decided not to complete your post-completion Optional Practical Training (OPT), you need to submit the appropriate Departure Form from the list below:
If you do not do submit a departure form, the International Center will not know that you have ended your F-1 or J-1 stay. You will be automatically re-enrolled in the International Student/Scholar Insurance Plan (and billed for the plan) if your UM-Flint-paid benefits coverage ends before your I-20, DS-2019 or (for F-1 students on Optional Practical Training) your OPT end date.
Private Insurance or Insurance Provided by a Sponsor
You will be automatically enrolled in UM-Flint IHI plan during your mandatory immigration check-in. If you would like to use your private insurance plan instead, or insurance provided by a sponsor, you can Apply for an Insurance Waiver . You must submit your waiver request form within 30 days of your check-in, or within 30 days of the start date of your new insurance plan. Your plan will only be approved if it meets UM-Flint Health Insurance Standards.
If your waiver request is approved, your IHI plan will be cancelled. Cancellation is retroactive (as of the beginning date specified on your request). The waiver request should have a start date no earlier than 30 days before the date you submit the form.
Automatic Re-enrollment in the IHI Plan
Waivers are only valid through the end of the academic year (August 31). You must submit a new waiver request form and documentation each academic year. If your waiver expires and you still have valid F-1 or J-1 immigration status, you will be automatically re-enrolled in IHI plan and your Wolverine Access account will be billed.
If you leave the University permanently before the end date of your I-20 or DS-2019, or leave the United States because you have decided not to complete your post-completion Optional Practical Training (OPT), you need to submit the appropriate Departure Form from the list below:
If you do not do submit a departure form, the International Center will not know that you have ended your F-1 or J-1 stay, and you may be billed for health insurance because you will be automatically re-enrolled in the International Student/Scholar Insurance Plan if your insurance waiver ends before your I-20, DS-2019 or (for F-1 students on Optional Practical Training) your OPT end date.