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Barnard Mental Health Insurance Information

         

Barnard's Mental Health Coverage

The new optional Barnard Student Health Insurance Plan is effective on August 22nd, 2013 and terminates on August 21st, 2014.

The benefits outlined below require a referral from Furman Counseling Staff.

Benefits are limited to $ 1,250,000 per condition per Policy Year.

Out of Pocket Maximum is $3,000 per Policy Year

For Biological Based Mental Illness[1]

Inpatient: 80% in-network, 60% out of network

Outpatient: 80% in-network, 60% out of network up to the Outpatient Aggregate Maximum2 per condition per Policy Year.

For Non-Biological Based Mental Illness

Inpatient: 80% in network, 60% out of network  up to 30 days per Policy Year.

Outpatient: 80% in- network, 60% out of network up to maximum of 20 visits per Policy Year.

For Alcohol Abuse & Chemical Dependency

Inpatient: 80% in- network, 60% out of network. Benefits will include 7 days for detoxification in any calendar year and 30 days inpatient days for rehabilitation in any calendar year.

Outpatient: 80% in network, 60% out of network. Benefits are limited to 60 visits per Policy Year, 20 of which may be used for family counseling.

USING YOUR AETNA STUDENT HEALTH INSURANCE

FOR THERAPY/PSYCHOPHARMACOLOGY OUTSIDE BARNARD

  1. You need a referral from the Furman Counseling Center Staff recommending you to a therapist or psychiatrist in the community. They will give you a referral sheet with the treatment provider’s information.  They will also go on-line and register this referral with Aetna Student Health.
  1.  Most mental health practitioners prefer you to pay their bill, and then submit to your insurance for reimbursement.  A few providers will agree to wait for the insurance payment.
  1. To access your coverage, simply send the bill, along with your identifying information (name, SSN, mailing address, copy of student ID) to:

                  Aetna Student Health

                  P.O. Box 981106

                   El Paso, TX  79998

  1. The Aetna Student Health policy is now your primary policy. If you are covered under your family insurance plan, you would submit the bills to them.

USING YOUR INSURANCE FOR MEDICATIONS

Take your prescription to the pharmacy, have them fill it, present your Aetna prescription card and pay $20 copay.

 

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[1] (Such biologically based mental illnesses are defined as (not limited to): Schizophrenia/ Psychotic disorder; Major Depression Bipolar Disorder, Delusional Disorder, Panic Disorder, Obsessive Compulsive Disorders, Bulimia, Anorexia; Children with Serious Emotional Disturbances Persons under the age of eighteen (18) years who have diagnoses of; attention deficit disorders, disruptive behavior disorders, or pervasive development disorders, and where there are one or more of the following: Serious suicidal symptoms or other life-threatening self-destructive behaviors; Significant psychotic symptoms (hallucinations, elusion, bizarre behaviors), or behavior caused by emotional disturbances that placed the child at substantial risk of removal from the household)

2The Outpatient Aggregate Maximum includes but is not limited to: Physician’s office visits, hospital or outpatient department or emergency room visits, durable medical equipment, clinical lab, or radiological facility

 

For more information regarding your Student Health Insurance benefits please read your Student Insurance Handbook or go to website for online services: www.aetnastudenthealth.com

    

Claims Administered by:

Aetna Student Health

PO Box 981106

El Paso, TX  79990

866-725-4396

www.aetnastudenthealth.com

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IF YOU OPTED OUT OF THE STUDENT HEALTH AETNA PLAN

Here's some guidelines to help you find out your family/parent's insurance coverage.

N.B.  Getting your money back from the insurance company will take organization and persistence.  Make an “Insurance” file now to keep copies of all documentation.

  1. Call the number on your insurance card.  Ask them the following questions: 

A: Do I have outpatient mental health coverage? 

B:  What is the coverage for in-network providers[1]?

C:  What is the coverage for out-of-network providers?

D:  What is the yearly maximum benefit ($ amt or # of visits)?

E.   Is there a deductible (amount you pay before insurance kicks in)?

2. If you have mental health coverage, and want to use your in-network benefit, obtain a list of providers for NYC, and bring it to your next appointment. We will pass the list around our staff so they can identify people they recommend.

3. For most therapists or psychiatrists who are out-of-network, you will need to pay them each month, then apply for your reimbursement.

4. You need to send their bill and possibly a claim form to your family insurance.  (Check if they require a claim form which you may be able to get off the internet.) 

 

[1] “In-network providers” refers to therapists/psychiatrists who have contracted with your insurance company to work for a set hourly fee.  A co-pay is usually a set amount you pay per session.  Partial payment means that you will pay a certain percentage of that provider’s fee.  “Out-of-network providers” refers to people not under contract with your insurance.