Insurance FAQ

What does “hard waiver” mean?

The term “hard waiver” means proof of comparable coverage must be furnished or the student will be automatically enrolled in the college-sponsored health insurance plan and the premium for that plan will be added to their tuition bill. “Hard waiver” does not mean a student must be enrolled in the Agnes Scott College-sponsored health insurance plan; it means a student must show evidence of adequate coverage by an acceptable health insurance plan. Being enrolled in the college-sponsored health insurance plan is one means to meet that requirement. Students are encouraged to compare the college-sponsored Aetna plan against other options, e.g., being a dependent on a parent’s health insurance plan or an employer’s health insurance plan. If no evidence of health insurance coverage is provided, the student will be automatically enrolled in the Agnes Scott College-sponsored health insurance plan. 

What is the Agnes Scott College-sponsored health insurance plan?

Aetna Student Health Insurance plan benefits include:

  • unlimited maximum benefit
  • no pre-existing condition exclusion
  • individual deductible per policy year: $250 in-network, $1,000 out of network
  • individual combined out of pocket maximum $2,500 per policy year
  • co-insurance: 80% in-network, 60% out of network with no internal maximums and wellness benefits payable at 100%

Who is required to show proof of insurance?

All domestic undergraduate, fifth-year and post-baccalaureate students are required to show evidence of an existing creditable health insurance policy, or they will be automatically enrolled in the college-sponsored health insurance plan. Students must actively attend classes for at least 31 days after the date for which coverage is purchased.

I already have health insurance. What do I need to do so I don't get billed for the college plan?

Students who are already covered by an insurance policy (i.e., through parent plans, family plans or employer-sponsored plans) will be able to go online and submit their insurance policy information for verification through the secure Aetna Website. No paperwork is required; once verified, the insurance fee is removed. Here is the link to start this process:  https://students.aetnastudenthealth.com/welcome.aspx?groupid=846572

How can eligible full-time students enroll in the college-sponsored health insurance plan?

Please visit the site listed below and follow the steps to accept coverage. 

https://students.aetnastudenthealth.com/welcome.aspx?groupid=846572

Can I utilize services at Agnes Scott College's Wellness Center if I waive the college-sponsored health insurance plan?

Yes, all registered students are eligible to utilize health services and counseling on campus.

How are the waivers monitored? What if a student does not enter correct insurance information in order to waive out of the college sponsored plan?

Waivers are monitored and verified by Aetna. Aetna will send an email message to students regarding acceptance or denial of waivers.

What insurance plan is acceptable?

Your plan should provide benefits similar to the college-sponsored student health insurance plan. In order to waive the student health insurance plan, the following criteria must be met under your current insurance plan:

  1. My plan is provided by a company licensed to do business in the United States.
  2. My plan provides major medical benefits with at a minimum of 70% of the preferred allowance with no maximum benefit.
  3. My plan’s total out-of-pocket costs do not exceed $7,150 (U.S.) per policy year. (Out of Pocket Costs is the total amount the insured pays for deductibles and coinsurance, in-network per policy year. This information will be listed in your policy.  If you cannot locate the benefit in your policy, please contact your provider). 
  4. My plan has an Individual Annual Deductible of $2,500 or less OR my plan has an HSA (Health Savings Account) which applies funds toward making the Annual Individual Deductible $2,500 or less.
  5. My plan covers pre-existing conditions with no limits.
  6. My plan provides prescription drug coverage at a minimum of 70% of the preferred allowance with no maximum benefit.
  7. My plan provides in-patient care and outpatient care (including office visits and behavioral health care) within a 50-mile radius of the Decatur Georgia area.  (If your plan covers emergency care only or is a Medicaid program from outside of Georgia, it does not meet this requirement and you must answer no to this question). 
  8. My insurance plan covers inpatient and outpatient mental health treatment, treatment for substance abuse (both alcohol and drug abuse, and treatment related to suicide or attempted suicide).
  9. My coverage will remain in effect for all semesters in which I am enrolled for the 2018-2019 academic year.
  10.  I agree that I will be held financially responsible for payment of all charges not covered by my health insurance plan.

Do I have to verify my insurance each semester?

No. All students must complete the waiver process only once per academic year, prior to Fall semester.

How can I enroll my spouse/domestic partner and/or dependent child(ren)?

If a student is enrolled in the college-sponsored student health insurance plan, coverage for eligible dependents (spouse/domestic partner and/or dependent child[ren]) may also be purchased. Application and enrollment deadlines are available at www.aetnastudenthealth.com.

What if a student waives out of the college-sponsored student health insurance plan and later loses their insurance that they had with their parents due to a job loss?

This would be a life status change, and students would be allowed to purchase the college-sponsored student health insurance plan within 30 days of the event. Inquiries regarding this process can be made by calling 800.922.3420.

What happens when I graduate before the plan ends?

When a student graduates, they are still covered by the college-sponsored student health insurance plan until the expiration date of the plan. Fall plan coverage is from 08/15/18 to 01/14/19; spring/summer plan coverage is from 01/15/19 to 08/14/19.

When will students receive their insurance coverage card?

Aetna is starting a new initiative for 2018-19 and will be Going Green in an effort to move away from mailing paper ID Cards to students. A welcome and introduction kit for students will be given Fall 2018. Please note, any student can still contact Aetna Customer Service and receive a paper ID card.

What if a student is enrolled in the college-sponsored student health insurance plan and then withdraws from school?

If the student withdraws from classes within 31 days of the first date of classes, they are not eligible for the college-sponsored plan and will not be covered under the policy. Otherwise, once enrolled the student is covered for and must pay the premium for the full 12 month contract (8/15/2018 – 8/14/2019) regardless of student status.

How do students who enroll in Agnes Scott College late (after the deadline date) obtain coverage or waive the plan?

Each request will be handled on a case-by-case basis.  Please email healthinsurance@agnesscott.edu or call 404.471.7100 for further assistance.

Do I need a referral from the Wellness Center before I go for treatment outside of Agnes Scott?

A referral from the Wellness Center is not required with the college-sponsored student health insurance plan. If a student goes to an off-campus medical provider, the student will be responsible for co-pays, deductibles and any portion of the bill not covered by the college-sponsored student health insurance plan. Students should verify with Aetna prior to scheduling an appointment to ensure that their provider is a part of the plan.

Does the college-sponsored student health insurance plan also cover treatment received outside of Georgia?

Yes, the college-sponsored student health insurance plan provides coverage in all 50 states, U.S. territories and foreign countries. Foreign nationals are not covered in their home country.

Will prescription drugs be covered on this plan?

Yes, prescription drugs are covered. Prescriptions dispensed through a preferred care pharmacy will be paid at 100% of negotiated charges following a $15 copay for each generic prescription drug, a $45 copay for each preferred brand name prescription drug or a $75 copay for each non-preferred brand name prescription drug. Prescriptions dispensed through a non-preferred care pharmacy will be paid at 80% of the recognized charge. The pharmacy benefit is provided to cover medically necessary prescriptions associated with a covered sickness or accident occurring during the policy year.

How can I find out if specific treatments or services are covered?

To view the college-sponsored student health insurance plan summary and a complete list of plan exclusions, click here and follow the link for 2018-2019 Plan Design and Benefits Summary.

Is dental coverage available?

Dental coverage for routine or non-injury services are not payable on the college-sponsored health plan. Benefits are payable if dental treatment is necessary due to injury. Specific benefits can be found under dental injury expense section of the brochure.

Whom do I contact with questions about a claim or using the college-sponsored student health insurance plan?

Please call Aetna directly at 855.821.9715.