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, your policy must:

  • Provide health coverage for the entire 2017-18 academic school year.
  • Provide benefits in the Metropolitan Atlanta area.
  • Licensed insurer and able to do business in the United States.
  • Provide inpatient and outpatient care (to include office visits and behavioral health care). Coverage for emergency only care does not satisfy this requirement (e.g. out-of-state Medicare is not acceptable).
  • Provide wellness visit benefits with no cost sharing
  • Cover treatment related to suicide or attempted suicide.
  • Provide major medical coverage at a minimum of 70% of the preferred allowance, with no maximum benefit.
  • Cover pre-existing conditions, without limits.
  • Individual annual deductible cannot exceed $2,500, or the plan has an HAS (Health Savings Account) which applies funds toward meeting an individual annual deductible of $2,500 or more.
  • Cover inpatient and outpatient mental health treatment as well as treatment for substance abuse (alcohol and drug abuse).
  • Provide prescription drug coverage at a minimum of 70% of the preferred allowance, with no maximum benefit.
  • Total out-of-pocket expenses cannot exceed $6,350 (U.S.) per policy year (the total sum of any deductible and coinsurance in-network)

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 08/15/17 to 01/14/18; spring plan coverage is from 01/15/18 to 08/14/18.

When will students receive their insurance coverage card?

ID cards will be mailed to the Wellness Center. When received, students will be notified via email to pick up their insurance cards.  Students who need to seek services prior to receiving their ID card can go to Aetnastudenthealth.com and follow the links for Agnes Scott College and print a temporary ID card or contact Aetna directly for pertinent information. Please note it is up to each individual provider to determine if they will accept the insurance or if they will require that the student pay up front and be reimbursed by the insurance company.

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 they will not be covered under the policy. Otherwise, they will be covered by the college-sponsored student health insurance plan through the end of the semester. Fall plan coverage is from 08/15/16 to 01/14/17; spring plan coverage is from 01/15/17 to 08/14/17.

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. 

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 2017-2018 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.