www.NUGSA.com

Healthcare Information

The following information serves as an introduction to resources at Northwestern and does

not necessarily reflect the official policies of your department or The Graduate School.

Please refer to your program’s handbook for additional information and direct your questions

to the representatives at the websites and email addresses listed here. Let us know if you

have questions or if your need additional direction!

Updated 8/4/2010

www.NUGSA.com

THE MOST IMPORANT SLIDE

• If you have a serious or life-threatening emergency, call 911

and go immediately to the Emergency Room.

• If you are sick, need a TB test, bloodwork, etc.

• GO TO THE STUDENT HEALTH SERVICES!

– Evanston campus: www.nuhs.northwestern.edu/evanston/default.aspx

– Chicago campus: www-chicago.nuhs.northwestern.edu

• Don’t go anywhere else. Call and make a same-day

appointment. Examinations are typically free of charge to

those enrolled in the Northwestern Plan (they are your

“primary care provider”). Go elsewhere and you’ll pay a pretty

penny.

www.NUGSA.com

Student Health Services: Urgent Care

• If the situation is not life-threatening but urgent (you are sick and

cannot wait until the next appointment), let Health Services know

when you call them, or just go there directly and ask to see a nurse.

• Do not wait long to get treatment just because you are afraid it’s

going to be too expensive.

• If you have the NU Plan, Student Health Services can take care of

many things for free (cold, flu, urinary tract infections, food

poisoning, muscle strains, X-rays, lab tests, women’s health, and

others).

• If you are more than 100 miles from campus, call the On Call

Operation Center for assistance:

• Inside the U.S.: 866-525-1956

• Outside the U.S.: 603-328-1956

www.NUGSA.com

Student Health Services: Women’s Health

• Student Health Services provides annual women’s

health exams free of charge for students at the NU

Plan.

• Counseling is available through the Women’s Center.

• http://www.northwestern.edu/womencenter/counseling.html

www.NUGSA.com

Counseling and Psychological Services (CAPS)

• CAPS is staffed by a variety of dedicated

professionals devoted to providing the highest quality

mental health care and service to the Northwestern

University community.

• Get help with anger management, depression,

stress, self-esteem, substance abuse, and much

more.

• http://www.northwestern.edu/counseling/

www.NUGSA.com

Northwestern Plan

• All students are required to have health insurance

as a condition of class registration

• http://www.tgs.northwestern.edu/studentlife/health/

healthinsurance/

• Northwestern currently partners with Aetna to offer

subsidized insurance to graduate students

• Aetna has staff at the Evanston Student Health

Services who can help you with any questions

• N.B. It is always a good idea to carry your

insurance card with you at all times!

www.NUGSA.com

Basic Health Insurance Glossary

• Co-payment: a predetermined (flat) fee that you pay for health

services, in addition to what the insurance covers (e.g., $20.00 for

each office visit).

• Deductible: the yearly amount you must pay for health care

expenses before the insurance cover their portion of the costs.

• Premium: the cost of health insurance, i.e., the yearly amount you

pay a health care company to provide you with health insurance.

• Primary care provider: a health care professional who monitors

your all of your health care needs. If you are in the Northwestern

plan, the Student Health Services is your primary care provider.

• Referral: a document that your “primary care provider” provides you

when you need to seek additional / external care (e.g., physical

therapy, long-term mental health care, MRI).

www.NUGSA.com

Cost (2010-2011 Academic Year)

Student Premium: $2466

– TGS subsidizes premium for all PhD and MFA

students at 100%

– Masters students are subsidized at 50% or 65%

by TGS

– McCormick engineering students are subsidized

at either 100% by TGS (1st year students) or 65%

(2nd through 5th year students)

– Remaining amount is expected to be covered by

the student’s department, program, or advisor

www.NUGSA.com

Important Numbers

The current deductible is $250. That means you

need to pay $250 of your own money before Aetna

will pay for medical services on your behalf.

After the deductible is met, Aetna will cover 80% of

all costs for providers in their network.

You pay the remaining 20% of the costs, up to a total

of $1,000 a year.

That means the most you will pay out of pocket in any

given year is $1,250, which includes the deductible.

In addition, each visit to a healthcare provider has a

$20 copay.

www.NUGSA.com

Deductible

Examples of services that count toward the deductible:

Referrals outside of Student Health Services

Some lab tests

Physical therapy

Inpatient / outpatient hospital care

Specialized care (dermatologists, allergists, etc)

Services that do not count toward the deductible:

Prescriptions

Mental health care

Copays

Visits to Student Health Services

www.NUGSA.com

Aetna Website

• You can register your account on the Aetna

website:

• https://member.aetna.com/MbrLanding/login.fcc

?TYPE=33554433

• There you can check claim information, if you’ve

met your deductible, and update your profile.

• You can also use DocFind to search for doctors

that are in Aetna’s network of preferred

providers.

www.NUGSA.com

Referrals

• You need referrals to seek treatment for injuries, ailments,

etc.

• Aetna will likely NOT pay for treatments such as

rehabilition, chiropractic care, etc. if you do not have a

referral.

• Thus, go to Health Services, tell them what is wrong with

you, and get a referral.

• Check with DocFind to find an in-network provider

• Show them the referral and get treatment (which then

should be covered by Aetna, subject to the deductible and

80% coverage as described earlier).

www.NUGSA.com

Student Health Services / Health Portal

• http://www.nuhs.northwestern.edu/

• There are websites for both campuses.

• They have lists of free services and more insurance

information.

• You can call for an appointment or make it online:

https://www-

healthy.nuhs.northwestern.edu/login_directory.aspx

• This is your Personal Health Portal, where you can

make appointments, send messages to doctors, etc.

www.NUGSA.com

Hours of Operation

• Evanston:

• http://www.nuhs.northwestern.edu/evanston/appointm

ents.aspx

• Chicago:

• http://www-

chicago.nuhs.northwestern.edu/hourslocation.aspx

www.NUGSA.com

Pharmacy

• In Evanston, Northwestern has a pharmacy which

subsidizes common over-the-counter (OTC) and

prescription drugs to students.

• It’s also convenient if you’ve just had an examination

and need to pick up a prescription.

• Check out the list of subsidized OTC items:

• http://www.nuhs.northwestern.edu/evanston/otcitems.

aspx

www.NUGSA.com

NU Health Insurance Flow Chart

You need medical

attention.

Go to NU Student Health

Services

Go to sick call at local hospital or

emergency room depending on

severity of condition.

No charge

Prescription

Referral

Full charge

up to $ 250$20 copay, plus

20% of total charges up to $1000

Deductible

already met?

Go to external

care / clinic

Copay only:

$10 generic

$25 name brand

YES NO

You are on campus

during business hours

You are out of town or

it’s not business hours

www.NUGSA.com

Examples – Use Cases

Bob is an imaginary graduate student who uses his Northwestern Health

Insurance. He starts a new academic year with a new $250 deductible. The

fees exemplified below are fictitious and do not reflect real values.

www.NUGSA.com

1. Bob gets strep throat

– He goes to Student Health Services and sees a doctor (FREE)

– The doctor does a throat culture on Bob (FREE)

– The doctor prescribes antibiotics for Bob. He fills the (generic)

prescription at the Student Health Services Pharmacy ($10 copay, not

subject to deductible) *

– Total cost to Bob: $10

– Bob still has $250 left of his deductible

* Or at a participating pharmacy (a pharmacist can look at your Aetna ID card and tell

you if they honor our insurance). If Bob had filled his prescription at a non-participating

pharmacy, he would have had to pay for the full prescription cost when he filled it.

Then he would be able to submit a reimbursement form for 50% of the cost of the

drug, minus the co-pay. So if the full price of the prescription was $50, Bob would be

able to file a reimbursement for $20 (1/2 of $50-$10). Moral of this story: make sure

you fill your prescriptions at a participating pharmacy, it is a much better deal!!

Examples – Continued

www.NUGSA.com

Examples – Continued

2. Bob’s girlfriend gets a cat and Bob gets allergies

– He goes to Student Health Services and sees a doctor (FREE)

– The doctor gives Bob a referral to see an (in network) allergist* and makes a visit

• Cost of visit: $150 negotiated fee between doctor and Aetna; to be paid when

Bob gets billed by the doctor; $20 copay (does not count toward deductible)

– The allergist tests Bob’s allergies

• Cost of tests: $50 negotiated fee between doctor and Aetna

– Bob fills a prescription for a name brand allergy medication at a participating

pharmacy

• $25 copay (paid at time of purchase, does not count toward deductible)

– Total cost to Bob: $245 ($200 toward deductible; $50 left of deductible)

* It is very important that you make sure that you see an in network provider! It is

not the responsibility of health services to check this. You can check it through the

DocFind on the Aetna website, or when you call to make an appointment just ask the

doctor if they are in the network. If they are not, you may use the same referral form to

make an appointment with any equivalent doctor (same specialty) that is in the

network.

www.NUGSA.com

Examples – Continued

3. Bob gets stressed over his qualifier and decides to seek help

for his anxiety

– Bob visits CAPS for a mental health referral (FREE)

– Bob is referred to a psychologist that he meets with weekly

• Cost of visit: $100 / cost to Bob: $25 per visit (Aetna covers 75% of mental health

visits; an unlimited number of visits are covered; no copays are charged)

• Mental health visits do not count toward the deductible

– Bob still has $50 left of his $250 deductible

www.NUGSA.com

4. Bob has a surfing accident over spring break and ends

up breaking his arm and needing stitches … in California

– Bob visits the local emergency room for stitches and a cast

• Cost of treatment: $2000 – negotiated fee between hospital and Aetna

• Cost to Bob: $50 (remaining of his deductible), plus $390 (20% of the $1950

remaining cost)

• Bob may not need to pay this right away, he will probably receive a bill from

the hospital later

• Bob calls Aetna within 1 business day to alert them of his emergency room

visit

• When returning to campus, Bob schedules follow up care with Student

Health Services

– Now that Bob has exhausted his deductible for the year, he will

only have to pay 20% of other medical charges he incurs (up to

$1,000 total) plus copays

Examples – Continued

www.NUGSA.com

Dependent Care

You can enroll spouses or children in your Northwestern plan

(NOT subsidized, unlike student plans).

Spouse Premium: $4,932 per year

Child Premium: $3,085 per child per year

Northwestern does not prorate these for the academic year, so

if you wish to only have coverage for two quarters, you will

need to pay the entire annual premium.

Notice too that spouses cost twice as much as students.

For children, consider the All Kids Covered Program offered

through the state of Illinois: http://www.allkids.com/

Keep in mind that spouses and children are also subject to the

deductible and 80% coverage

www.NUGSA.com

Dental Insurance (Optional)

• You can register for dental insurance on Aetna’s

website:

• http://www.aetnastudenthealth.com/stu_conn/stu

dent_connection.aspx?groupID=812845

• The cost for the 2010-2011 academic year is

$171 per student.

www.NUGSA.com

Summary of Information

• We didn’t cover everything, so turn to this

website for more information or clarification.

• http://www.nuhs.northwestern.edu/evanston/insu

rance-returning.aspx