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Choosing A Plan

Your health and wellness is an essential part of your academic success while you are at Washington University in St. Louis.

Student Health Services provides excellent care for the evaluation and treatment of illness or injury, preventive health care, mental health services, and health education. Some SHS services have additional costs, such as laboratory tests, x-rays, procedures, etc.

The American College Health Association recommends that all universities require students to have adequate health insurance and what the benefit plan should include. Accordingly, Wash U offers a robust student health insurance policy for your convenience. We feel confident that our plan is one of the best student plans available. View a summary of the plan​.

Choosing Health Insurance

Which plan will be right for you?

You are the best person to decide this. You should be an informed consumer. Make sure you read the details carefully for high deductible or individual plans. Understand coverage for vision/dental/prescription drug care. It is also important that you consider what benefits are available if you need specialty care and diagnostic services and what care the plan excludes. Insurance plans for families must now provide coverage for children up to age 26. Some plans may provide adequate coverage while you are in the St. Louis area, others may not. Many plans cover “emergency” only care while you are away from your network of providers. This type of plan does not meet Wash U’s coverage requirement. It is important that you have in-network coverage in the Washington University in St. Louis Physicians Network and the Barnes-Jewish Hospital Network.

Three major categories need to be considered when choosing your health plan.

Please review the waiver criteria carefully to make sure you are adequately insured under Wash U’s requirements.

 

  • Network Coverage: All insurance plans have a specific network that is considered “in-network.” This means you must access certain doctors and hospitals in order to have a full benefit under your plan. You must make sure you have coverage in the Washington University Provider Network and the Barnes Jewish Hospital Network. Your coverage must include comprehensive inpatient and outpatient medical and mental health care. The student health insurance plan provides comprehensive in-patient and out-patient medical and mental health care in the St. Louis area, nationwide, and for travel abroad. The plan also provides emergency assistance for medical evacuation whenever a student is 100 miles or greater from home. This includes worldwide assistance.
  • Financial Issues: Every insurance plan has several financial pieces that must be considered when choosing a plan. These are:
  •  Premium
  • Deductibles
  • In-network and Out-of-network payments for care
  • Out of pocket expenses, including co-pays

All plans charge a premium based on the number of months you are purchasing insurance. In addition to paying this premium, you will have expenses for the care you incur.  

  • A deductible is the amount of money you must pay prior to any benefits being paid by the insurance company.
  • A co-pay is generally required up front at the time of service. Co-pays vary from plan to plan and also vary by service. You will also most likely have a different payment structure for accessing doctors, hospitals, radiology, etc from a list of “in-network” providers than from those not in network.
  • An out-of-pocket maximum is the total amount of money you are responsible to pay for medical expenses you incur during a policy year. Your plan will pay 100% of all medical expenses incurred once this amount has been reached.
  • Privacy Concerns: In the United States, once a person reaches the age of 18, they are considered an adult and do not need consent from a parent to seek medical care. Students who participate in the student health insurance plan provided by the university will be the “owner” of that coverage. Many times students express concerns about seeking care related to their privacy while seeking health care and how this works if they are on another person’s health plan.  All financial matters between SHS, the student and the student health insurance carrier will only be known to the student. Bills sent to other insurance carriers may be viewed by the owner of that plan, many times a parent. This should be a consideration in your decision for choosing a health insurance plan. We encourage parents and students to discuss privacy matters openly so it can be determined how to handle out of pocket costs for medical care and the explanation of benefits that will be sent from the insurance company once a claim has been paid should the student waive Wash U’s health care and remain on their parents’ insurance.
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