Help Center

Enrollment Forms *	Plan Descriptions	Prescription Drug Program Information	Claim Forms
2008 Fall Session 2008-09 Dependent Enrollment Form	Summary of Benefits	YourChoice Rx Manual Rx Mail order Form	Medical Claim Form Pharmacy Claim Form

1. Who is required to have coverage?
2. I already have medical insurance. Do I need to enroll in the Loyola Health Care Plan for Medical and Graduate Biomedical Students?
3. I am currently enrolled in the student health insurance program and plan to continue my coverage for the next school year. How do I ensure my coverage is uninterrupted?
4. During the fall quarter I will be enrolled for only one class, but I will be enrolled for 12 undergraduate hours /8 graduate hours in the spring semester. How do I enroll in the plan?
5. How do I enroll my spouse or dependent children for coverage under the student health plan?
6. Who can I call for assistance with enrolling myself or my dependents in the plan?

1. Do I need to submit proof of other coverage every year?
2. Where can I obtain a waiver form?
3. Can I reverse my waiver if I change my mind after waiving coverage?

1. When does the new plan year start?
2. What is the term of the student health insurance?
3. When will I receive my health insurance ID card?
4. Why didn't I receive a health insurance ID card?
5. Will I get a new health insurance ID card next year?
6. I have a doctor's appointment in early August, how can make sure I am covered under the student health plan?
7. Please explain why the cost for student health increased again this year?
8. How much does dependent health care insurance cost?
9. Is the cost for health coverage included in my tuition?
10. Where can I find information on network providers?
11. Is there a pre-existing condition exclusion under the plan?
12. Who do I call if I have a question about benefits covered under the plan?
13. How do I file a claim?
14. Follow the steps below if you see a network provider:
15. Follow the steps below if you see an out-of-network provider:
16. Who do I call if UniCare denied my claim?
17. Does the plan cover prescriptions?
18. Is there a dental plan offered?
19. Does the student health plan have a vision plan?

1. When does my coverage end?
2. What are my options when my student health care expires or I graduate?

1. Who is required to have coverage?

Loyola University Chicago's Board of Trustees requires that the following students have individual health care insurance:

• All graduate students enrolled in the Biomedical Science program, and
• All students at the Stritch School of Medicine.

2. I already have medical insurance. Do I need to enroll in the Loyola Health Care Plan for Students?

No, however, you must complete a waiver to opt out of the Loyola Health Care Plan for Medical and Graduate Biomedical Students before the stated deadline to avoid unwanted charges on your student account.

3. I am currently enrolled in the student health insurance program and plan to continue my coverage for the next school year. How do I ensure my coverage is uninterrupted?

If you are currently enrolled to attend Loyola for the 2008-2009 academic year, you will be automatically re-enrolled in the student health insurance program for the coming year. You will not be required to take any action to keep your health coverage, which will continue without interruption.

4. What happens to my coverage if I leave the university?

To be eligible for insurance coverage under the University plan, you must be fully enrolled for first 60 days of the academic year. If you are not enrolled for the first 60 days, or if you leave the University within the first 60 days of your enrollment as a student, your coverage under the Loyola Health Care Plan for Medical and Graduate BiomedicalStudents will be terminated.

5. How do I enroll my spouse or dependent children for coverage under the student health plan?

You can enroll your spouse and/or children under the student health plan by completing an application and submitting it along with payment directly to HTH Worldwide. For an application and instructions on how to enroll, go to the Loyola Healthcare Plan for Studentslink at www.stritch.luc.edu/current/current.htm. Please note that you must be a student registered for classes at Loyola and enrolled in the student health plan for your spouse or children to be eligible for coverage under the plan.

6. Who can I call for assistance with enrolling myself or my dependents in the plan?

Please call HTH Worldwide at 866-281-1668.

1. Do I need to submit proof of other coverage every year?

Yes, a waiver form must be filled out at the start of each academic year. Go to www.stritch.luc.edu/current/current.htm and click on Loyola Healthcare Plan for Students. Complete the waiver and submit it electronically by the appropriate deadline as posted. If you do not waive coverage, you will automatically be enrolled and the $1,823 fee will be added to your student account.

2. Where can I obtain a waiver form?

The waiver form is located on the Loyola website. Go to www.stritch.luc.edu/current/current.htm and click on Loyola Healthcare Plan for Students.

3. Can I reverse my waiver if I change my mind after waiving coverage?

Yes, however the waiver must be reversed by the waiver deadline. To reverse your waiver you must send your email request to luc@hthworldwide.com. Please make sure to include your name and Social Security number.

1. When does the new plan year start?

The new plan year begins August 1, 2008.

2. What is the term of the student health insurance?

The term for the annual student health insurance is August 1, 2008 - July 31, 2009.

3. When will I receive my health insurance ID card?

Once your information is received by the insurance company, your card should be mailed out within 10 business days.

4. Why didn't I receive a health insurance ID card?

If you haven't received your ID card, call UniCare Customer Service at 800-696-9776 to request another card be sent to you. Please confirm that UniCare has your correct address.

5. Will I get a new health insurance ID card next year?

If you are currently enrolled in the health plan and you confirm that you want the coverage for the 2008-2009 school year, you will not receive a new ID card but continue to use your existing card.

6. I have a doctor's appointment in early August, how can make sure I am covered under the student health plan?

To ensure that you are in UniCare's eligibility system, please confirm that you are enrolled in the student health plan by calling Unicare Customer Service at 800-696-9776.

7. Please explain why the cost for student health increased again this year?

Premium costs are determined by the insurance carrier based on the actual cost of the medical claims paid by the health plan. Unfortunately, national health care costs are expected to increase in the double digits again this year. Rising health care costs are a national problem brought on by a variety of factors including a greater demand for services, rapid expansion of medical technology and treatment options, new and more expensive prescription drugs and an aging population. Loyola will continue to review this plan regularly and is very conscious of controlling the cost to students.

8. How much does dependent health care insurance cost?

The annual cost to cover yourself is $1,823. If you are adding a dependent, the additional cost would as follows:

• Spouse, add $4,161;
• One child, add $2,731;
• Two or more children, add $3,440.

9. Is the cost for health coverage included in my tuition?

If you are automatically enrolled in the Loyola Health Care Plan for Students because you are required to have coverage, the Loyola Healthcare Plan for Medical and Graduate Biomedical Students fee will be added to your student account.

10. Where can I find information on network providers?

Go to www.unicare.com

• In the middle of the page, toward the right, click Online Provider Directory;
• Go to the Visitor Search column and click Next;
• Select Large Group Plans;
• Choose Unicare PPO;
• And select your provider type.

11. Is there a pre-existing condition exclusion under the plan?

Yes, there is a six-month pre-existing condition exclusion under the plan. Pre-existing conditions are injuries or sicknesses for which you incurred expenses, received medical treatment, consulted a health care professional or took prescription drugs during the six-month period immediately preceding your effective date of coverage. If you have a pre-existing condition, the health care plan will not pay benefits for the condition until you have been continuously covered for six months. The pre-existing condition limit does not apply to pregnancy or to any newborn or adopted child.

This pre-existing condition limit will be waived if you had prior creditable health care coverage (such as another group or individual policy). You will receive credit for prior health insurance as long as you did not have a break in coverage of 63 days prior to the effective date of coverage under the Loyola Health Care Plan for Medical and Graduate Biomedical Students.

12. Who do I call if I have a question about benefits covered under the plan?

Contact UniCare Customer Service at 800-696-9776.

13. How do I file a claim?

The process for filing a claim depends on whether you see a health care provider that is in the network or out of the network.

14. Follow the steps below if you see a network provider:

1. Go to your provider to receive medical care.
2. Present your ID card at the beginning of your visit. .
3. Your doctor will submit a claim to UniCare for you.
4. You will receive an Explanation of Benefits (EOB) from UniCare showing what was paid by UniCare, the provider contracted discount and any balance that you must pay.
5. You will receive a bill for the balance from your provider.
6. Make your payment directly to the provider.

15. Follow the steps below if you see an out-of-network provider:

1. Go to your provider to receive medical care.
2. Pay for the entire cost of the service up front.
3. Print out a claim form from www.unicare.com and submit it, along with your receipt, to P.O. Box 4458 Chicago, IL 60680-4458.
4. UniCare will reimburse you based on the out-of-network benefit level (60% of the cost, after the deductible, for most services).

To check on the status of your claim, log on to www.unicare.com and click on View Claims. If you have specific questions and need to speak with a customer service representative, call 800-696-9776.

16. Who do I call if UniCare denied my claim?

Contact UniCare Customer Service at 800-696-9776 to find out why UniCare did not pay your claim.

17. Does the plan cover prescriptions?

Yes. Under the plan there are four categories of drugs and how much you pay depends on the drug type. The categories are:

• Level 1 - Generic drugs that are labeled with the medication's basic chemical name and usually have brand-name equivalents that are priced less then the reference price. They have the same active ingredients and must meet the same FDA standards for quality, strength, purity and stability as their brand-name counterparts. You are responsible for copay of $15 at a retail pharmacy and $30 at mail order for all Level 1 prescription drugs. If the cost of the prescription is less than $15 you pay the entire cost.



• Level 2 - Brand drugs that do not have a generic equivalent and are less than the reference price. You are responsible for copay of $30 at a retail pharmacy and $60 at mail order for all Level 2 prescription drugs.



• Level 3 - Non-Preferred Brand drugs that cost more than the reference price. You are responsible for copay of $60 at a retail pharmacy and $120 at mail order for all Level 3 prescription drugs.



• Level 4 - Self-injectable drugs including insulin and other self-injectable medications. Certain limitations may apply. You are responsible for a 20% coinsurance up to a maximum of $200.

Depending on how much medication you need, you may fill your prescription either through a retail pharmacy (such as Walgreen's or CVS) or through UniCare's Mail Order Drug Program. If you need a certain drug for a chronic condition, such as allergies or asthma, you can save time and money by using the Mail Order Drug Program.

18. Is there a dental plan offered?

Loyola does not sponsor a dental plan.

19. Does the student health plan have a vision plan?

There is not a vision plan; however, the plan does offer a vision discount program for contact lenses and eyeglasses. Information on the vision discount is located on the UniCare website at www.unicare.com.

1. When does my coverage end?

All coverage ends on July 31, 2008 for the 2007-2008 academic year and July 31, 2009 for the 2008-2009 academic year.

2. What are my options when my student health care expires or I graduate?

Prior to your coverage expiring, you can enroll in a separate six-month continuation policy. To qualify, you must have participated in the Loyola Student Health Plan for the six months immediately preceding July 31^st of that academic year.