Frequently asked questions

How you enroll in an Aetna Student Health plan depends upon your school.

Some schools automatically enroll students. Some schools enroll students unless they waive coverage. At other schools, students will need to enroll themselves.

To check how your school handles enrollment in an Aetna Student Health plan, go the Aetna Student Health home page and choose your school. Your school page will let you know if you need to enroll or waive coverage. If there is no enrollment information, your schools automatically enroll you in a plan.

You can also learn on your school’s homepage if your school offers dental or vision coverage.

There are three ways you can access your ID card:

• You can request to have your Aetna medical insurance card emailed to you. You just need your student ID number, date of birth, and email address.
• You can log in to your Aetna member website to view or download your ID card.
• You can use the Aetna Health app to view your ID card on your mobile device.

You can download an insurance card for On-Call International from the travel assistance page. 

You can usually save more money by visiting an in-network provider. Some plans may require you to visit an in-network provider to be covered. Other plans allow you to see out-of-network providers as well, but you usually have to pay more for care when going out of network.

You can find an in-network provider using the Aetna health care directory. You can search as a guest, or log in to find a provider who accepts your plan.

You can also review your plan documents to learn more about your coverage.

Yes, we cover emergency care. In fact, emergency care is covered 24 hours a day, seven days a week – anywhere in the world.

Generally speaking, an emergency is a situation in which you could reasonably expect that the absence of immediate medical attention could result in serious jeopardy to your health, or if you are a pregnant woman, to the health of your unborn child.

In general, you should an emergency room for life-threatening or severe injury or illness. For moderate to serious injury or illness or when a visit to your primary doctor is unavailable, visit an urgent care center.

If an emergency happens close to home:

• Call your local emergency hotline (911) or go to the nearest emergency facility. If possible, you should also call your primary care doctor. In all cases, you should contact your primary care doctor as soon as possible after receiving treatment.
• Once an emergency facility has stabilized your condition, their staff members should try to contact your primary care doctor. Your primary care doctor knows your medical history and is also responsible for coordinating your health care.
• Please note that all follow-up care should be coordinated through your primary care doctor.

If an emergency happens when you’re traveling away from home:

• Remember that urgently needed care is covered while you are traveling outside of your local Aetna service area.
• You should seek immediate treatment for any illness or injury that would be considered an emergency, or for the care of any urgent problem.
• If you are admitted to an inpatient facility, you should immediately notify your primary care doctor and Aetna.
• In other cases, you should notify your primary care doctor and Aetna within 48 hours of an emergency.

When seeking emergency care, please note that:

• Any services you receive must be covered under the terms of your Aetna plan.
• You are responsible for any emergency room copay.
• An emergency room copay does not apply when you are admitted for an overnight hospital stay.

Here are some of the unique benefits of student health insurance plans:

• Enrollment periods are specific to your academic schedule.
• Enrollment requirements do not depend on age, but on student eligibility status as determined by your school.
• Coverage is continuous during your academic career, 24 hours a day, anywhere in the world – summer break included.
• The student health insurance plan coordinates care with each campus and its local community providers to promote access to appropriate medical care.
• In most cases, a student health insurance plan will include a worldwide travel assistance service offering unlimited emergency medical evacuation services.
• Spouse and dependent coverage is available at most schools.

The answer depends on your parent’s health insurance plan, such as what it covers and how much it costs to keep you on their plan. But generally, student health plans can be a more cost-effective solution for families, especially if you are attending school out of state. They also provide benefits designed around student life, such as enrollment periods specific to your school schedule. Remember, your parent’s plan may have age and other eligibility requirements, so make sure to check and compare options when making a decision.

You may also need insurance for your family while attending school. The first step is to ensure your school offers dependent coverage. (Your student health insurance brochure will highlight this information.) During the open enrollment period, you may add your dependents onto the student health insurance plan. You may also add a dependent outside of the enrollment period when you experience a "change in life status" (marriage, birth, divorce or loss of a job).

Some insurance companies offer plans that students can buy on a short-term basis. But, a school-sponsored student health insurance plan may be a better option than buying a short-term policy. Here’s why:
 

• Short-term policies may have strict enrollment guidelines.
• Pre-existing conditions may be limited or completely excluded from a short-term policy.
• There is no guarantee that you can extend coverage past your original enrollment period.

When you go to the doctor, make sure to bring the following items:
 

• Health plan ID card
• Passport or other valid form of photo identification
• Relevant medical records and list of current medications

A primary care doctor is your first point of contact for your care. Depending on your health plan, they can also be the most cost-effective choice for care. Your primary care doctor treats you when you’re sick and refers you to a specialist if you need one. They also help you get preventive care you need, such as a flu shot and annual physical.

Go to the Find a doctor page. You can search for a provider by language.  

Massachusetts students must have health insurance – it's the law.

If you are planning to attend school in Massachusetts, you must have health insurance that provides adequate coverage and is easily accessible (that is, insurance that is recognized and available in Massachusetts). This is the law under QSHIP (Qualifying Student Health Insurance Program).

Coverage by an insurance company outside the U.S. is not considered comparable.

National Health Service Programs from other countries are not considered comparable.

If you have comparable coverage, and the University you attend allows you to waive the student health plan, it is your responsibility to provide proof of comparable coverage by following the waiver process at your school.

Find more info about student insurance needs or about Massachusetts health policy.

Sponsors must require that all exchange visitors (as well as their accompanying spouses and dependents) have insurance in effect that covers them for sickness or accidents during the time of their exchange visitor program.

Program participants and their dependents are required to have medical insurance coverage with the following minimum benefits.

• Medical benefits of at least $100,000 per accident or illness
• Repatriation of remains in the amount of $25,000
• Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $50,000
• A deductible not to exceed $500 per accident or illness.

A claim is when a healthcare provider or a plan member asks a health insurer to pay for a medical service. It is a formal request that lists the costs of services. The health insurer processes claims based on how the member’s health plan covers each service.

If you visit an In-Network Preferred Provider, they should file a medical claim on your behalf. In the event that the provider does not submit a claim for you, go to the resources and claims page for more info on what to do next.

An EOB is a list of medical services you received and their costs. It explains how much of the costs will be paid by your health plan and how much you may have to pay. An EOB is not a bill. It is a summary of the claim and your plan’s coverage. You may want to keep it for your records. You can compare any bill you receive from your provider with your EOB to ensure you are being billed for the correct amount. If the bill doesn’t match, contact your provider. If a claim is denied or you disagree with the EOB, you can file an appeal with your insurance provider.

If you get a bill you don’t understand, review your Explanation of Benefits (EOB) first. You can contact your provider who may have more information about the bill you received. Then contact us with any questions you still have. We’re here to help. 

When you receive treatment outside the United States:

Most providers outside the United States will not file a medical claim for you. If that's the case, you'll need to pay the provider in full for your treatment and then file a claim with Aetna Student Health.

What you will need to do:

1. Get an itemized medical bill from the provider -- in English, if at all possible -- before you leave the country you're in. The bill should include:

• The full name and address of the provider.
• The date that services were provided.
• A detailed listing with separate charges for each service provided.
• A notation that you paid the bill in full. (This is very important so that we'll know to send any payment to you, not to the provider.)

2. Send us the itemized bill, along with the following information:

• Student's name
• Patient's name (This is especially important if the patient is the student's spouse or dependent)
• School name
• Student's identification number

You may write this information right on the bill, if there's space, or attach a separate piece of paper, if necessary.

Mail the bill to:

Aetna Student Health

P. O. BOX 981106

EL PASO TX 79998

Or, fax to 1-859-455-8650. You can also submit it on your student portal or the Aetna  HealthSM app.

Be sure to include your current mailing address if you're studying abroad for the year, so we'll know how to reach you. When we receive your claim, we will process it according to the benefits and other plan provisions of your school's student health insurance plan. If your address changes, please contact Customer Service.

Preventive care includes routine screenings and checkups. It also includes counseling you get to prevent illness, disease or other health problems.

Many of these services are covered as part of physical exams. These include regular checkups and routine gynecological and well-child exams. You won’t have to pay out of pocket for these preventive visits, when provided in network. 

But these services are generally not preventive if you get them as part of a visit to diagnose, monitor or treat an illness or injury. Then copays, coinsurance and deductibles may apply. 

Aetna follows the recommendations of national medical societies about how often children, men and women need these services. Be sure to talk with your doctor about which services are right for your age, gender and health status.

Yes, Aetna's Student Health student health insurance plans provide coverages for medically necessary treatment of substance abuse and mental health conditions. Generally, the extent of coverage may depend on whether the treatment is provided on an inpatient or outpatient basis. Please refer to your student health insurance brochure for specific details or call the toll-free 800 number on the front of your student identification card.

A national network of more than 1 million health care providers. That includes more than 567,000 primary care doctors and specialists and more than 5,400 hospitals.* Of course, you can also seek treatment with a non-preferred physician or hospital, but you can generally reduce your out-of-pocket expenses and maximize your savings by using Preferred Providers that bill Aetna Student Health directly.

Your student health insurance plan may require you to contact Aetna Student Health when you are being admitted to the hospital on an inpatient basis. Outpatient services, including day surgery and emergency room visits, do not need to be pre-certified. Your specific pre-certification requirements are listed on the back side of your student health insurance identification card. If it is not an emergency, your plan may have a referral requirement through the health center.

We may need more details before we can approve some care options and products. We call this precertification. Sometimes we may call it prior authorization or preapproval. These all mean the same thing. It’s the process of confirming if your plan will cover a certain service or prescription drug.

Precertification is required for all inpatient admissions. If you see an in-network provider, the provider will request precertification. If you see an out-of-network provider, you are responsible for requesting precertification. You can request precertification by contacting Aetna Student Health. Your student health insurance brochure has detailed information about what additional services require precertification.

Yes, Aetna Student Health's student health insurance plans provide coverage for a pregnancy the same as any other medical condition. Please refer to your student health insurance brochure for specific details or call the toll-free 800 number on the front of your student identification card.