THE STUDENT HEALTH INSURANCE BENEFITS PLAN■ low out-of-pocket costs■ robust provider choice■ usable nationwide and abroad■ year-round

Home Campus Any Any Year State Country Round

Medical, mental health, prescription, dental and vision care. Enhanced benefit level at the Wilce Student Health Center. Preferred Providers in all 50 states.

The Wilce Student Health Center is an accredited outpatient facility providing a variety of health care services to students, including primary care, pharmacy, physical therapy, radiology, dental and optometry. shs.osu.edu

FOR MEDICAL, PRESCRIPTION AND MENTAL HEALTH:

Your deductible $0 at Student Health Center $150 at Preferred Providers

Your coverage 100% for many campus services 90% at Preferred ProvidersYour out-of-pocket maximum $2,700 at Preferred Providers

SHI Benefits Plan Student Coverage Highlights

Wilce Student Health Center | shs.osu.edu Local and National Preferred Providers

Office Visit 100% 100% after $20 copay

Emergency Room n/a 90% after $100 copay

Physical Therapy 100% 90%

Diagnostic labs 100% 90%

Prescription drugs Generic: 90%. Brand with no generic option: 80%. Brand with generic option: 50%. Minimum $10 copay.

Counseling and Consultation | ccs.osu.edu Local and National Preferred Providers

Outpatient psychotherapy 100% - no limit 100% after $20 copay

Outpatient psychiatry 100% 100% after $20 copay

Inpatient services n/a 90%

Wilce Student Health Center or College of Dentistry Clinic Local and National Network Providers

Adult Dental Deductible n/a $50

Annual Dental Benefit Max $750 $750

Wilce Student Health Center or College of Optometry Local and National Preferred Providers

Vision Exam: 100% after $15 copay Exam: 100% up to $50 $100 allowance on glasses or contacts. 20% discount on glasses. after $20 copay

Please visit shi.osu.edu for official benefit documents. This document is not an insurance policy. Preferred Provider coverage is subject to a $150 deductible.

SHI Benefits Plan eligibility and fees are assessed in both Autumn and Spring and determined by academic course enrollment. Spring automatically includes summer. The full policy year runs 8/18/20 to 8/16/21. When you select the SHI Benefits Plan, it stays in place all academic year assuming eligibility.

Semester fee premium rates will be posted to shi.osu.edu.Visit shi.osu.edu or contact 614-688-7979 with questions. We are here to help.