Medical Needs & Health InsurancePrepared for UW-Platteville International Students

Spring 2013

Overview

UW-Platteville Health Insurance• Insurance Company is Rust Associates• Insurance is billed to your student account• You are covered by the UW-Platteville

Health Insurance Plan all year (12 months)• You will automatically be re-enrolled in the

UW-Platteville Health Insurance as long as you are enrolled or are a visiting scholar at UW-Platteville

What should you do if you aren’t feeling well?

What time and day of the week is it?

What is your illness or injury?

It depends!

Where should you go first if you are sick or injured

(non-emergency)?

UWP Student Health Services!

Royce Hall

Student Health Services

Go to Student Health Services in Royce Hall to treat

“Normal Illness or Injury”•Sore throat•Cough/cold•Upset stomach•Nosebleed•Earache •Sprains•Deep cuts•Flu•Fever•Allergic reactions (non-life threatening)•Rashes

Student Health Services

• First call (608-342-1891) or visit Royce Hall, 2nd floor

• Many no cost services and low cost medications and/or lab tests

• Referral to specialist for treatment for illnesses/injuries that are more complex, generally at a Platteville clinic

• Hours: 7:45-4:15 p.m., Monday-Friday

What if you have a normal illness/injury (non-emergency) and Student Health

Services is closed?

Ask Mayo Clinic!

Ask Mayo Clinic

• Call 855-839-0004

• 24 hours a day, 365 days a year

• Telephone line staffed by registered nurse who can answer questions about health concerns and help decide on appropriate ‘level of care’

Making a Doctor’s Appointment

Before scheduling an appointment or a medical procedure, it is important to make sure that the doctor/provider you see is covered by your health insurance policy. Please call the phone number(s) below or visit www.healtheos.com for the names of doctors/providers who are covered by your health insurance plan.

Finding Doctors/Providers INSIDE Wisconsin:

Call HealthEOS Network 800-279-9776

Finding Doctors OUTSIDE of Wisconsin:

Call PHCS Network 800-922-4362

 

If you have questions about your insurance coverage or claim form:

Call Rust Associates 800-336-0747

*Instructions for Finding a Provider/Doctor using HealthEOS.com on ISSS website*

Recommended Clinic

Doctors Park Southwest Health Center

1450 Eastside Rd, Suite 110

Platteville, WI

Call (608) 348-2455 to schedule a doctor’s appointment.

Hours:

Monday: 8 a.m.-6 p.m.

Tues - Fri: 8 a.m.-5 p.m.

• 

Where should you go if you have an emergency?

Emergency Room (ER)!

Definition of Emergency

Your insurance company defines emergency as:

“Acute symptoms of sufficient severity (including severe pain) within 72 hours of the date of injury or onset of illness.”

Emergency Room

What are examples of emergencies?•Loss of consciousness (passing out)•Major injury, such as a head injury or broken bone•Bleeding that does not stop after 10 minutes of direct pressure•Sudden severe pain•Severe shortness of breath•Unexplainable stupor, drowsiness, or disorientation•Coughing up or vomiting blood•Severe and/or worsening reaction to an insect bite, medication, or food—especially if breathing is affected•Signs of a heart attack (chest pain) or stroke (numbness, elevated blood pressure)•Poisoning, including alcohol or drug poisoning•Suicidal or homicidal feelings•Anything else you reasonably believe may be an emergency

Emergency Room

• May walk-in or be transported via ambulance

• Call 911 for ambulance; have location/address available to tell person answering phone

• Emergency Room (in Platteville) at Southwest Health Center

• Open 24 hours a day, 365 days a year

• $100 charge, unless there is hospital admission

What if I don’t know how serious my illness/injury is, and I don’t know where I

should go?

Call “Ask Mayo Clinic”

MEDICAL NEEDS & HEALTH INSURANCE

Using your Health Insurance

Health Insurance Documents

Health Insurance Card

Accident and Illness Claim Form

Front of card

Back of card

Health Insurance Card

• Front of card• Name

• Policy number

• Effective date of insurance

• HealthEOS (Wisconsin)

• PHCS (outside Wisconsin)

• Pharmacy (Walgreens)

• Back of card• Phone # for student questions

• Phone # for health provider questions

• Mailing address

• Travel assistance contact info

Front of card

Back of card

Coverage

• Brochure outlines coverage• Exclusions (not covered):

• Pregnancy, childbirth, etc

• Routine physical exam

• Dental care

• Eye examinations

• ‘Elective’ and/or plastic surgery

• Payments you must make:• $25 per injury/illness except at SHC or if

referred by Student Health Services

• $100 per Emergency Room visit unless admitted to Hospital

http://

Accident & Sickness Claim Form• A Claim Form MUST BE FILED whenever you

are treated by a health professional (who is not a part of UW-Platteville Student Health Services).

• The Claim Form is available online at http://www.uwplatt.edu/intprog/iss/current_students/health_insurance.html

• Complete ALL of the form (#5 for an injury; #6 for an illness).

• Sign and date the form.

• Ask the hospital/doctor for a “fully itemized bill.”

• Make copies of the claim form and your bill for your own records.

• Mail or FAX the form to AMA & Associates (see upper left hand corner).

REMEMBER:You MUST fill out a CLAIM FORM whenever you are

treated by a health professional off campus.

NOTE: We recommend that YOU send in the claim form, even if the hospital offers to do it for you.

Remember to make copies of your claim form and supporting documents before mailing them to the insurance company!

Medication Prescriptions

If the doctor gives you a prescription for medication:

• Walgreens provides a discount; present your insurance card with your prescription; receive the discount immediately.

• If Walgreens does not give you an automatic discount, you should complete the Walgreens Reimbursement Form. http://www.rustassoc.com/forms/Walgreens_Reimbursement_Form_B7CFEC9DF8E1F.pdf

• You will need mail in the reimbursement form, a copy of the prescription and the cash register receipt for each medication claim.

• Make copies of what you mail for your own records.

Medication Prescriptions

Walgreens Discount Additional Information

•Preventative drugs are not covered

•You are responsible for paying:

• $10 co-pay for generic prescription

• $20 co-pay for brand name prescription

• $30 co-pay for multi-source prescription

•If you have questions about your Walgreens discount, please call 800-207-2568

MEDICAL NEEDS & HEALTH INSURANCE

What do I do for health care if I’m NOT in Platteville?

Options…

• If it is a ‘true emergency’, call 911. Know your address, as an ambulance will be sent. [Or, if you are able, go to the hospital emergency room.]

• Call Ask Mayo Clinic and ask for advice– Call toll-free: 855-839-0004

• For routine illness IN Wisconsin, refer to your health insurance card.– Call HealthEOS (800-279-9776) for a participating

physician referral.

• For routine illness OUT of Wisconsin, refer to your health insurance card.– Call PHCS (800-922-4362) for a participating physician

referral.

What is Covered By My Health Insurance?

Health and accident insurance does not cover all medical expenses. In general, it covers the higher costs that result from accidents and serious illness .

For a complete list of what is covered, please see the brochure on http://www.rustassoc.com/university_forms/?UniversityID=112&Domestic=0.

Misconceptions about Health Insurance in the U.S.

Misconception: If I have health insurance, all my medical expenses will be covered.

Reality: They will not. See the previous slide called "Coverage Provided by Health Insurance.“

Misconception: Any visit to the hospital emergency room will be paid for if I have health insurance.

Reality: An emergency room visit is covered only in case of a genuine emergency.

Misconception: If you look carefully, you can find a reasonably priced, very comprehensive health insurance policy.

Reality: No. The more comprehensive the coverage an insurance policy offers, the more costly it will be.

Summary

• Not every medical situation (illness or injury) requires a visit to the hospital emergency room. Waiting until the next day and going to Student Health Services or calling “Ask MayoClinic” will often take care of the problem.

• If you do see a doctor or go to the emergency room or hospital, you need to fill out a claim form.

• If you are experiencing a true emergency, call 911 or go to the Emergency Room!

ISSS Website

View the ISSS website for more information on health insurance:

http://www.uwplatt.edu/intprog/iss/current_students/health_insurance.html

Questions?

Thank you for your attention!