PRESENTATION:
MANDATORY HEALTH
INSURANCE
FOR INTERNATIONAL
F-1, F-2, AND J-1
STUDENTS
WHY MUST I HAVE A HEALTH
INSURANCE PLAN?



UNITED STATES FEDERAL LAW
REQUIRES YOU HAVE INSURANCE
WHILE YOU ARE UNDER OUR
SPONSORSHIP.
HEALTH INSURANCE IS
ABSOLUTELY NECESSARY IN THE
U.S., ESPECIALLY ON LONG
ISLAND, SINCE MEDICAL COSTS
ARE VERY HGH.
YOU MAY HAVE ANOTHER PLAN,
BUT OURS IS MANDATORY
WHILE YOU ARE A STUDENT
HERE.
WHAT IS INSURANCE ?





IT IS A CONTRACT YOU AND A COMPANY MAKE,
WHICH ASSURES THEY WILL PAY FOR CERTAIN
MEDICAL EXPENSES YOU MAY HAVE.
THEY TAKE THE RISK—YOU DON’T !
THE CONTRACT STATES WHAT THE INSURANCE
COMPANY WILLPAY FOR YOU.
HEALTH INSURANCE IS PURCHASED WHILE
YOU ARE HEALTHY.
JUST AS CAR INSURANCE IS ALWAYS
PURCHASED BEFORE YOU HAVE THE
ACCIDENT!
OK, SO HOW MUCH AM I PAYING
AND WHAT DO I GET?
•THE COST OF THE SPRING 2011 INSURANCE IS $636,
INCLUDING MEDEX.
•THIS WILL BE POSTED TO YOUR SOLAR ACCOUNT AS SOON AS
YOU REGISTER FOR CLASSES.
•THIS INSURANCE PLAN WILL PROVIDE HEALTH INSURANCE
BENEFITS FOR YOU, JANUARY 15, 2011 THROUGH
AUGUST 14, 2011.
•ALL OF YOUR NECESSARY MEDICAL BILLS WILL BE PAID AT
100% BY HTH.
MANDATORY HEALTH INSURANCE
What are the benefits?
ALL ILLNESSES AND ACCIDENTS ARE COVERED:
1. MEDICALLY NECESSARY INPATIENT HOSPITAL CARE IS PAID
BY HTH, INCLUDING FEES FOR ROOM AND BOARD,
DIAGNOSTIC TESTING, SURGERY, MEDICINE, AND MORE.
2. MEDICALLY NECESSARY OUTPATIENT CARE IS PAID BY HTH
INCLUDING:
– DOCTOR VISITS
– EMERGENCY ROOM
– DIAGNOSTIC TESTS
– X RAYS, SONOGRAMS, ETC.
– HIGH COST PROCEDURES
– SURGERY
– MENTAL HEALTH COUNSELING
– MEDICINES,
– AND MORE
YOU DIDN’T MENTION DENTAL WORK
OR EYE EXAMS
THE MANDATORY PLAN DOES NOT
PAY FOR DENTAL PROBLEMS LIKE X-RAYS, FILLINGS,
EXTRACTIONS, ETC.
IT ALSO DOES NOT PAY FOR VISION (EYE) EXAMS,
EYEGLASSES, OR CONTACT LENSES
HOWEVER, YOU MAY VOLUNTARILY ENROLL IN A
DISCOUNT PLAN
FOR VISION EXAMS, EYEGLASSES AND CONTACT LENSES, AND A
SEPARATE DENTAL DISCOUNT PLAN.
GO TO : www.aetnastudenthealth.com
Enter STONY BROOK, and look for DISCOUNT PLANS
You may enroll on-line.
SPRING INSURANCE COVERAGE
ENDS
AUGUST 14


Although your academic work ends in MAY, we
are required to keep you enrolled in the
international health insurance plan through the
middle of August.
if you leave the U.S. briefly (such as visiting your
home country or anywhere else during the
winter, spring or summer breaks), you will
remain on our health insurance plan.
WHAT IF I AM A
TA, GA OR RA ?
•REMEMBER that FIRST you will be automatically billed for the
Mandatory Health Insurance as soon as you register for classes
EACH SEMESTER!
•If you enroll in either the TA, GA, or RA insurance plan, we will
remove the charges for the mandatory insurance plan in
March.
•HOWEVER, because you may not have an assistantship all the time
you are here, you may remain on the mandatory health
insurance plan during certain semesters. Please listen to the
entire orientation!
WHAT IF I HAVE A SPOUSE WHO IS A TA or GA
or RA at Stony Brook and I have health
INSURANCE THROUGH him or her?
1. You must enroll as a dependent on either the TA, GA, or RA
insurance plan at the health insurance office.
2. You must also apply at the same office for a waiver of the
mandatory insurance plan by February 14, and submit the proofs
we specify on the instruction form. We will waive your mandatory
insurance only once during a semester.
3. if your spouse loses the TA, GA, or RA insurance, then you and
your spouse will both be billed for the mandatory plan.
HOW DO I ADD DEPENDENTS TO MY
MANDATORY INSURANCE PLAN ?
TO INSURE DEPENDENTS YOU MUST:
• GET AN APPLICATION FROM THE HEALTH
INSURANCE OFFICE.
•COMPLETE THE FORM, AND SEND IT TO THE
INSURANCE COMPANY WITH YOUR CHECK OR
MONEY ORDER.
YOU MUST ENROLL YOUR DEPENDENT WITHIN 30 DAYS
OF HIS/HER ARRIVAL IN THE U.S., OR WITHIN 30 DAYS OF
YOUR MARRIAGE , OR THE BIRTH OF A CHILD, OR
WITHIN 30 DAYS OF THE TERMINATION OF OTHER
INSURANCE.
USING YOUR INSURANCE PLAN
WISELY


THE STUDENT HEALTH SERVICE (INFIRMARY)
SHOULD ALWAYS BE YOUR FIRST STOP WHEN
YOU ARE SICK OR HAVE AN INJURY.
IT IS ON THE WEST CAMPUS ACROSS FROM
THE ‘H’ AND MENDELSOHN QUADS.

PHONE NUMBER IS 631.632.6740.

FOR STUDENTS ONLY; NO DEPENDENTS
USING YOUR INSURANCE PLAN WISELY,
CONTINUED



ALL STUDENTS MUST PAY AN INFIRMARY
FEE EACH SEMESTER. THE SPRING 2011
FEE IS $138.50.
THE INFIRMARY FEE PAYS FOR MEDICAL
CARE ONLY AT THE CAMPUS INFIRMARY.
(NOT AT UNIVERSITY HOSPITAL).
YOUR MANDATORY HEALTH INSURANCE
PLAN WILL START PAYING YOUR
NECESSARY MEDICAL BILLS AFTER YOU USE
THE INFIRMARY. THE $50 PLAN
DEDUCTIBLE WILL BE WAIVED IF YOU USE
THE INFIRMARY FIRST.
USING THE EMERGENCY ROOM (ER)



IN THE U.S. THE EMERGENCY ROOM (ER) IS
THE PLACE TO GO IF YOU HAVE A LIFETHREATENING PROBLEM (such as chest
pain, a broken bone, problems breathing, or
bleeding that cannot be stopped).
No matter where you are, if you are NOT
SURE if you have a true emergency, go to
the closest emergency room, and visit our
office when you feel better so we can help
you with your claim.
If you are SURE you DO NOT HAVE a true
emergency, then go to the west campus
Infirmary first, and follow the nurse or
doctor’s recommendations. If you are away
from campus and have a bad cold you may
go to a walk-in or urgent care clinic. In this
situation you will pay the first $50of your
medical bill.
MEDICAL CARE IN THE U.S.



We have some of the best medical professionals in the
world.
Physicians either have a private “practice” of their own,
or join up with other physicians in a larger “practice”, or
see patients at a hospital office.
Some physicians offer “family medicine” or a “general
practice”; some are specialists in specific diseases such
as “internists”, who specialize in many medical
problems, including digestive problems. A physician who
has a State license to practice medicine, and is also an
“acupuncturist” is covered by our plan.
More…
 Expect to be charged a minimum of $100 for a
physician office visit. If you consult a specialist, the
cost could be $250 or more for an initial visit,
depending on the specialty and what the physician
provides.
 The international insurance plan will pay in full for
these costs ONLY if you have been seen by a
physician in the Infirmary first.
 If you consult a physician in a hospital setting, you
will receive a bill from the hospital, as well as a bill
from the physician, for the professional analysis of
any diagnostic tests or x-rays that are done.
WHAT DOCTORS CAN I USE
WITH THE MANDATORY PLAN?

Our insurance company has made an agreement
with a “preferred provider organization” (PPO)
called Aetna. There are many doctors and other
medical providers associated with this PPO. Try to
use these medical providers, since they usually
charge less for their services, and usually you will
not owe them anything after HTH pays your bill.
 Locate these providers before you make a medical
appointment :
 www.aetnastudenthealth.com (enter Stony Brook,
then look for Docfind, and then ‘open choice PPO’).
HOW DO I GET THE INSURANCE
COMPANY TO PAY MY MEDICAL BILLS?






SHOW YOUR HTH INSURANCE ID CARD TO THE
BILLER AT THE HOSPITAL OR DOCTOR’S
OFFICE. TELL THE BILLER THAT YOUR PLAN
USES AETNA OPEN CHOICE PPO.
ASK THE BILLER TO SEND AN ITEMIZED BILL
TO HTH—THE ADDRESS IS ON YOUR HTH ID
CARD.
OR THEY CAN SEND AN ELECTRONIC BILL TO
PAYOR # 60054
LABORATORIES MAY SEND THE BILL DIRECTLY
TO YOU.
IF YOU RECEIVE A MEDICAL BILL BRING IT TO
OUR OFFICE RIGHT AWAY AND WE WILL HELP
YOU COMPLETE A CLAIM FORM.
BASED ON THIS MATERIAL, THE INSURANCE
COMPANY WILL PAY YOUR BILL AND INFORM
YOU OF THEIR ACTIONS.
PRESCRIPTION MEDICINES




If you consult with a physician at the Infirmary,
and receive a written prescription, you may fill it
at the Infirmary pharmacy. The full cost of the
medicine will be billed to your University account.
You must pay your pharmacy bill at the Bursar in
the Administration Building.
You MUST then complete an HTH claim form, and
send the claim form and the full pharmacy receipt
(including the names of the physician and
medicine) to HTH.
Within four weeks HTH will send the full
reimbursement to you.
MEDICINES, Continued



If you see a physician outside the Infirmary, and
he gives you a written prescription, you cannot
bring it to the Infirmary to be filled. Instead, you
must take it to an outside pharmacy. You will need
to show your HTH ID card, and pay $20 (called a
co-pay)before you can pick up the medicine.
In addition, the Infirmary pharmacy does not
carry every medicine that students require; there
may be times that you must bring the prescription
to a pharmacy outside the Infirmary.
In this case, as explained above, you must pay a
co-pay at that pharmacy before you can pick up
the medicine.
WHAT ABOUT CAR ACCIDENTS?





If you are involved in a car accident, even as a
pedestrian or cyclist, call “911” or ask someone to do
this.
When the police arrive, show them your car registration
(if you were driving), driving license, and insurance card.
If another driver is involved, share your license,
registration, and insurance card information with that
person.
If you are injured, you should go to the nearest hospital
emergency room, show them your health insurance card,
and follow their medical recommendations.
If you have car, body, or property damage, you must
contact your car insurance company as soon as possible.
FOR GAs, TAs, AND RAs


You must complete an enrollment form in
the Health Insurance Office, within 30
days of your appointment.
You must bring with you for each enrollee:
• A copy of a birth certificate or passport
AND
• A copy of a Social Security card
AND
• A copy of your marriage certificate, if you are
enrolling your spouse
WHAT IF MY DEPARTMENT IS SLOW GETTING MY RA
MATERIALS TO PAYROLL?



We have a cut-off date for enrollments in the RA
health insurance plan.
If your paper work is received late—after March 16—
you will remain covered by the mandatory health
insurance, and you must pay for it.
If you wish, you may discuss this additional cost with
your academic department.
MORE



If there is any gap (even of one day) between the ending date
of your TA or GA or RA health insurance coverage, and the
extension date of your insurance, your University account will
be billed for the International Health Insurance for at least one
month. For example, if your assistantship ends March 20, and
a new or extended assistantship begins April 1, we must
charge you for one full month of International Health
Insurance.
If your TA, GA, or RA insurance ends at any time, and is not
extended, your University account will be billed for the
mandatory International Health Insurance for the remainder of
the semester (through August 14).
Even if you are enrolled in the TA, GA, or RA insurance plan
you will still be billed separately for MEDEX ( Spring 2011 cost
is $43.75). This special plan ensures you will be returned to
your home country if you are extremely ill and need medical
transport.
J-1 AND J-2 WITH ASSISTANTSHIPS
 YOU ARE NOT ELIGIBLE FOR THE TA, GA OR RA
INSURANCE PLANS.
 However, we will enroll you in the mandatory International
Health Insurance at a discounted rate, which is $59 for
Spring 2011. The cost of MEDEX ($43.75) is additional to
this. All TAs, GAs, and RAs must have insurance and
MEDEX coverage.
 If your assistantship ends before August 14, you will be
billed for the mandatory insurance at the full rate of
$84.75 for every month you do not have an academic
appointment and no TA,GA, or RA insurance coverage.
The cost of MEDEX, as indicated above, is additional to
this fee.
FOR ALL GRADUATE STUDENTS

If you become a University employee and are
offered University employee insurance (e.g. as an
adjunct professor), you are no longer a TA, GA, or
RA! YOU MUST INFORM US WITHIN 30 DAYS OF
YOUR NEW APPOINTMENT DATE IF YOU HAVE
OTHER INSURANCE IN EFFECT, AND WISH TO
FILE A WAIVER APPLICATION. Otherwise, we will
charge you for the International Health Insurance
for the entire semester, even though you may
already have insurance coverage as an adjunct.
MORE FOR ALL GRAD STUDENTS…
If you register for classes, but will study or do
research in your home country for the entire
semester, you MUST inform our office. We will
verify this information with your academic
department, and then remove the mandatory
SUNY insurance fee from your University
account. You must discuss this with us by
February 14, 2011.
PRACTICAL TRAINING
PARTICIPANTS (OPT)



If you graduate from Stony Brook in May, and are
offered practical training, you will remain on our
insurance plan through the end of the semester
(August 14 ).
The International Health Insurance is NOT
mandatory for you after August 14.
We do recommend you enroll in an insurance plan
during your OPT. The International Insurance
plan is available to you for up to a year after
graduation, and is very reasonably priced. Please
come to the Health Insurance Office to discuss
this.
THINGS TO REMEMBER
We want to communicate with you.
SO PLEASE DO THE FOLLOWING:



1. CHANGE OF ADDRESS—update your
“preferred” mailing address via your SOLAR
account, or report this to the Registrar/Records
Office in the Administration Building
2. UPDATE YOUR ADDRESS on the HTH WEBSITE
(www.hthstudents.com)
3. CHANGE OF IMMIGRATION STATUS (such as
J-1 to F-1, or F-1 to H-1, or approval of
permanent United States residency)—report this
to the Office of Visa and Immigration Services in
the Computer Science Building.
IMPORTANT NUMBERS



INFIRMARY----------------------631.632.6740
OPEN by appointment, M-F, 8am-5:30pm;Tuesdays to 7:30pm
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
HEALTH INSURANCE OFFICE
OPEN M-F, 9 am-4:15 pm
INTERNATIONAL: leta.edelson@stonybrook.edu
631.632.6054; 632.6376
TA/GA/RAs:
edmond.anderson@stonybrook.edu
631.632.6144
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
HEALTH INSURANCE COMPANY (HTH)
1.888.350.2002
WEB-SITE: http://www.hthstudents.com
or
http://www.customerservice@hthworldwide.com
00710