    |
Frequently Asked Questions About the TCNJ Student Health Insurance Plan (SHIP)
I am covered by my parent's insurance plan. Therefore I don't need Student Insurance, right?
We find that most students are not aware of the kind of health or prescription plan they have or how it works. Some plans cover non-emergency expenses only if the college is within the plan's geographic area. Some require referrals for certain services or lack coverage for out-of-network providers. Most plans require the patient to pay high co-pays and deductibles before benefits begin. Some prescription cards can only be used at network pharmacies that are often inaccessible to college students without personal transportation. Most plans provide coverage only to full-time students and only until they are 21-23 years of age. These issues complicate and delay health care needed at college. In view of the affordability of student health insurance, the benefit of no co-pays or deductibles and our experience with the health care needs of our students, we strongly encourage students to enroll in this plan even if they have other health insurance.
Let's say I am sick and need to see someone. What do I do?
Call Health Services and make an appointment. There is no charge to see a doctor, nurse practitioner or nurse.
How about if I live an hour away and I get sick? Or what if I get sick when Health Services is closed?
Call your doctor or local urgent care clinic and make an appointment to be seen. Take your SHIP insurance ID card and a claim form with you. Some doctors' offices will ask that you pay them upfront for your visit. They will give you a receipt of payment which you will then submit to SHIP, along with a Claim Form (available at www.bollingerinsurance.com/tcnj), to Bollinger Insurance Solutions. Some offices will submit the claim form for you. SHIP will cover $80 of your doctor's visit.
What if I have an illness or injury that needs emergency care?
Go to the nearest emergency room. If you are on campus, dial 9-1-1 from any campus telephone or 609-771-2167 from a cell phone to summon medical assistance. Ambulance is covered up to $300 per transport. Emergency Room coverage is up to $1,500 per problem.
I need to see a skin doctor for my problem. Will SHIP cover these visits?
SHIP will pay up to $80 per visit starting with the second doctor's visit to an $800 maximum. You can contact Health Services and request a referral to the skin doctor (or any specialist) so that SHIP can begin paying at your first visit to the specialist. Remember that if the condition existed before you enrolled in SHIP, you have to be insured by SHIP for at least 6 consecutive months before any coverage will begin.
What if my doctor orders laboratory tests when I'm sick? Is this covered?
Yes, laboratory tests and x-rays are covered for illnesses up to $600 per problem.
Can I use the Prescription Card to pay for prescriptions that a doctor other than Health Services gave me?
Yes. Just take your Prescription Card and prescription to any pharmacy. Remember that the allowance for the entire policy year for prescriptions is $300 (Aug 15, 2008-August 15, 2009).
I need a physical examination for a new job. Will SHIP cover it?
Yes, as long as you haven't used any benefit from the Wellness portion of your plan ($250 maximum allowance). You can also schedule your physical at Health Services as long as you are currently taking classes. There is no charge.
Can I still use Health Services if I waive enrollment in SHIP?
Yes. Any TCNJ student currently taking classes can use Health Services. However, we are out-of-network providers for all other insurance plans. That means that although there is no charge for a basic office visit, your insurance may not cover the tests we order, or cover them at full benefit. In addition, Quest Diagnostics (referral lab), Quakerbridge Radiology Associates (x-rays), Quick Chek Pharmacy (prescription medicines with free delivery to campus), and local hospitals (x-rays, EKG, emergency room) and their physician groups may not accept your insurance.
Why is Student Insurance so important at TCNJ.
College-sponsored health insurance plans are tailored to the school's student health services and greatly facilitate the use of these services. This is the greatest benefit of the student health insurance plan. Enrollment in the student health insurance plan allows students to take full advantage of the services offered conveniently on campus by providing coverage for necessary laboratory testing, medical supplies, vaccinations, x-rays, and most prescription medication.
Can I use SHIP outside of Health Services?
Yes, you can use it worldwide, 24 hours a day, year-round. Please contact Bollinger BEFORE leaving the U.S. to discuss coverage. The purchase of traveler's insurance is still recommended for all individuals traveling abroad regardless of type of U.S. health insurance coverage.
How many TCNJ students are enrolled in SHIP?
Over 80% of full-time undergraduate and 15% of graduate TCNJ students are enrolled in the Plan.
I won't be using Health Services when I'm sick because I have my own doctor. So I won't need student insurance, right?
First of all, student insurance can be used off-campus. Secondly, using Health Services is usually much more convenient if you live on-campus or if your doctor is some distance from the College. Sometimes, a sudden or severe illness or injury may not provide you with time to get home to see your own doctor. Thirdly, you never know when you may need first aid while on campus.
If I keep SHIP, should I still bring my other health insurance cards with me to school. Absolutely. You should always carry all health insurance cards (Medical, Dental, and Prescription) or a copy of the front and back of the cards with you.
What if I don't have any other insurance? Is TCNJ SHIP adequate?
This Plan was designed by Health Services to be affordable for students to use in addition to another policy and adequate enough for those students who have no other insurance. But since individual health care needs vary among our students, please carefully review the coverage, policy limits, and exclusions of the Student Insurance Plan before going "solo". For those students interested in more comprehensive health insurance coverage, please contact Larry Shoemaker, Senior Vice President, Bollinger Insurance, at 973-921-8086 for quotes on individual health insurance policies. You may also log on to the New Jersey Department of Banking and Insurance website for information on individual health insurance. Don't forget to investigate whether or not you are a candidate for COBRA.
How much does the Student Insurance Plan cost?
For coverage from August 15, 2008 to January 15, 2009: $120.00
For coverage from January 15, 2009 to August 15, 2009: $120.00
Who can enroll in this Plan?
The TCNJ student health insurance plan is available to all registered students. There is no minimum credit hour requirement for eligibility.
How do I enroll in the Plan?
Full time students will be billed for student health insurance each semester on their tuition bill. Part-time students may enroll in the Plan by visiting the Office of Student Accounts, Green Hall 119, or the Bollinger Insurance website at www.bollingerinsurance.com/tcnj - Click on "Dependent Enrollment Application".
I enrolled in SHIP but where are my insurance cards?
SHIP health insurance ID card and Prescription card are available through the Bollinger Insurance Solutions website at www.bollingerinsurance.com/tcnj. Print them both out andkeep it in your wallet.
When do I pay for student health insurance?
Bills are posted on TESS. You will receive an email from the Office of Student Accounts when your bill has been posted on TESS. The Billing Calendar is available on the Office of Student Accounts website at http://www.tcnj.edu/~sfs/account/documents/08cal.pdf . Responsible bill payers (e.g., parents, guardians, etc.) can also sign up for e-mail notifications by visiting the Office of Student Accounts' website at www.http://www.tcnj.edu/~sfs/account/index.html.
Do I have to have health insurance to attend college?
Yes, every full-time college student is required by New Jersey law to maintain health insurance with at least basic hospital benefits while attending a New Jersey college or university. Therefore, if you are registered as a full-time student and do not have other health insurance, you must enroll in this plan or another comparable plan with basic hospital benefits. Health insurance is not mandatory for part-time students.
Can I enroll in the Student Insurance Plan if I am only taking classes part-time?
Yes.
Is the student insurance an excess policy, like athletic insurance?
No, this since this is not an excess policy, claims for covered services may be filed regardless of other insurance coverage.
Does this plan pay for prescription medicines?
Yes, for covered illnesses and accidents, there is a total benefit of $300 per policy year (Aug 15, 2008-August 15, 2009) of prescription drug coverage (no deductibles or claim forms). Birth control IS covered. There is no waiting period for pre-existing conditions for prescriptions.
Does the insurance cover vaccinations?
Yes, those vaccinations recommended by current clinical guidelines/standard are covered as part of the $250 per year "Wellness Benefit" rider. These vaccinations include hepatitis A and B, HPV (e.g., Gardasil), chickenpox, tetanus, pertussis, etc. Student insurance also covers flu vaccines for high risk students (see CDC influenza recommendations). Vaccinations required as a pre-requisite to college entry are not covered.
Is dental coverage included?
No, only if there is an injury to sound, natural teeth. There is coverage for impacted wisdom teeth extraction (see policy). However, the student insurance company can offer an individual dental program to students. Call the student insurance company at 1-800-526-1379 for details or visit the Bollinger TCNJ website at www.bollingercolleges.com/TCNJ.
How long do I have to file a claim?
Within 90 days after loss occurs or as soon as reasonably possible.
Where can I get a claim form?
Click here to download a Claim Form.
Does the student insurance prescription cover pay for birth control?
Yes
What if I have a complaint about SHIP. Where do I go?
Contact Sandra Whaley, Student Health Insurance Coordinator, at 609-771-2484 or via e-mail at swhaley@tcnj.edu.
Does the student insurance cover pre-existing conditions?
Yes, after 6 months of continuous coverage on the Plan.
I am playing football at TCNJ. Will this insurance cover me if I get hurt?
No. The Student Insurance Plan will not cover injuries that result from intercollegiate sports, only intramural and club sports. The College provides athletic insurance for intercollegiate sports injuries, which is an excess policy after private insurance. Athletic injuries and the insurance are coordinated by the Head Athletic Trainer, phone #: 609-771-2387
What is the deadline for completing a health insurance Waiver Card?
The deadlines this academic year are August 1, 2008 and January 1, 2009.
Do I have to complete a Waiver Form every semester?
Yes.
Can I use my own insurance in Health Services?
No. But remember that visits to see the Health Services' doctor, nurse practitioner and nurse are free.
What happens if I opt-out of SHIP, come to Health Services to be seen and need laboratory testing to diagnose my problem?
We will direct the laboratory to send the bill to your permanent home address. You can then submit the bill to your insurance company for payment consideration. Please note that Quest Diagnostics, our reference laboratory, does not accept all insurance plans.
Where can I find out more about benefits, coverage, claims procedures, and exclusions?
Go to the Bollinger Insurance TCNJ website at www.bollingercolleges/tcnj . For additional information about the insurance, contact Bollinger directly at 1-800-526-1379.
For more "Frequently-Asked Questions & Answers", go to the Bollinger website at www.bollingercolleges.com/tcnj/
