Adequate Health Insurance Coverage (Waiver Process)
Northwestern University requires all students maintain health insurance while registered at the University. During the time you are registered at the University, you are required to enroll in the Aetna/Northwestern plan. You may waive enrollment by providing evidence that you have health insurance coverage that is comparable for the entire period of registration. International students holding a F1 or J1 visa may not waive the Aetna/Northwestern plan.
The coverage provided by your health insurance plan must meet applicable following criteria in order to waive participation in the Northwestern University-sponsored student health insurance plan from Aetna Student Health. Waivers will be denied if the plan does not meet all of the following requirements
- Provide coverage for routine, non-emergency care (‘in network’ providers), in addition to emergency care, in the Chicago area. *Examples of Chicago area health systems include: Northwestern Medicine, Northshore University Health Systems, Advocate Presence, and Resurrection Health.
- Provide coverage for “essential health benefits” per the Affordable Care Act (ACA)
- Outpatient Care (ambulatory patient services)
- Emergency Services
- Hospitalization (treatment for inpatient medical and mental health care)
- Mental Health Services & Addiction Treatment
- Prescription Drugs
- Maternity & Newborn Care
- Rehabilitative Services & Devices
- Laboratory Services
- Preventative Services, Wellness Services, & Chronic Disease Treatment
- Pediatric Services
- No exclusions for pre-existing conditions, or have waiting periods before coverage applies
- Must provide active coverage from the day the student arrives on campus through either August 31, 2016 or the end of their academic program (whichever comes first)
- Must cover medical evacuation and repatriation expenses (for students who plan to study abroad or travel internationally)
- Annual out-of-pocket maximum limit: individual insurance plans < $6,350; family insurance plans < $12,700 (consistent with the Affordable Care Act)
- Plan must be a US-based plan with US claims administration. Travelling Health Insurance or international-based insurance programs are deemed not comparable for waiver purposes.
Any Illinois based Exchange Plan rated Gold or Platinum as defined by the ACA will be deemed comparable for waiver purposes. Any non-Illinois based Exchange Plan rated Gold or Platinum as defined by the ACA will be deemed comparable only if such plan provides in-network coverage in Cook and Lake County for all the plan requirements noted above.
For the 2015-2016 academic year, Northwestern University will accept waivers by students on Illinois Medicaid. Out-of-state Medicaid waiver requests will not be granted. Northwestern will reevaluate the acceptance of Illinois Medicaid for the 2016-2017 academic year.
Undergraduate students currently enrolled in Medicaid are encouraged to contact Financial Aid to determine whether alternate sources of funding may be available for you to enroll in the Aetna Student Health Insurance Plan.
Northwestern strongly recommends that students consider whether Medicaid plans appropriately address their needs. The University’s previous experience is that Medicaid subscribers have significant challenges with access in the Chicagoland area, especially for mental health needs. While some providers state that Medicaid is an accepted form of payment, in practice, Northwestern students with Medicaid have significant challenges accessing health services in the area. It is Northwestern’s position that Medicaid is not comparable to the coverage provided by the Aetna Student Health Insurance Plan.
Students also need to be aware that within Medicaid, the various Medicaid Managed Care plans will provide access to different providers and may provide different levels of benefits. The selection of a plan will impact the care you are able to receive.
Should you elect to waive the Aetna Student Health Insurance Plan with Medicaid, you will not be eligible for emergency enrollment in the Aetna Plan should Medicaid not meet your future healthcare needs. Students accept full financial responsibility for hospital, laboratory, physician, diagnostic testing and other medical costs not covered by their insurance.
Silver and Bronze ACA-Compliant Plans
For the 2015-2016 academic year, Northwestern University will accept waivers by students covered by Silver or Bronze level plans. Northwestern will reevaluate the acceptance of these plans for the 2016-2017 academic year and may adjust this stance.
Northwestern strongly recommends that students consider whether these plans appropriately address their needs. When evaluating a health insurance plan, students need to consider the deductibles, coinsurance and covered benefits along with the premium in order to make an educated decision about the value of the plan. Silver and Bronze plans will have significant upfront deductibles and large coinsurance requirements, meaning you will need to pay large out-of-pocket costs at the point of care. It is Northwestern’s position that these plans are not comparable to the coverage provided by the Aetna Student Health Insurance Plan.
Students also need to ensure that any Silver or Bronze level plans provide in-network care in the Chicagoland area, as required in the waiver requirements above. Northwestern’s experience is that Silver and Bronze level plans do not provide an appropriate level of access to local providers.
Should you elect to waive the Aetna Student Health Insurance Plan with a Silver or Bronze plan, you will not be eligible for emergency enrollment in the Aetna Plan should your plan not meet your future healthcare needs. Students accept full financial responsibility for hospital, laboratory, physician, diagnostic testing and other medical costs not covered by their insurance.
If you cannot afford health insurance, you are required to contact the Insurance Office no later than the end of the second week of classes to discuss how to meet the health insurance requirements for students enrolled at Northwestern University by emailing email@example.com or calling 847.491.4134.