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FAQ & Health Insurance Glossary

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Q: My wife and I are enrolling now. Do we need to be covered as husband and wife?
A: If both the husband and wife are scholars they may be covered separately at the scholar rate rather than at the family rate.

Q: I need to get a prescription filled. What do I do?
A: The Plan pays for 50% of prescription costs. Scholars may go to Student Health Center Pharmacy and pay only their 50% (the Plan will be billed for the other 50%). The Student Health Center Pharmacy can not fill prescriptions for Scholar dependants or spouses.

Scholars, spouses and dependents using local pharmacies to fill prescriptions will have to pay for their prescription in full and be reimbursed the Plan's 50% portion once a claim is submitted.

The Plan will pay 100% for prescriptions used on an inpatient basis.

Q: Does the policy cover the Emergency Room?
A: The Northwestern University Visiting Scholar Health Insurance Plan will cover the Emergency Room in the same way as any other medical expense with the exception of an additional $50.00 deductible for use of the emergency room for treatment of a sickness. If the insured individual is confined in the hospital immediately, the additional deductible is waived. The purpose of the additional deductible is to discourage use of the Emergency Room for treatment of a sickness and not an injury.

Q: If someone has duel citizenship can they be covered under Northwestern Plan and their country of Origins Plan?
A: Yes. However, Northwestern University insurance is always secondary to any other insurance coverage.

Q: What about coverage for pregnancy?
A: The Northwestern University Visiting Scholar Health Insurance Plan is in compliance with the Federal Newborns' and Mothers' Health Protection Act. Pregnancy coverage shall include benefits for prenatal care and post-delivery inpatient Hospital Care (regardless of whether or not the birth occurred in a Hospital) for a mother and her newly born Child, for any length of stay not to exceed 48 hours following a vaginal delivery; or 96 hours following a caesarian section. Well baby benefits cover circumcisions and a pediatrician visit before the baby goes home. Once the baby is home well baby care is not a covered benefit.

Q: How is a new baby added to the policy?
A: Notify the Office of Risk Management of the birth. Until notification is made the new baby will not be covered under the insurance and subsequent bills will be returned to the care provider.

Health Insurance Glossary

Health Insurance
The first level of insurance designed to cover those expenses that exceed a small deductible (payable by the insured person). The basic medical benefit usually covers physician's fees, laboratory tests, nurse's fees, prescription medicine, and hospital expenses.

Coverage, or Covered Expenses
Those medical expenses that will be paid by the insurance company.

Deductible
Initial medical expenses per doctor visit or within specific time period paid by the insured person and not reimbursable by the insurance company.

Effective Date
The date on which the insurance policy takes effect.

Exclusions
Expenses not reimbursable by the Insurance Company

Premium
The nonrefundable cost of the insurance.