Plan Information: Risk Management - Northwestern University

Refer to the plan brochure for a more comprehensive overview of the Visiting Scholar Health Insurance Plan.

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Medical Treatment and Preferred Provider Networks

Visiting scholars in need of medical treatment should contact Northwestern University Health Service. There is a physician on-call 24 hours at each campus location.

When a scholar is treated at Northwestern University Health Service in Evanston, billing is done directly to the Office of Risk Management with the scholar paying no deductible, coinsurance or copay. Visits to NU Health Service on the Chicago campus are subject to the usual out-of-pocket costs.

Insured dependents, including spouses, domestic partners, and children are not eligible to utilize the Northwestern University Health Services. Dependents in need of medical treatment may visit a physician in the Visiting Scholar Health Insurance Plan network. To identify a physician in the network, conduct a Provider Search at either of the following websites:

In the event of an emergency on either campus, Visiting Scholars and Eligible Dependents should seek treatment at the nearest emergency room.

Out-of-Pocket Costs

All members are required to pay a portion of the cost of service at the time care is received or after a claim has been processed. Under this Plan, members are responsible for the following out-of-pocket costs:

Copay: A flat dollar amount paid by the member that is applied to physician office visits. Copays are due at the time each service is received and represent a small fraction of the total cost of care.

Coinsurance: The percentage of the total expense paid by the member, after the deductible has been applied.

Deductible: The amount of covered expenses an individual pays in full each year before the plan pays any benefits. Under this Plan, the deductible applies to inpatient and outpatient services, but is waived for prescriptions.

Once the $250 deductible is met, the insurance will pay 80% of covered expenses, and the insured is responsible for 20% coinsurance up to an additional $1,000 out of pocket. Once the total of $1,250 is met, the insurance will pay 100% of covered expenses. The copay does not count toward the deductible or coinsurance totals.

Please note: There is no deductible, coinsurance or copay for covered expenses incurred at Northwestern University Health Service in Evanston. Visits to Northwestern University Health Service on the Chicago campus are subject to the usual out-of-pocket costs listed above.

Prescription Drugs

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 cannot fill prescriptions for dependents 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. Scholars will be reimbursed 50% for each prescription fill for each 30 day's supply.

To receive reimbursement for covered prescriptions, please mail the pharmacy receipt (not the cash register receipt) and a copy of your Visiting Scholar Health Insurance ID card to:

Northwestern University Health Service
Student Health Insurance Office
633 Emerson St
Evanston, IL 60208-4000

Claims Procedure

Claim forms and medical bills should be mailed to:

Northwestern University Student Insurance
Northwestern University Health Service
633 Emerson Street
Evanston, IL 60208-4000

Please include a copy of your insurance card.

ID Cards

The Office of Risk Management will send the scholar's hosting department an insurance card following processing of the Visiting Scholar Health Insurance Application. Individual insurance cards will be created for the scholar and the scholar's spouse and dependents, if applicable.

Immediately upon receipt of the insurance card(s), the scholar must activate their card by calling Ethlyn Senecal at Northwestern University Health Service (847) 491-4134.

Please note that ID cards will be issued as soon as possible. If you need medical attention before the ID card is received, benefits will be payable according to the Policy. You do not need an ID card to be eligible to receive benefits.

Rates

Exclusions

Refer to the plan brochure found at the top of this page for a comprehensive list of excluded charges and expenses. A summary of such exclusions is noted below: