Rate
Increase: For applications received on or after July 1, 2006 with
a starting date of January 1, 2007 or later, the rates will be $25
per week for single coverage, or $100 per week for family coverage.
The
Federal Government mandates health insurance coverage for Visiting
Scholars and their dependents. To facilitate University compliance,
the Office of Risk Management has established minimum health insurance
requirements for Visiting Scholars. The University self-insures
the Visiting Scholar Health Insurance Plan and the Office of Risk
Management provides program and claims administration.
All
Visiting Scholars/spouse/dependents or other authorized personnel
not receiving a salary from Northwestern University, are not benefits
eligible or would be eligible for benefits but did not sign up for
benefits and therefore must wait for an open-enrollment period are
eligible for the Visiting Scholar Health Insurance Plan. ( All personnel
eligible for NU benefits are not enrolled on their date of hire. Therefore,
interim insurance through the Plan is mandatory until the first day
of the following month when NU benefits are activated.)
The
host department is responsible for enrolling visiting scholars in
the Visiting Scholar Insurance program.
The Northwestern
University Visiting Scholar Health Insurance Application
is the only instrument that can be used to enroll Visiting
Scholars in the Plan. Click
here to download the application. It is a pdf file (Adobe Reader).
If you are having difficulties opening it, click here
for help.
Please
fill out and print the application, have it signed by the Dean,
Director, or Department Head, and fax it to (847) 467-7475.
It is important to note that a statutory condition of the Visiting
Scholar's visa is proof of health insurance coverage. Therefore,
the host department, as sponsor for the Visiting Scholar, must be
sure that coverage is in place from the date the Scholar arrives
in the United States until the date they leave the United States
(not just the time they are here at Northwestern).
Premiums
for Visiting Scholar Health Insurance are billed to the host department
through CUFS. The department account to be utilized for this purpose
must be listed on the Northwestern
University Visiting Scholar Health Insurance Application
when submitted. Departments may designate only operating or
discretionary accounts for Visiting Scholars Health Insurance (grant
accounts can not be used). All CUFS charges will be billed
to object 5720. Please be sure this object is open so the charges
can be applied appropriately. Billing will be either for (a) the period
of time from the date the Scholar arrives to the date his or her University
benefits commence, (b) the entire time the Scholar is staying at Northwestern,
or (c) the balance of the fiscal year. When a Scholar's stay bridges
two or more fiscal years, billing for each fiscal year will take place
in September. The current rates for the Visiting Scholars Insurance
Plan are $20 per week for single coverage, $75 per week for family
coverage. For applications received on or after July 1, 2006 with
a starting date of January 1, 2007 or later, the rates will be $25
per week for single coverage, or $100 per week for family coverage.
Refund
of pre-paid premium is made only when a Scholar leaves the University
early and the Office of Risk Management is notified in writing within
30 days of the Scholar's departure. In addition, premium can only
be refunded in the same fiscal year payment was made.
The Office of Risk Management can not accept payment from the Scholar.
However, many departments pass the cost of coverage on to the Visitor
and, at the department's discretion, charge the Scholar on a monthly
or quarterly basis.
Visiting
Scholars wishing to utilize health insurance other than that afforded
by the University must provide an English translation of their policy
to the Office of Risk Management for approval. Scholars should be
advised to seek Risk Management approval of potential outside coverage
prior to purchase. Doing so may help the Scholar avoid the purchase
of coverage that does not meet University standards and which involves
a non-refundable premium.
The
Office of Risk Management will send the scholar's hosting department
a Plan Brochure and 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
Student
Health Service (847) 491-4134.
Evanston
campus Visiting Scholars in need of medical treatment must
contact the Evanston
Student Health Service at the 24-hour hot line (847) 491-8100.
When a scholar is treated at Student Health, billing is done directly
to the Office of Risk Management with the Scholar paying no deductible.
In those cases where the Student Health physician refers the Scholar
to an area physician outside Student Health, the Scholar will incur
a $20 deductible. Scholars who seek treatment of an injury or illness
outside the Student Health Service without first obtaining a referral
from the Student Health Service will be charged a $50 deductible.
Chicago campus Scholars in need of treatment must
contact the Chicago
Student Health Service at (312) 695-8134. They are open during
normal business hours with a physician on-call 24 hours.
Dependents
of Visiting Scholars from both campuses can not be treated at Student
Health. To assist Scholar dependents that are in need of non-emergency
treatment, the Office of Risk Management has arranged for "gatekeeper"
services through Omega, 1000 Central Street, Evanston, (847) 657-1700.
Omega (Evanston) is open for appointments from 8:00 AM to 11:30
AM Monday, Wednesday, and Friday. They also have a Glenview facility,
(847) 657-1700 that is open Saturday from 8 AM to noon. Diagnosis,
treatment and referral services are available through Omega. Dependants
on both campuses are welcome to use Omega and will incur a $20 deductible
for each visit. The Office of Risk Management is working to identify
a similar "gatekeeper" in Chicago in the near future.
Dependents
wishing to seek medical services outside of Omega may visit a physician
in the Visiting Scholar Plan network for a $20 deductible per visit.
To identify a physician in the network, a Provider Search for Group
Health Plan (HFN-20) should be conducted at the following web address:
www.hfninc.com.
In the event of an emergency on either campus,
Visiting Scholars should seek treatment at the nearest emergency
room. However, it should be noted that in addition to the above-mentioned
$50 deductible, an additional $50 deductible will be charged to
the Scholar unless he or she is admitted to the hospital directly
from the emergency room.
Claim forms and medical bills should be mailed to:
Northwestern University Student Insurance
Student Health Service
633 Emerson Street
Evanston, IL 60208-4000
Refer to the Plan Brochure
for a comprehensive list of excluded charges and expenses. A summary
of such exclusions is noted below:
- Elective,
cosmetic or reconstructive surgery
- Treatment
in student's home country
- Routine
exams
- Dental
work, unless for an injury to natural teeth (Expenses will be
paid up to $100 per tooth of the reasonable and customary charges
with no aggregate cap.)
- Hearing
Aids and Glasses
- Birth
Control or Infertility
- Intercollegiate
Sports Injuries (Intercollegiate sports injuries will be covered
up to $25,000 per injury. Club and intramural sport injuries will
continue to be covered up to $250,000. Only professional sports
injuries are excluded.)
- Mental
or nervous disorders (Benefits will be paid for inpatient treatment
of a mental or nervous disorder up to a limit of (a) 50% of covered
inpatient hospital expenses, or (b) a lifetime maximum of $5,000.
Outpatient treatment will be paid at 50% of covered expenses subject
to a lifetime maximum benefit of $300.)
- Act
of war or related injury.
My
wife and I are enrolling now. Do we need to be covered as husband
and wife?
If both the husband and wife are scholars they may be covered separately
at the scholar rate rather than at the family rate.
I
need to get a prescription filled. What do I do?
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.
Does
the policy cover the Emergency Room?
The Northwestern University Visiting Scholar Plan Insurance 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.
If
someone has duel citizenship can they be covered under Northwestern
Plan and their country of Origins Plan?
Yes. However, Northwestern University insurance is always secondary
to any other insurance coverage.
What
about coverage for pregnancy?
The Northwestern University Visiting Scholar 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.
How
is a new baby added to the policy?
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.
If
a scholar has been enrolled on the insurance and never shows up.
Do we get the premium back?
Yes. Departments will be billed only for the time that coverage
is in effect.
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.
Northwestern
University
Office of Risk Management
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