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Summary of Coverage

The Northwestern University Student Health Insurance Plan (NU-SHIP) complies with all Patient Protection and Affordable Care Act (ACA) requirements for student health insurance plans. There are no exclusions for pre-existing conditions for this plan.

The plan year runs September 1–August 31. Annual benefits apply to services received during this period of time.

NU-SHIP: What's Covered at a Glance

NU-SHIP Coverage at a Glance
Type Description Preferred Care (In-Network Provider) Non-Preferred Care (Out-of-Network Provider)
Plan Deductible Amount you pay for medical costs, before NU-SHIP begins to pay for covered services. $250 $500
Annual Out-of-Pocket Limit Amount you pay out of pocket before NU-SHIP pays 100% for covered health benefits, subject to any benefit maximums or limits that may apply. (Applicable co-pays and deductibles will be applied to out-of-pocket maximum.) $2,000 (individual) / $4,000 (family) None (you are encouraged to use only in-network providers)
Co-insurance The percentage of covered medical expenses that you are responsible for. 20% of negotiated rate 40% of allowable expenses
Co-payment Specified dollar amount you pay for certain covered medical expenses. (Prescription Drugs ONLY!) see below see below

Inpatient/Outpatient Medical Expenses

See Plan Guide for details Aetna pays 80% of negotiated charge Aetna pays 60% of recognized charge
Physician Office Visit Note: $50 penalty incurred without referral from NUHS Aetna pays 80% of negotiated charge After $20 co-pay per visit, Aetna pays 60% of recognized charge
Outpatient Mental Health 80% of the negotiated charge per visit. Maximum patient responsibility of $20 per visit. No policy year deductible applies. $20 copayment then the plan pays 80% of the balance of the rrecognized ccharge per visit thereafter. No policy year dedeductible applies. (Please note if the recognized charge is less than the provider's full charge, the student may be responsible for additional costs.)
Emergency Room $100 co-pay (waived if admitted) then, Aetna pays 80% of negotiated charge Aetna pays 80% of recognized charge
Prescription Drugs

Each prescription fill:
$10 copay – generic
$30 copay – brand
$60 copay - non-formulary

Click here to view the 2020 Aetna Advanced Control Formulary.

Deductible per supply of 50% of recognized charge
Routine Physical Exam Includes routine vision and hearing screenings given as part of the routine physical exam Aetna pays 100% of negotiated charge After $20 deductible per visit, Aetna pays 60% of recognized charge

For a brief summary of benefits, download a copy of 2021-21 NU-SHIP Pamphlet

For detailed medical coverage info, download a copy of the 2020-21 NU-SHIP Plan Design & Benefits Summary

Additional Benefits

Students enrolled in the NU-SHIP have access to the following benefits:

 

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