INTERNATIONAL STUDENT AND SCHOLAR SERVICES
SUNY INTERNATIONAL HEALTH AND ACCIDENT INSURANCE |
(NAME OF HEALTH INSURANCE COMPANY: HTH WORLDWIDE INSURANCE SERVICES)
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HOW DO I USE MY SUNY INTERNATIONAL HEALTH AND ACCIDENT INSURANCE?
ALWAYS VISIT THE UNIVERSITY HEALTH SERVICE FIRST!
University Health Services offers basic services, including office visits, medication, and common medical supplies are pre-paid by the separate Health Fee, which is included in your tuition bill at the beginning of each semester. This eliminates the need for you to pay cash for medications or for care at University Health Services. There is also the convenience of receiving medication and services right here on campus, rather than having to go off campus to a pharmacy. Finally, you will not need to submit claim forms and wait for reimbursement of your expenses for treatment and medicines available to you through University Health Services. Also, you will not be required to pay the “$50.00 deductible” that you would be charged by your health insurance company if you chose to visit a health care provider without first visiting University Health Service.
Health Services Hours of Operation:
Monday – Friday 8:00am – 4:45pm
Breaks & summer 8:00am – 3:45pm
HOW DO I KNOW WHAT HEALTH CARE PROVIDERS TO USE IF I AM REFERRED OFF CAMPUS?
If you are referred off-campus for healthcare, be sure to use a participating “preferred provider” in the AETNA System. To locate an AETNA participating “preferred provider”, go to their website at http://www.aetna.com for instructions for locating a “preferred provider” (e.g., doctor, hospital).
By using a “preferred provider”, you will avoid having to pay the difference between the provider's charge and the rate that the insurance company contracts to pay a “preferred provider” for a particular service. For example, if a “non-preferred provider” charged $100.00 for an office visit and HTH Worldwide Insurance Services pays the “non-preferred provider” at their contract rate of $75.00 for a “preferred provider”, you will be responsible for the difference of $25.00.
WHAT IF I HAVE AN EMERGENCY and UNIVERSITY HEALTH SERVICE IS CLOSED?
If your situation is such that you feel that your life is endangered (e.g., acute illness, severe injury, extreme pain) and that you cannot wait until University Health Service re-opens, then you have the option of going to a doctor’s office, a “walk-in clinic” or a hospital Emergency Room*. (NOTE: All of the local hospitals (Binghamton General Hospital, Wilson Regional Medical Center and Lourdes Hospital) are participating “preferred providers” in the AETNA System.
If you go to an Emergency Room or are hospitalized, you will not receive any bills when you leave the hospital. The hospital will send their bills directly to your health insurance company, HTH Worldwide Insurance Services.
If you seek emergency medical care off campus, you are responsible for obtaining a stamped “Authorization and Referral Claim Form” (claim form) from the University Health Service to send to HTH Worldwide Insurance Services, Inc. as soon as you are well enough to do so. Even though you do not receive any bills for your care at this time, you must send in a claim form.
Your stamped claim form will verify for your health insurance company (HTH Worldwide) that your doctor or hospital visit was an emergency or that it occurred when University Health Service was closed. If you do not send a claim form to the health insurance company for your Emergency Room care or hospitalization, your health insurance company will not pay the medical providers for your medical care until you do. The stamped claim form will also assure that you will not be charged the $50.00 deductible.
Approximately three to four weeks after your Emergency Room visit or hospitalization, you will receive other bills from the doctor who treated you in the Emergency Room, from a radiologist if you received x-rays or from a laboratory for tests. These bills are not the same as the bills that the hospital already sent directly to your health insurance company for your hospital care.
Make copies of all bills and receipts and mail the originals to HTH Worldwide Insurance Services. Do not send a second “Authorization and Referral Claim Form” (claim form) to the insurance company for the same illness, accident or injury. The insurance company will know where to apply your additional bills and receipts for your medical care after receipt of your original “Authorization and Referral Claim Form” (claim form).
If your visit to a doctor or hospital is not an emergency, you will be responsible for the $50.00 deductible.
*Please note: Emergency Room services are very expensive and should not be used as a doctor office visit. You should allow a minimum of 2-3 hours to be seen and treated. For non-emergencies, we recommend that you use one of the numerous “walk-in” clinics in the area that offer comparable, faster and not as cost prohibitive care. Remember, if you visit a provider for a non-emergency condition without a referral from University Health Services, you will be responsible for the $50.00 deductible.
WHAT IF THE HEALTH SERVICE IS OPEN, BUT I WOULD PREFER TO BE SEEN BY A DOCTOR IN THE COMMUNITY?
Go to the University Health Service first anyway for an evaluation so that they can stamp your claim form to show that you were referred to a provider off campus. Otherwise, if you seek medical care without going first to University Health Services, you will be responsible for a $50.00 deductible toward the total cost of your care. In addition, if you do not select an AETNA “participating provider”, you will pay the difference between what the non-participating provider charges and what HTH will pay the provider for your care. With a referral from University Health Services to an off-campus health care provider, you will avoid having to pay the $50.00 deductible.
WHAT IS THE PROCEDURE FOR FILING A CLAIM?
If you are referred by University Health Services for off-campus health care, are hospitalized or use an Emergency Room, request a stamped international student “Authorization and Referral Claim Form” (claim form) from University Health Service to send to the health insurance company (HTH Worldwide) after your visit. If HTH Worldwide Insurance Services receives your claim form without the University Health Services stamp, you will be responsible for the $50 deductible.
Directions for filing a claim are on the back of the “Authorization and Referral Claim Form” (claim form). Answer all of the questions on the front page of the “Authorization and Referral Form” (claim form) that pertain to your situation and sign your name and the date at the bottom of the “Authorization and Referral Claim Form”. Remember: make copies of your completed “Authorization and Referral Claim Form” (claim form) and all of your medical bills and/or receipts for payments already made by you for your personal records.
Where to mail the “Authorization and Referral Claim Form” (claim form):
Medical bills: HTH Worldwide, PO Box 30259, Tampa, FL 33630.
Prescription Drug receipts: HTH Worldwide Insurance Services, PO Box 968, Horsham, PA 19044.
If you require follow-up care for your illness, accident or injury, do not send another claim form for the same “event” (illness/accident/injury). Submit all or any additional bills for the same “event” without a new claim form.
Note: the insurance company will make payment to the provider (doctor/lab/hospital), NOT to you. However, if you paid for your medical care, to receive reimbursement, you must include a paid receipt or statement when you submit your “Authorization and Referral Claim Form” (claim form) to the health insurance company. If you receive new bills and/or receipts for the same “event” (illness, accident or injury) after you have submitted your initial claim form to HTH Worldwide, make copies of the bills and/or receipts for your records and mail the originals to HTH Worldwide Claims Department (address above). REMEMBER: do not send another claim form for the same event. Send only one claim form per illness/accident/injury.
Processing for payment of claims and reimbursement takes approximately three to four weeks.
SINCE THIS INSURANCE POLICY DOES NOT COVER DENTAL CARE, WHERE CAN I GO FOR INEXPENSIVE DENTAL TREATMENT?
Broome Community College, on upper Front Street in Binghamton, offers a dental hygiene clinic, which is open to the public by appointment during the academic school year. All of the hygienists at the clinic are students and are supervised by a dentist and licensed professional hygienists. Services offered include fluoride treatments, plaque control, X-rays, teeth cleaning, and pit and fissure sealants. Please call 778-5015 for information and/or an appointment. Please note: The clinic cannot diagnose a dental condition, only a dentist can do that.
To locate a dentist, look in the yellow pages of the local telephone book under “Dentists”.
WHO CAN I TALK TO IF I HAVE ANY QUESTIONS REGARDING MY INSURANCE, OR IF I NEED CLAIMS ASSISTANCE?
Any questions, concerns or problems regarding health insurance should be directed to the International Health Insurance Coordinator at the Office of International Student and Scholar Services, (607) 777-2510 or intl.insure@binghamton.edu.
You may also contact HTH Worldwide Insurance Services, Inc. for questions about coverage and claims. The toll free number is (888) 350-2002. HTH also has a website: www.hthstudents.com for information about your enrollment and claims processing.
REMINDER: If you are referred off-campus by University Health Services for health care, you can locate a participating “preferred provider” at: http://www.aetna.com.