What is the difference between a deductible, a copayment and coinsurance?
A deductible is a specific amount of covered medical expenses that must be incurred and paid for by you before benefits are payable under the plan. Deductibles are usually applied to in-patient, out-patient and surgical expenses. A copayment is your share of the expense for office visits or prescription drugs. Co-payments are usually collected at the time of the office visit or at the pharmacy. Coinsurance is your out of pocket share of on going medical expenses. This cost sharing can be preceeded by copayments and deductibles.Can I cancel this coverage at any time and get a refund for the unused portion of the plan?
The policy can not be cancelled, and no premium refund is available. Your coverage will continue until the expiration date of the policy regardless of whether you have graduated or left school for any reason.Why wasn't this bill paid by the student insurance plan?
Your student health plan has coinsurance, co-payments, deductibles, exclusions, and limitations. Please refer to your brochure to determine if one of these applies to your claim. If you feel there has been an error or unjustified denial, please complete the claim inquiry/satisfaction survey located on the first page of your college-specific page of our website.Do I need a claim form, if so, how do I get one and how do I complete it?
Only one claim form is needed for each accident or illness. A claim form may be obtained through your health center or downloaded from your college-specific page on our website. To complete the form, please fill in your name, address, ss# and details regarding your accident or illness. If you paid for your medical services, please attach a copy of your bill and receipt to the claim form. Mail the completed form with attachments to the address on the top of the claim form.Does this plan include Dental and Vision benefits?
Dental and Vision care are not covered. Dental care is covered only for injury to sound and natural teeth to a limit. This limit applies as a flat benefit . Vision care is covered only for injury to or medically diagnosed illnesses of the eye. No coverage is available for routine eye exams or corrective lenses of any kind. Please check your brochure or your college-specific page on our website for details.Where do I find the policy number?
The policy number is located on the front page of your brochure and on the first page of your college-specific page on our website. The policy number is the same for all students at a particular school.Does this plan cover me off campus and/or outside Maine?
The student insurance plan provides world-wide coverage. However, most foreign countries will not accept your insurance card as payment. You must pay the provider at the time of service and submit bills which have been translated to English and U.S. currency, with a claim form, to the insurance company for reimbursement.How do I get reimbursed for covered medical expenses?
To obtain reimbursement for covered medical services, obtain a claim form at health services or download one from your college-specific page on our website. Complete the claim form and submit it with a copy of your bill and receipt to the address on the top of the form.Are athletic injuries covered under the student plan?
No, athletic injuries from any intercollegiate, club or professional sports are not covered under the student plan, however, your college may have a separate policy especially for sports injuries coverage. Please refer to your athletics department for more information.May I enroll later and get a reduced rate?
Students may enroll for the full year, or prior to the beginning of the second semester. Mid-term enrollment is available to students who have lost other coverage. Enrollment to the Student Health Insurance plan must occur within 30 days of the loss of coverage. The premium for mid term enrollment is either for the full year, or for second semester charge depending on when applying.Is an optional separate policy available that would provide major medical coverage?
Yes, Cross Insurance offers an optional individual Anthem Blue Cross major medical plan for those students and dependents interested in purchasing a plan that offers a high maximum benefit. Please email or call our office for prices and an enrollment packet.How do the benefits of the student plan coordinate with benefits of other plans?
The student health insurance plan is intended to supplement existing coverage, or pay as primary coverage for those with no other insurance. Some plans have a limited primary benefit before the coordination with other plans is activated. Please check your brochure or your college-specific page on our website for details.Are pre-existing conditions covered?
Pre-existing conditions are covered to the extent they were covered under prior insurance AND if that coverage was in place within 90 days of applying for the student insurance program. If these requirements are not satisfied, there is a 12 month waiting period before pre-existing conditions are covered.
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