Major Medical Q and A

I have signed up for the insurance but have not received my ID card. What should I do?

ID cards are mailed from the Aetna Insurance Company at the beginning of each policy year in August. If you do not receive a card please feel free to call Aetna at 866-378-6909 to verify your address and request a new card.

They will also be able to provide you with your policy number so you can go online and print out a temporary card.  If you are a new enrollee in the spring semester you will receive your card in February. If you enroll as a pro-rate you will receive a card shortly after your coverage beginning date.

Will I have a primary doctor if I purchase the Student Health Insurance through Northern Arizona University?

Yes. Northern Arizona University Medical Services will be the primary care physician for students with the Student Health Insurance.

There is a $15 co-pay for visits and $10 copay for labs, and x-rays at medical Services.

If you live outside a 25-mile radius of Flagstaff, you may find a primary care physician in the area in which you reside by visiting Aetna’s website. Click "Students," "Find Your School," and enter 697444 as your policy number. You may also use the Arizona State University and University of Arizona student health centers.

What happens if I need care after hours?

If Medical Services is closed, there is an answering service to reach the on-call provider. The phone number to reach the on-call provider is 928-773-7671. The answering service is only for students who have a Student Health Insurance policy.

You can also go to Concentra Walk-In Clinic in Flagstaff (928-773-9695), or NextCare Urgent Care in Flagstaff (928-779-3844).

If it is an emergency, we suggest going to the Flagstaff Medical Center emergency room. An emergency is defined by the Student Health Insurance as "a medical condition that manifests itself by symptoms of sufficient severity that in the absence of immediate medical attention could reasonably be expected to result in any of the following:

  • serious jeopardy to the patient's health
  • serious impairment to bodily functions
  • serious dysfunction of any bodily organ or part”

What happens if I am not in Flagstaff and I need health care?

For non-emergency situations outside of Flagstaff or out-of-state you may find a primary care physician, walk-in clinic, or emergency room in the area in which you are visiting by going to Aetna’s website, then clicking "Find Your School," and entering 697444 as your policy number.

Is the emergency room covered in the Student Health Insurance plan?

Yes. There is  $200 co-pay for visits to the emergency room if you are not admitted. If you are admitted overnight then the emergency room co-pay is waived. If admitted to the hospital, there is a $250 (starting Fall 2016) deductible that must be met if you have not met your deductible for the year. Once the deductible is met, the bills will be covered at 80 percent. You will be responsible for 20 percent up to $2,000 (starting Fall 2016).

What happens if there is a service needed that is not provided by Northern Arizona University Medical Services?

You may need to see a specialist outside of Medical Services. All care provided by an outside doctor will need a referral from one of our providers (if receiving care in Flagstaff). There is a $25 co-pay (starting Fall 2016) for specialty office visits. Without a referral to an outside doctor, you will have to pay out-of-pocket expenses at a higher level instead of the $35 co-pay.

What are the requirements for getting a referral?

You are required to obtain a referral for everything except:

  • if you are receiving services outside of a 25-mile radius of Flagstaff
  • emergency room services
  • maternity care
  • annual eye exams
  • injury to sound or natural teeth

My parents currently have me on their insurance but as of a certain date I am no longer eligible; can I buy the Student Health Insurance mid-semester?

Yes. If you have a qualifying life event and are being dropped off of another insurance carrier you may pro-rate from the day your coverage is terminated. You can call our insurance office at 928-523-6343 for rates throughout the semester. You have 30 days from the day coverage is terminated to pro-rate onto the Student Health Insurance.

How do I enroll my dependents/domestic partner in the Student Health Insurance?

Dependents are not covered under this policy.

I am going to be studying in a foreign country; will Student Health Insurance cover me while I am there?

If you must see a doctor while studying abroad, the fees will have to be paid out-of-pocket at the time of service. The Student Health Insurance will reimburse you when you get back to the states provided you have the correct documentation from your doctor visit. Doctor visits in a foreign country will be treated as an in-network benefit. Repatriation and Medical Evacuation has an unlimited benefit as long as you go through the travel assistance program through the insurance company before incurring any expense.

What is an annual deductible?

An annual deductible is the amount a covered person must pay for health services in a contract year before the company will begin paying benefits in that contract year. There is an annual deductible of $250 (starting Fall 2016) for network benefits and an annual deductible of $1,000 for non-network benefits. Co-pays are in addition to the annual deductible.

The contracted year is August 16 to August 15.
Fall dates are from August 16 to January 3.
Spring dates are from January 4 to August 15.

What do network and non-network benefits mean?

Network benefits are defined as:

  • obtaining health services from your primary care provider (Northern Arizona University Medical Services or assigned provider)
  • when a referral is written from your primary care provider to see a specialist who is contracted with the Student Health Insurance

Non-network benefits are defined as:

  • obtaining health services from a provider who is not contracted with the Student Health Insurance
  • receiving services outside of your primary care provider without a referral