Columbia University Student Services June Mailing

What the Plan Offers

The Columbia Plan provides coverage for the following types of care. Go to the Health Services website for a complete list of benefits.

• Physician office visits, including allergy care
• X-rays and outpatient laboratory services
• Inpatient hospitalizations
• Dependent coverage enrollment options
• Pre-natal and maternity care^
• Dental care options
• Discounted vision care
• Emergency travel assistance services*
• Emergency care^
• Prescription plan benefits, including contraceptive medications and devices
• Mental health coverage
• Surgical services

^ For these benefits, a referral does not need to be obtained in advance.
* For these benefits, services must be arranged by On Call International.

How the Plan Works with the Program

The Columbia Plan works with the Health Service Program to provide consistent, efficient care that complements the programs offered on campus:

• Primary Care Medical Services (PCMS) clinicians are the primary care providers for students enrolled in the Columbia Plan
• Clinicians in PCMS and Counseling and Psychological Services (CPS) arrange access to off-campus care and services after students are seen and evaluated on campus
• A referral by PCMS or CPS is mandatory when seeking off-campus services to utilize benefits under the Columbia Plan

Coverage for Specific Off-Campus Services

Limited coverage for certain off-campus services is provided through the Health Service Program. This coverage is separate from the Plan. It is available to all students enrolled in the Health Service Program regardless of the type of health insurance plan a student carries. There are limits and restrictions on this special coverage. Coverage is provided for:

• off-campus mental health services*
• outpatient treatment for chemical abuse*
• treatment of accidental injury or medical emergencies, including emergency room care, emergency inpatient hospital care, physician services related to the treatment of accidental injury or medical emergencies

Basic Level

The basic level of the Columbia Plan is designed to provide a level of coverage that is adequate for many people attending college or graduate programs. It is appropriate for students who:

• Do not have a chronic health condition
• Do not expect to need health care services frequently
• Are looking for essential coverage at a reasonable cost
• Are interested in utilizing a “pay-as-you-go” strategy: participants pay a lower insurance premium at the outset but a higher proportion of the cost of any services that may be utilized
• The total maximum aggregate lifetime benefit available is $300,000 per condition

Comprehensive Level

For students who have chronic health conditions, take prescription drugs regularly or anticipate utilizing mental health services in an ongoing way, this level of the Columbia Plan may be appropriate. Students will:

• Pay a higher insurance premium up front
• Pay less in out-of-pocket expenses as services are utilized
• The total maximum aggregate lifetime benefit available is $1,000,000 per condition

Fees & Premiums

Health Service Program

Insurance Premiums for the Columbia Plan

Early Arrival Insurance Plan (Summer)

Enrollment

Waiver of Automatic Enrollment

To request a waiver of automatic enrollment in the Basic level of the Columbia Plan by providing documentation of alternate coverage under a comparable insurance plan, go to www.health.columbia.edu before September 30. All requests are considered but approval is not guaranteed.

If enrollment in the Columbia Plan has been waived for the fall term the waiver will automatically be extended to the spring term unless a significant life change occurs that warrants enrollment. Some examples of significant life changes are termination of insurance coverage under a partner’s or employer’s benefit plan, or surpassing the maximum age for coverage as a dependent under a parent’s plan. Late requests for enrollment will be reviewed upon receipt of documentation of such a change.

Because students’ alternate insurance coverage may change, students wishing to request a waiver of automatic enrollment in the Columbia Plan must submit a new waiver request by Sept. 30 of each year the student is registered.

Criteria for Comparable Alternate Medical Insurance Coverage

Please review your alternate coverage carefully to determine if the plan meets all six of the criteria listed below. Also inquire if you will “age-out” of your current insurance plan carried by parents or legal guardians at any time from September 1, 2009 through August 31, 2010. This may occur when you reach 19, 21 or 23 years of age.

All online requests are considered but approval is not guaranteed. The University verifies the information you provide. If you have not provided sufficient information or if your plan does not meet all of the requirements of the criteria, you will be contacted by the Health Services Insurance Office and enrolled in the Basic Level of the Columbia Plan and charged for the premium.

Your alternate plan must meet all of the following six criteria:

1. My plan provides coverage for all medically necessary* care including routine and emergency services while I am in New York City, or traveling or studying in the United States or abroad.
   *Please refer to the Detailed Health Insurance plan brochure for a definition of medically necessary.
   
2. The lifetime maximum benefit for my coverage is at least $300,000 per condition.
3. My coverage will remain in force as long as I am a registered student, including during approved leave of absence for medical reasons and non-degree status at Columbia University.
4. My coverage is effective as of September 1, 2009, (January 19, 2010 for new Spring enrollees and June 1, 2010 for new Summer enrollees) through August 31, 2010, and will cover me for any pre-existing conditions.
5. My plan covers all of the following types of care: treatment for injuries resulting from the practice or play of athletics, inpatient and outpatient psychiatric care and treatment for chemical dependency
6. My coverage is provided by a company licensed to do business in the United States and has a U.S. claims office and telephone number. Foreign state government plans do NOT meet this requirement.
   
   Please note that Medicaid plans are not considered comparable to the University’s plan.

Insurance Charges on your Student Account Statement

• If you submit a valid waiver request by July 27, no insurance charge will appear on your first fall Student Account Statement.
• Waiver requests submitted after July 27 but before the Sept. 30 deadline will generate a reversal of the insurance charge that appeared on your first fall Student Account Statement. This adjustment will be reflected on your Student Account Statement by October.
• If no waiver request is recorded by Sept. 30, the insurance charge will remain on your account and coverage under the Columbia Plan will be in effect.