All full time studentsofficially enrolled within the Southern University system have health insurancecoverage provided by the student injury and sickness insurance plan. Studentsare automatically enrolled in the program as the premium is added to the theirtuition. The coverage becomes effective in the fall semester and continuesthroughout the beginning of the next academic year.
The student injury and sicknessinsurance plan pamphlet issued by the university gives a general summary of theinsurance. It explains the eligibility and effective dates and what medicaltreatments are covered and not covered by the policy. Unfortunately, sometimesstudents misinterpret the terms of the insurance policy.
“The university will only paythe maximum cost that is covered by the policy,” said Carol Burls, studenthealth insurance coordinator. “Ifthe treatment exceeds the maximum, the difference is paid by the student.”
Treatments not covered in thepolicy will not be paid for and will be the responsibility of the student.”They exclude a lot of things,” said Jason Paul, a freshmen civil engineeringmajor from Baton Rouge. “It seems that the most reoccurring things thathappens, they don’t cover.”
The plan, which includes lifeand accidental death and dismemberment benefits, is a supplement to using theresources of the Student Health Center. Students are to report first to the Student Health Center wheretreatment will be administered before going to the nearest hospital in anon-emergency situation. Areferral is issued to students that may have to go to outside care.
The referral is issued by theStudent Health Center; the exceptions are outlined in the student injury andsickness insurance plan brochure. If a referral is issued, the student shouldpresent the referral, along with a valid university identification card and acurrent Health Insurance ID card (which is located in the Health InsuranceBrochure), to the medical facility where treatment will be received.
A copy of the referral and acollege claim form completed by the student must be submitted to the insuranceclaims office within 30 days of injury or first treatment for a sickness orinjury. The claims office willdetermine whether to pay for receiving treatment at hospitals if it is a truemedical emergency. Expenses formedical treatment rendered outside of the Student Health Center with no priorapproval or referral are excluded from coverage.
“The students are recommended tomake appointments at the health center, if it can be treated here it would bedefrayed them from expenses,” Burls said. “If they are referred to aspecialists that referral doesn’t mean that it is covered.”
The insurance plan pamphlet gives details about studentreferral procedures, the exclusions and limitations, definitions of injury,sickness and medical emergency, and the medical expenses benefits for inpatientand outpatient services. It also explains the maximum benefits for each servicefor injury and sickness.
“It seems unfair that we have topay for services that we don’t use and the ones the policy don’t cover,” saidPaul.
Students should read thebrochure to understand the expenses of treatments that they receive on and offcampus Students may contact the Insurance Coordinator for assistance inprocessing claims for medical bills or resolving problems with providers andthe insurance claims office. For additional information, questions or concernscontact the Student Health Insurance Coordinator at the Student Health Centerat (225) 771-4770.
