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When does my coverage become effective?
Coverage will become effective on the date the coverage period begins or the date your application and full premium are received, whichever is later.
When do I get my insurance identification card?
Your insurance identification card will be mailed 2 - 3 weeks after your enrollment application and full premium are received. The card will be mailed to the address listed on your application.
Can I seek treatment when I do not have my insurance card?
Yes. You do not need your insurance card to seek treatment.
How do I submit an insurance claim?
In the event of Injury or Sickness, the Insured should consult a doctor and follow his/her instructions. Claim forms and instructions are available at the Student Health Service and all claims should be mailed to:
Consolidated Health Plans, Inc.
195 Stafford St.
Springfield, MA 01104-3503
(800) 437-6448info@consolidatedhealthplan.com
Written notice of a claim should be given within 30 days after the occurrence or commencement of any loss covered by the Policy. All bills for which benefits are to be paid must be submitted within 90 days for the date of treatment.
Am I required to see specific providers?
No. The University of Delaware Insurance program allows you to seek care with any provider you choose. However, if a MultiPlan provider is utilized, this may reduce your out-of-pocket co-insurance through discounts offered on the overall billing.
What is MultiPlan?
The University of Delaware Student Accident and Sickness Insurance Plan is being assisted by the MultiPlan Preferred Provider Network, a nationwide provider network. The MultiPlan network of providers is on the web at www.MultiPlan.com or you may call them toll-free at (800) 557-6794. If you utilize the services of a MultiPlan Provider you will be accessing discounts that may reduce your co-insurance payment. NOTE: You are not required to use a MultiPlan Provider. You may seek treatment at any provider of your choice.
What do I have to pay when I see a provider?
If you seek treatment for a sickness or injury, a $50.00 deductible is applied. The $50.00 deductible will be waived in the following instances:
a) covered x-ray services performed at the Student Health Service; or
b) care rendered to students at the Newark Emergency Center, Christiana Hospital, or Beebe Medical Center for the bonafide emergencies; or
c) covered outpatient physical therapy rendered for treatment of a Sickness at the University of Delaware Physical Therapy Health Clinic; or
d) outpatient prescription drugs when prescribed and filled at the University of Delaware Student Health Service.You will also need to pay 20% of any charge up to $2,000 per illness or injury.
It is at the providers discretion to charge the deductible up front. In most instances, the doctor will generate a bill for services and you will have to submit the claim. Please refer to ãHow do I file a claim?ä.
Are routine physicals covered?
No. Elective treatment or elective surgery is not covered. Expense for routine exams or check-ups and other preventive care is not covered under this program. This insurance will cover you in the event you have been injured or have a sickness.
Is there any dental coverage?
The only dental coverage is for treatment resulting from an injury to sound, natural teeth. A sound, natural tooth is a healthy, non-diseased tooth. There is no coverage for the removal of wisdom teeth, braces, or routine dental treatment.
Are insured dependents treated differently than insured students under this insurance?
No, although dependents are not eligible to utilize the University of Delaware Student Health Service.
Is Holistic or Christian Science Medicine covered?
No
Is Acupuncture and Massage Therapy covered?
Yes, if medically necessary. This would be provided for under the Physiotherapy Benefit.
Is it possible to submit bills electronically?
No. All bills must be sent in to Consolidated Health Plans via mail service.
What is the turnaround time for processing LabCorp charges?
4-5 weeks
Are Prescriptions covered?
Yes, there is prescription coverage:
After a $50.00 deductible has been satisfied, expense for outpatient prescription drugs are a Covered Medical Expense payable at 80% to a maximum of $250.00 for an injury or sickness. NOTE: If your prescription is prescribed and filled at the Student Health Center your $50.00 deductible will be waived.
Student Accident and Sickness Insurance Definitions
Ancillary means miscellaneous items that are associated with an inpatient claim i.e., prescriptions, x-rays, lab, anesthesia, operating room charges, or medical and surgical supplies.
Deductible means the amount the insured pays up front before the insurance company makes payment.
Co-insurance means the amount the patient is responsible for after the insurance has paid their portion i.e., insurance pays 80% and the insured pays 20% co-insurance.
Reasonable and Customary means the normal charge of the provider, in the absence of insurance, (a) for a medical service or supply, but not more than the prevailing charge in the area for a like service by a provider with similar training or experience, or (b) for a supply which is identical or substantially equivalent, The final determination of a Reasonable and Customary charge rests solely with the Company.
For comments or questions about this information, please contact Student Health Service, University of Delaware. This information was provided by University Health Plans, Inc..University Health Plans can be contacted at:
Phone:
800-437-6448