Frequently Asked Questions
How does the Drew Student Insurance Plan work when there is an athletic injury?
Students who are enrolled in the student insurance program, and who are injured during intercollegiate sports at Drew, are covered by the student insurance plan up to $1,000. When costs exceed $1,000, a separate Athletic Insurance Policy, that is paid for by Drew, will pay second (excess) up to $75,000. In extreme cases, the NCAA catastrophic insurance will cover major injuries that exceed $75,000.
However, the process for filing the insurance claims is different for athletic injuries than for other illness and injuries covered by the student plan. Specifically, if an intercollegiate athlete is injured during practice or play, and needs off-campus care, the parent’s insurance plan pays first, and the student plan pays second (excess). When the student intercollegiate athlete is not enrolled in a parent or family plan, and has the Drew student insurance as his/her only insurance, the student plan will pay for all covered services up to $1,000. Any charges over $1,000 will be paid by the Drew athletic insurance policy at 100% up to $75,000.
Club and Intramural sports accidents are treated as any other illness or injury by the student insurance plan. Covered expensed will be paid up to the policy maximum of $100,000, and the student plan pays first. Club and intramural sports injuries are not eligible for NCAA or Drew Athletic Insurance coverage.
Why should athletes consider buying the student insurance if they are covered by a parent plan?
Drew encourages all resident students and student athletes to purchase the student insurance plan. That is because so many out of area HMOs (even in NJ) will not pay for non-emergency care such as follow up x-rays or consultations with off-campus orthopedists. Less restricting parent insurance plans may have large deductibles instead. These situations can either strand our student athletes, or create an out-of pocket expense for parents.
In the past, the student plan excluded athletic injuries. This policy was changed a few years ago and student insurance will now pay “excess” up to $1,000. Essentially that means that the student plan will pay all co-pays, deductibles and any gaps in the parent insurance. If the parent plan declines local care for any reason, or if the student plan is the student’s only insurance, the student plan will pay most expenses up to $1,000. If the bills are higher than that, the Drew athletic policy will kick in and cover 100% of expenses over $1,000 on an excess basis.
My HMO says that they will pay for local care at Drew as long as the referral is to an in-network provider. Do I still need to buy the student insurance?
Keep in mind that Drew has a network of local providers for both athletes and non athletes. We pick top docs, local x-ray facilities, and we do blood work on site through the national laboratory LabCorp. These local providers may or may not be listed as providers in your family plan. It family insurance is your only insurance, it will be the student’s/family’s responsibility to arrange for pre-authorizations, notifications, and claims processing. It is also the student’s responsibility to pay any balances that remain.
Sometimes parent plans say that they pay for non-emergency local care, but then they will send students to doctors that we do not know, or that may be hard to get to without a car. It may also mean that students will wait weeks before they can get an appointment. Because of our ongoing relationships with our local preferred providers, we can have students seen right away which is a big plus. Having student insurance means that our students have options.
Does the Student Insurance Plan pay for other things too?
The student insurance plan also works as the primary payer for all non-athletic injuries or illnesses up to $50,000 per illness. Therefore, the Health Service can order blood work, x-rays or seek outside specialist consultations without worrying about whether parent insurance will cover the service. This is good and gives students seamless care in a timely way. It is very frustrating for both parents and Drew healthcare providers to have to deal with an insurance system that designates that only certain labs or certain providers can be used for these services, or that requires pre-authorization from family primary providers for everything.
If I have both parent and student insurance, how will my bills get paid?
Students/families are responsible for all medical bills that are related to sports injuries. When needed, students will be referred to local specialists or radiology centers, and it is up to students to arrange pre-authorizations and payment. It is important to know that the student athlete must complete a claim form for each accident/injury. It is not necessary to complete a separate form for each bill related to any one accident or injury. It is highly recommended that students keep copies of all itemized bills and submitted forms.
- Family plan only:
If students only have parent insurance they should follow the claims procedures of their insurance carrier as soon as possible. We want to keep our positive working relationships with our local providers and prompt payment is important.
- Family plan and student insurance plan:
If students also have the student insurance plan, they should submit any bills to their family insurance company first and wait for a response. If there are co-pays, deductibles or remaining charges (or if they decline any payment), an itemized bill with an explanation of benefits from your company should be submitted to the athletic trainer for confirmation, These bills will then be forwarded to the student insurance plan for payment. The student insurance plan will not accept balance bills that do not describe explanation of benefits and prior payments. If a student has current information about the family plan, it is possible to complete a universal insurance form in the training office where the student plan will be listed as second payer. The athletic trainers signature is required on this form as verification that the bill was related to play at Drew. In this case, the completed form, with accompanying bills can be submitted to the parent plan first. It is expected that the family insurance company will forward any remaining balances to the student insurance plan directly.
- Student insurance is your only insurance:
Bring all bills to the athletic trainer for verification. Complete the student insurance form, obtain trainer signature, and submit for payment. When possible, students should take the completed form to the provider at the time of service for direct payment to the insurance company.