The following benefit changes will apply for the 2013-2014 plan year:
1) Increase Emergency Room copay from $50 to $100 (waived if admitted).
2) Add $100 copay for outpatient surgery and procedures (applies to Surgeon Fee charge).
3) Increase brand name drug copay $35 to $45.
4) Increase office visit copay from $20 to $25, including outpatient mental health and outpatient therapy expenses.
In addition, the following benefit cahnges from 2012 remain in effect:
1) Contraceptive Coverage: All generic contraceptive pills will be covered at no cost to students. Brand name oral contraceptive pills will continue to have a brand name co-pay applied. Contraceptive devices (NuvaRing, OrthoEvra, intrauterine devices (IUDs) and implantable rods) will be covered at no cost to students.
Free Preventive Care: Please refer to the following link for a list of services covered under the plan. Please note that services available at the Student Health Service must be obtained at the SHS if the student is within 50 miles of the SHS. If the preventive service is not available at SHS it will be provided by a participating Aetna Student Health provider at no cost to the student. When outside of the 50 miles radius these services are covered at 100% only through a participating Aetna Student Health provider. Note: NY well woman mandate still applies (which states direct access is allowed for well woman care)
3) Coverage for sexual reassignment surgery: In accordance with requirements as defined in the Aetna Clinical Policy Bulletin
4) Increase policy year maximum to $1,250,000
5) No lifetime maximum will apply.