Graduate Student Health FAQThis page is meant as a guide to the Student Health Plan  , University Health Services, and other health-related information, written by and for graduate students. Most of the information found on this page is available in some form in the Student Health Plan documents or spread across the various webpages of UHS, Aetna, Medco, etc. However, we hope this will provide a one-stop source for some of the most commonly asked (or misunderstood) questions regarding healthcare for graduate students at Princeton University.You can find most of the locations mentioned in the answers below on this map: Graduate Student Health FAQ Google Map GeneralAetna, Medco, Healthplex, VSP, Aetna Student Health, Chickering... who are they, and who covers what?[+]The Student Health Plan (SHP) provides graduate students with a combination of comprehensive medical insurance, prescription coverage, and optional dental and vision plans, all of which are administered by different entities. The basics:
Can I decline the SHP coverage?[+]No. All graduate students are automatically enrolled in the SHP program. When does SHP coverage begin? When does it end?[+]The annual period for SHP coverage is Sept 1 - Aug 31. If an incoming student arrives on campus any time after July 1 prior to their September start-date for an assistantship or other Graduate School-approved program, coverage can begin then, with a pro-rata fee assessed for the period of time between arrival and Sept 1. SHP coverage will continue, with fees automatically assessed, as long as a student is enrolled at Princeton (including in absentia and DCE status). SHP coverage ends 90 days after the date on which your degree is approved. Degrees at Princeton can be approved five different times during the year: September (SHP extends to Dec 31), November (SHP extends to Jan 31), January (SHP extends to Apr 30), April (SHP extends to June 30), or May/June (SHP extends to Aug 31). If the student becomes insured as an employee under a separate policy before this 90-day period is over, coverage will end at that time. SHP coverage will immediately end if a student withdraws or takes a leave of absence (unless the leave of absence is due to medical leave, see last section below). SHP coverage for a dependent ends when the student he or she depends on is no longer eligible for the SHP, when the dependent becomes insured as an employee under a separate policy group, or when he or she reaches the age of 19. Once your SHP coverage ends, you may purchase conversion coverage, which the University offers through Celtic Insurance Co. Students and dependants who have been covered by the SHP for at least one semester are eligible to purchase an individual health insurance policy from Celtic Insurance Co. Celtic offers a number of plans with different deductibles and coverages. You must apply for this policy within 31 days of SHP coverage ending. Please note that Celtic's plans are not the same as the SHP. The University does not administer this program, so you will have to contact Celtic directly for information: (800) 365-2365, www.celtic-net.com .How much does the SHP cost, and how is it paid?[+]The SHP plan currently costs $1150 for the 2008-2009 academic year. In 2009-2010, the premium will be $1270. This amount is rolled into the comprehensive fee assessed to all graduate students, which is included as part of tuition. I've received several cards associated with the SHP. Do I need to present these to receive medical care?[+]You should receive at least one card from Aetna Student Health for medical claims and one from Medco for prescription claims. If you sign up for the supplemental dental plan (see below), you should also receive a card from Healthplex. The supplemental vision plan from VSP does not require a card. If you did not receive one or more of these ID cards, you should contact the vendors (Aetna, Medco, or Healthplex) directly. You will not have to present your Aetna Student Health card at McCosh? Health Center, except when receiving lab work from Quest Diagnostics, but you will need it when you use off-campus services. How do I contact the various vendors?[+]
On-campus CareWhere is University Health Services located?[+]UHS is currently located in the McCosh? Health Center building (not to be confused with McCosh? Hall). This building is located in the center of Princeton's main campus, next to the Frist Campus Center. The main entrance is off Washington Rd. The only parking near the building is restricted to emergency vehicles, handicapped parking, and other authorized vehicles. Public Safety (609-258-3134) can drive you to the Health Center if you are unable to walk there. (See map, green) What services are offered through UHS? Where? When?[+]McCosh? offers a range of services, including outpatient primary medical care services, urgent care, women's and men's health, athletic medicine, nutrition services, immunization and allergy service, travel medicine service, inpatient services, lab, radiology, and physical therapy. A full description of these services can be found on UHS's webpage , but the table below gives a basic overview.
UHS also includes an urgent care center for walk-in service, located on the first floor. Hours are the same as the outpatient clinic. During the academic year, many services (indicated above) are available 24 hours a day. After hours, all service is conducted at Inpatient Services on the second floor of McCosh?. In order to enter the building, use the intercom system at the front entrance of the building; a staff member will respond and unlock the door. Students will be seen by a registered nurse; if necessary, physicians and mental health professionals are on call 24/7. These services are intended for urgent problems that cannot wait until the morning. Is all on-campus care free?[+]Most services offered through UHS at McCosh? are offered without any direct cost to either students or Aetna. The exceptions to this rule are listed here, and are billed according to the SHP as follows:
Also, if a student fails to show up for a scheduled appointment, a no-show fee will be assessed to the person's student account. Off-campus careI need/want to see a doctor outside of UHS. Is this possible?[+]In order to be covered by the SHP, you must receive a referral from UHS before seeing an off-campus doctor. Referrals must be updated every 12 months to receive continuing care from an off-campus doctor. However, you do not need a referral if...
McCosh Health Center is closed (summer and academic breaks) and I need care. Where should I go?[+]For true emergencies, go straight to an emergency room. This is true at all times of the year, regardless of whether UHS is open. The closest hospital to Princeton's main campus is the University Medical Center at Princeton (see map, yellow). University Medical Center at Princeton 253 Witherspoon St Princeton, NJ 08540 (609) 497-4000 For non-emergency situations, you may also go to a hospital emergency room, but many students prefer to avoid this option due to the potential for high costs. As an alternative, you can instead use an urgent care center. These centers can perform most medical and minor surgical procedures for much less than an emergency room visit. See their websites for specifics on the services offered (see map, red). Princeton Primary and Urgent Care Center 707 Alexander Road 609-919-0009 Hrs: M-F 8AM-7PM; Sat 9AM - noon www.ppucc.com Brunswick Urgent Care PA 3110 State Hwy #27 Kendall Park, NJ 08824 732-422-4889 Hours: 9AM-10PM M-Sat?; 9-5 Sun www.brunswickurgentcare.net All services received off-campus will be billed according to the SHP. At the Princeton Center, Aetna is accepted for primary care; urgent care is treated as "fee for service", so you will have to pay upfront and then can be reimbursed when you file a claim with Aetna. The New Brunswick office accepts Aetna insurance directly. If you take public transportation to reach one of these facilities, you may be able to get reimbursement through UHS's special needs fund; call 609-258-3555 for information on this. I will be traveling out of the country for my research. How should I prepare? Will the SHP covers expenses incurred outside the U.S.?[+]UHS offers travel planning services, including immunizations, for students traveling to foreign countries. To begin this process, a student must first schedule a travel planning appointment at McCosh? Health Center. This should be done at least 4-6 weeks prior to your trip; students traveling to multiple countries and/or continents should allow at least 10 weeks. The SHP does cover medical expenses incurred outside the U.S.; however, it will not make direct payments to providers outside the U.S. Students must arrange for payments until their claims can be processed. Therefore, it is recommended that you carry claim forms with you so that claims can be processed as quickly as possible. These forms can be downloaded from UHS's website or picked up from the waiting areas at McCosh? on the first floor. For each claim, you will need to attach original medical bills to the form (including your name and ID number, date of service, itemization of services rendered, charge, and diagnosis). Also, if the service was rendered in a country using a different language and/or currency than the US, you will be required to provide translations and currency conversions. DentalDoes the SHP cover any dental services?[+]Yes. The SHP offers $125 towards preventive dental care each year. This covers the services that you would expect for a typical yearly visit, including examination, cleaning, x-rays, and fluoride treatment. Unlike most off-campus services, this one does not require a referral or preauthorization; you can make an appointment with the dentist of your choice. You are not required to use an Aetna preferred provider, but if you would like to find a dentist in Aetna's network, you can use the DocFind? tool on their website (enter "Aetna PPO" for plan type). The $125 does not apply towards your yearly SHP deductible. Some local offices provide discounted rates to Princeton graduate students (see map, purple): Dr. Craig Tyl Dental Health Care 601 Ewing St, Suite B-15 Princeton, NJ 08540 609-921-0034 609-497-2722 fax www.drtyl.com Princeton Park Dental Dr. Eric Abrams Princeton Professional Park 601 Ewing St Suite B16 Princeton, NJ 08540 609-924-5111 What qualifies as "catastrophic dental"? In other words, when is dental care treated as a medical/surgical situation?[+]Extraction of a partially- or fully-impacted wisdom tooth (not a fully erupted one) and treatment for injury to natural teeth both qualify as medical care under the SHP. To receive these benefits, you must first make an appointment at UHS. These procedures will be treated under the medical/surgical part of the SHP, with 80% of expenses covered after the deductible is satisfied. You may work with UHS to choose a dentist to perform the procedure, but will often be encouraged to use an Aetna preferred provider due to the savings they offer. What is the optional dental plan?[+]If you would like additional dental services other than those listed above (namely, anything non-preventative), you can enroll in the optional dental plan, which is administered by Healthplex/Eastern Dental. The enrollment costs an additional $71.00 for a student, $142.00 for a student plus dependent, or $238.00 for a student plus two or more dependents, which will be billed to your student account when you send in the enrollment form. The optional plan covers a one-year period, from Sept 1 - Aug 31; you must reenroll each year to continue this coverage. The enrollment period is limited to early May through August 15; you will receive an email from the Graduate School each year with exact dates of the enrollment period for the coming year. The optional plan covers a wide variety of dental services. The price of each procedure varies. A complete list of services and their costs, as well as the enrollment form, can be found on UHS's Optional Health Benefits site.Can I visit any dentist using the optional plan?[+]No. The optional plan is limited only to the Eastern Dental network, which (as of August 2008) consists of 17 offices throughout New Jersey (see map, blue). When you enroll in the optional plan, you must choose one of these offices as your provider. The closest office to Princeton is the Lawrenceville office, which will be assigned to you by default if you enroll and do not specify an office. The reviews we've received from students regarding the Eastern Dental service have been mixed. They provide assembly-line style dental, where each dentist performs only one task (cleaning, filling, etc). However, based on the experiences of students in recent years, we do not recommend the Ewing office. What is the Vital Savings program?[+]If you would like to see a dentist of your choice (within the Aetna Dental Access network) for dental procedures beyond the $125 covered in the SHP, you may enroll in a discount program offered through Aetna, known as Vital Savings on Dental. For $25, you receive a card that allows you to receive the contract price for a wide range of procedures. The contract price is a price that has been negotiated between Aetna and the various providers, and can be between 15-50% lower than the typical rate for a procedure. Because the rates vary by region, you must contact individual providers to learn about the exact costs of various procedures. The Vital Savings program is simply a discount program, not insurance; all payments will be made by the student directly to their dental provider, and these services do not count towards the SHP deductible. Generally, under this program, procedures will be more expensive than under the optional Eastern Dental plan, but this can be an alternative to dental insurance for students who don't wish to use the optional plan or who missed the enrollment period and need to have an expensive procedure. Questions about Vital Savings should be directed to Aetna Student Health (1-877-437-6511). VisionDoes the SHP cover any vision-related expenses?[+]Yes. The SHP automatically enrolls students in the Aetna Vision Discounts (formerly known as Vision One) program. This is not an insurance program, but rather a discount program. It provides discounts on eye exams, the purchase of contact lenses or glasses, and LASIK procedures. To find a provider, use Aetna's DocFind? utility (Provider category: pharmacy/vision discount/hearing, Provider type: Vision discount program). More details of this plan can be found in the Aetna Vision Discounts brochure . Payments for vision services do not count toward your yearly deductible.Some local businesses also offer discounts for students (see map, purple): 30% discount Optical Gallery of Princeton 301 N. Harrison St. Princeton Shopping Center Princeton 609-921-6620 10% discount Au Courant Opticians 57 Palmer Square West Princeton 609-921-9600 What is the optional vision plan?[+]A vision insurance program is offered through Vision Service Plan (VSP). This program offers low copays on eye exams and the purchase of glasses or contacts as well as discounts on LASIK through VSP-network providers. This is a separate network from the Aetna network; see the VSP Find a Doctor website to locate a provider.Like the optional dental plan, there is an enrollment period each year (early May - Aug 15). You must reenroll each year to continue receiving the optional vision benefits. The supplemental plan costs $77.00 for a student, $124.00 for a student plus spouse, $126.00 for a student plus children, or $204.00 for a student plus spouse and children. A complete list of services and their costs, as well as the enrollment form, can be found on UHS's Optional Health Benefits site.I have enrolled/am thinking of enrolling in the Vital Savings program; do I get any additional vision benefits through this program?[+]No. The Vital Savings on Vision program is the same program as the Aetna Vision Discounts program, simply under a different name. You do not have to pay the additional $25 to receive the vision discounts. (However, you may wish to pay this extra to receive dental discounts, which are not included in the SHP, see above). PrescriptionsWhat prescription benefits are included in the SHP?[+]The SHP includes a prescription benefit through Medco, which offers a $5 copay for generic drugs, a $20 copay for brand name drugs, and a $30 copay for multi-source drugs, with a $100 deductible per student or $200 deductible per family per year (Sept 1-Aug 31). Many prescriptions can be filled with even lower copays when ordered through Medco's mail order service; register for an account on Medco's website to see if your prescriptions can be filled through this service.How did the Deficit Reduction Act of 2005 affect birth control availability through UHS?[+]The Deficit Reduction Act, passed by Congress in 2005, required pharmaceutical companies to offer Medicaid and similar services their lowest price on prescription drugs. Prior to this, most pharmaceutical companies offered deeply discounted prices to university clinics; however, the change in law would have required the pharmaceutical companies to match these deep discounts for Medicaid. The companies were unable to do this, and so the unintentional consequence of the law was that prices for universities were raised significantly. Lobbying efforts by the American College Health Association to exempt university clinics from this Act are ongoing. Based on the new prices, Princeton is no longer able to offer the wide variety of birth control options at a low price as they did previously. UHS still offers two generic options: Aviane (the generic form of Alesse), and Cryselle (the generic form of Lo Ovral), both of which are estrogen/progestin birth control pills sold in 28-day packs. Both are offered at $6-$8 per pack at UHS. This amount can be applied towards your prescription deductible if you choose (most students simply don't report these purchases to Medco because the total yearly cost will not reach the $100 deductible, but students taking other medications may choose to do so in order to reach their deductible more quickly). Note that if you have already reached your deductible for the year, it is cheaper to purchase Cryselle and Aviane through Medco or a local pharmacy with the generic copay of $5 for one pack at a retail pharmacy or $10 for 3 packs via mail order (both retail for around $25 per pack prior to the deductible being reached). Does this mean I have to pay out of pocket for birth control if I don't want to use one of the two generics offered through UHS?[+]No. The majority of birth control products, including other brands of the pill, the patch, and the ring, are covered by the prescription plan offered through Medco, with a $5 copay for generics and $20 copay for brand names after the deductible. Medical Leave and Outside InsuranceDue to medical problems I am thinking of taking a Leave of Absence. Will the SHP cover me during this time?[+]Yes, but only for 90 days after your leave of absence begins (note that this applies only for medical leaves of absence; if you take a leave of absence for any other reason coverage ends on your official leave date). Try to avoid LOA status for medical reasons if at all possible. Talk to your advisor, department, the deans of the Graduate School, etc.; you may be able to arrange for lower workloads while still maintaining the status of an enrolled student. How do I get health insurance if I am no longer eligible for the Student Health Plan (non-medical leave of absence, graduating, etc)?[+]First, you should know that if you graduate while still enrolled in the SHP (i.e. as a regularly enrolled or DCE status student), your SHP coverage will extend for 90 days past the date on which your degree is approved. See the question above on SHP beginning and end dates for more details. If you are no longer eligible for the student health plan, there are a few options available: (1) Princeton offers a conversion program from Celtic Insurance to provide health insurance for students when they are no longer eligible for the Student Health Plan. The conversion program that is sponsored by Princeton, contract #C0S002002 (as of August 2009), does not require medical underwriting (i.e., it will cover all pre-existing conditions), does not have limitations based on state of residence and does not have limitations based on length of policy coverage. More information about the Celtic conversion program is available on the UHS SHP website . Look for the Conversion Application (PDF) form, which includes the Group number for the program (C0S002002) and the phone number to contact to sign up (800-365-2365).Celtic supposedly also sells an individual health insurance policy which is NOT the conversion program that Princeton provides to students. This individual health insurance policy requires medical underwriting and has various limitations based on state of residence. If you choose Celtic Insurance, make sure you enroll in the conversion program from Princeton and not an individual policy. As of August 2009, the cheapest price listed for Celtic Insurance, for a single person, for the conversion plan is $1080.00 per month (Visit the New Jersey Individual Health Coverage Program Rates website for the latest prices).Note: You may have heard about COBRA plans, which allow employees to buy into a health plan they held with a particular job after leaving that job. Graduate students don't qualify for COBRA since COBRA is for an individual who had an Employee plan which is regulated under the federal ERISA guidelines. Students don't fall under ERISA because they are not employees, so Princeton offers the conversion program through Celtic as an alternative. (2) Unless you have a preexisting condition, you can probably qualify for a much more affordable individual insurance plan than the Celtic conversion policy. There are a number of other health insurance companies form whom you can choose to buy a long-term or short-term individual health plan. The State of New Jersey Individual Health Coverage website lists many of these options. They offer a variety of plans, with different levels of benefits.Most insurers offer some type of "Basic and Essentials" or "EPO" plan. Be careful since while these are usually the cheapest plans, they offer very limited benefits, especially for catastrophic injuries or expensive hospital care. If you are trying to save money, are generally healthy, and are mostly worried about protecting yourself in case of catastrophic injury, you should consider a high-deductible plan with co-insurance options. Many insurance companies offer such plans for $300-500 per month, and usually allow you to see a Primary Care Physician that is in their network of providers with only a small co-payment. Some of these plans do cover preexisting conditions if you have been covered continuously for 18 months and have not had a break in coverage of 31 days or more. In particular, students have reported good experiences with: Horizon Blue Cross/Blue Shield of NJ - 1-800-224-1234 and Americhealth - 1-866-681-7368You can also search actual health plans and rates for any state at http://www.ehealthinsurance.com .Note that some plans provide different benefits for in-network providers (doctors and facilities who have agreements with the insurance company) and out-of-network providers (all others). If you will be moving out of New Jersey, you should make sure that you can access in-network providers from where you will be living.
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