Health Care and Insurance

3.7 HEALTH CARE AND INSURANCE

Special Needs

Additional Health Care Resources

Financial Considerations

Health Care in America

For better or for worse, the American health care system is unique, offering unprecedented benefits to those who are ill while sometimes creating confusion and even despair among those responsible for the financial end of the cure!

That said, it is critical that international students and their families try to understand the basic vocabulary and processes of the American health care system, and budget health care costs into their living expenses.

With some review, it is possible to learn well enough how the system works in practice, and it is possible to find good and affordable health care within the community.

Before Leaving Home

If you are reading this information before leaving for the United States, please include health care considerations in your departure preparations. It is important to bring with you a copy of your medical records, especially for immunizations and any chronic conditions for which you must seek continued care. If you are covered by insurance in your home country, bring these records, as well, in order to establish continuous coverage for conditions that may be designated as pre-existing.

(A pre-exisiting condition, according to the University’s group policy, United Healthcare, means a disease or physical condition for which medical advice, diagnosis, care, or treatment was received by the Insured, or recommended to the Insured, during the six (6) months before the Insured’s Effective Date under the policy. Pregnancy will not be considered a pre-exisiting condition under the United Healthcare Insurance plan.)

The American Health Care System

Generally speaking, the type of mainstream health care practiced in America is referred to as allopathic. Physicians, upon whom the M.D. has been conferred, have been trained in and practice allopathic medicine. It is difficult to offer a definition of allopathic medicine, as the term itself is usually used only to distinguish its practices from those of what is referred to as homeopathic medicine. You might consider the following table , written by a nurse, of comparisons between homeopathic and allopathic practices,

Sometimes you will hear the term alternative medicine, which often refers to not only non-allopathic practice, but to other techniques and practices which are frequently not a part of American and European tradition, such as acupuncture, ch’i, or channeling prana. When practices from various medical disciplines are combined to address body, mind, and spirit, sometimes you will hear the expression holistic to describe this particular approach.

Physicians and Health Care Practitioners: Definitions

An intern is someone who has completed medical school but is engaged in a year of additional training before the residency. A resident is one who has completed an internship, then continues training in clinical medicine or surgery in a hospital setting. Sometimes you will hear that a physician is a specialist in reference to a medical doctor who practices in a particular field. The following glossary provides several definitions of specialties and health professions.

There are other types of physicians besides the MD (Doctor of Medicine), including osteopath. After the name of an osteopathic physician, you will see the letters D.O. More about osteopathy

A chiropractor (look for DC after the name) practices a medical technique based on a theory that the seat of many health problems is a misalignment of the bones, particularly of the spine. You should seek more information about the kind of care a chiropractor can provide before choosing one.

A midwife is a health care professional who provides primary care to women of childbearing age including prenatal, labor, delivery, and postnatal care. You should choose only those midwives who have national certification either as a nurse-midwife (CNM) or carry the title, Certified Midwife (CM).

For the role a nurse plays in health care, see this (in English, Espanol, Francais)

Cultural Issues

In the last few decades, American health care practitioners, administrators, and policy makers have become increasingly aware of how language and different ethnic, national, and religious cultures affect the way a person manifests, articulates, and seeks care for illness and injury. Since you may be unfamiliar or even uncomfortable with the American health care system, you may want counsel and assistance in determining when and how to secure medical care.

More about cultural issues in health care, developed by University of North Texas.

All students and dependents in J status must carry adequate insurance as stipulated in the DS-2019. Please note that the University’s group policy meets the minimum standards for a health insurance policy required to maintain the J-1 and J-2 immigration status.

Language Aids

For glossaries of medical and insurance terms, you may find some of the following sites helpful:
English and eight other Languages Medical Dictionary
English-Chinese Medical Dictionary
English-Russian Insurance Terms
Managed Care Terms
General Medical Terms Dictionary in English

Local Translators/Interpreters

Memorial Hospital (the preferred provider in an emergency for those insured under the University’s group policy) maintains a list of physicians who speak fluently another language in addition to English: 284-7219
Healthy Family Center: 236-7100 or 254-2799
South Bend School Corporation/ Bilingual Department: 283-8150

For Spanish Speakers:
La Casa de Amistad: 233-2120
El Campito: 232-0220
El Buen Vecino: 287-8228

Also staff members of various University departments and administrative offices are willing to help. Please phone the ISSA for further assistance.

Seeking Health Care Services

Choosing health care services and providers in America is a decision that must include considerations for manner and quality of care, as well as for your personal economy. It is important that, if you have questions and concerns about either care or financial responsibility, you discuss them with your care provider and his or her staff assistants before agreeing to a course of treatment.

Naturally, in an emergency you should seek care immediately and then seek assistance for unresolved financial issues. However, with some preparation, you can make better decisions in the case of an emergency, even when there is little time to consider alternatives.

Emergency/Urgent Care

Emergency phone numbers:
Keep near your phone or in your possession a list of emergency numbers for your hospital, personal physician, insurance policy pre-notification, etc. If you have children it is a good idea to have the poison control center number handy, as well: 800-382-9097.

In cases where you are in immediate need of assistance for serious illness or injury, phone: 911

Remember that this number is only for situations that require immediate response and should not be used if you are able to make other arrangements. If you require an ambulance for immediate transportation to a hospital, phone: 911

The University Health Services walk-in clinic staffs a nurse to assist students 24-hours a day.

It is important to have read your insurance policy instructions for seeking care in an emergency. Most policies state that a call must be made to notify the company either before or shortly after admission to a hospital, though even notification does not mean that your policy will cover all costs associated with an emergency. You should have with you at all times your insurance card to speed admission.

Sometimes, you will experience delays seeing a physician in the emergency room if there are other patients waiting and your symptoms are not considered life-threatening. It is important to be patient, but you may request attention persistently if you are experiencing pain.

Under federal law, a hospital cannot deny you emergency care, regardless of your ability to pay. However your condition must meet, through a screening process, certain criteria to be considered an emergency case. The hospital must, at any rate, provide stabilizing care until you can be transferred to the appropriate care facility, if such a transfer is necessary.

The following is a summary of Social Security Act 1867, Examination and Treatment for Emergency Medical Conditions.

Intermediate Care

Sometimes you will have conditions where you may not need to see a physician for an emergency, but you cannot wait until a physician is able to take you on an appointment basis. There are several facilities where you may walk in for care without an appointment. (Students with United Healthcare Insurance should seek care and referrals through the University Health Service first).

Check with your insurance company, but usually you can send in the paperwork yourself for reimbursements, even if the facility will not file the claim for you.

MedPoint at:
6913 N. Main St
Granger, IN
243-4300

1815 E. Ireland Rd.
South Bend, IN
291-3600

4630 Vistula Rd
Mishawaka, IN
254-7200

If you have already established yourself as a patient with any physician or within the practice of a particular group of physicians, you should call there first and explain your symptoms. They can often refer you for more immediate care if they are not able to set up an appointment for you.

Non-Emergency Care

When seeking health care it is important to know that you can contribute to a proper diagnosis and treatment by explaining well your symptoms and expressing your concerns to the care provider: How to talk to your doctor: Link

All students enrolled at the University of Notre Dame may seek medical treatment through the University Health Service.

Please note:
Students with United Healthcare Insurance: If you are a student enrolled in the University’s group insurance plan, you must seek care at the University Health Center or receive a written referral from the Center in order to ensure that the costs of such services are covered under your policy.

For circumstances when you might be directed to seek care elsewhere (vacations, emergencies, etc), please read the policy’s guidelines under “referral required”.

Dependents with United Healthcare Insurance:

Dependents, even if insured under the University’s group policy, must seek treatment from providers outside the University Health Center. Currently, Memorial Hospital is the only care provider listed as “preferred”. Go to Memorial Hospital’s emergency room only in an emergency. (Remember that you must notify the company of any hospital admission for an emergency within two days!)

For non-emergency care, you may go to whichever provider will accept your coverage or where you find the best financial arrangements. In some instances, you may go to a provider, regardless of your health insurance coverage, and then file the claim yourself with United Healthcare Insurance for reimbursement according to the terms of your policy. See Charlotte Bostic for assistance.

Dependents with alternate insurance: For those who do not hold a policy with United Healthcare Insurance, it is especially important to check with your company and with the physician or health care institution from which you hope to receive care about eligibility for coverage. Making sure that your provider accepts the insurance coverage you carry is ultimately your responsibility.

Participants in the Graduate School Assistance Program: Remember that if you have received a Graduate School assistanceship or intend to apply for one you must establish yourself as a patient through St. Joseph Hospital and its affiliated health care system. Always present the special membership card whenever you are seeking care. Other questions concerning the program may be directed to the Graduate School.

Dependents without health insurance: If members of your family are not covered by a health insurance policy, you may ask the University Health Service to recommend a physician, although they do not issue official referrals for family members. You may also search for a care provider yourself. Below are listed a few university and community resources. Remember that the following resources do not take responsibility for the care you may receive, nor for the financial arrangements! You should seek as much information as possible in order to make good health care and consumer decisions.

There are a number of clinics in the area that offer care on a “sliding scale” (charges are made according to your income and ability to pay). Please see the following link for a list of clinics that provide services to the uninsured: http://www.stjosephcountyindiana.com/sjchd/uninsured.htm

Pamphlets and resource materials are available through the following offices to help you locate local other health care providers :
University Health Center
Graduate Student Union
Campus Ministry
International Student Services & Activities
Rector, University Village Community Center

Women’s Health Care

Women’s Health
Prenatal Care and Birth: If you have insurance, consult with your providers on care during and after your pregnancy.
There is also a network of centers for women that can offer assistance when your financial resources are limited.

Women’s Care Center
The Women’s Care Center is a non-profit agency, supported by individuals, businesses, congregations and charitable foundations. The centers offer counseling, pregnancy tests, assistance in selecting a physician, prenatal and parenting workshops and classes, as well as, maternity and infant clothing.
There are 5 South Bend/Mishawaka locations:
305 S. Chapin St.
234-0395

417 N. St. Louis Blvd
234-0363

2004 Ironwood Circle
273-8986

1910 Miami St.
234-2502

201 Lincolnway West
254-2784

or the 24-hour hotline: 219-234-0363
En Espanol: 236-5523

Pregnancy Testing: Check your insurance policy for coverage; United Healthcare Insurance pays for a pregnancy test within the context of a medical exam to determine whether you are pregnant. For free testing, visit the Women’s Care Center (see above) or Ancilla Prenatal Clinic, 1708 S. High St, South Bend, IN; 237-6648.

Family Planning: For what is referred to as natural family planning (of interest to those who are looking for homeopathic and alternative methods), please consult with Women’s Care Center (see phone numbers above) or St. Joseph’s Regional Medical Center: 288-9977.

Oral contraceptives are prescribed through the University Health Service only for medical conditions where such therapy is medically necessary. United Healthcare Insurance currently does not cover any supplies or procedures related to reproduction and fertility outside of those supplies and services stipulated as necessary to determine pregnancy and provide for care, prenatal through birth. Note that this is standard to most student and employee policies, regardless of an institution’s religious affiliation, though this category of health coverage is currently under review by many companies.

Keep in mind that representatives of the University of Notre Dame strive to respect the intellectual and spiritual values of the Catholic Tradition when making referrals for family planning.

Breast-Feeding Information and Assistance

Both hospital systems, St. Joseph and Memorial, retain a Lactation Consultant.
St. Joseph: (574) 237-7043 or 258-1347
Memorial: (574) 284-3475

The LaLeche League is an international non-profit, non-sectarian organization dedicated to providing education, information, support and encouragement to women who want to breastfeed. Call the contact person at (574) 287-0702. LaLeche’s mailing address is 2002 Wilson Ave, South Bend, IN, 46617.

WIC (Women, Infants, Children) offers assistance for those who have limited finances, but require supplemental nutrition in order to breastfeed. For information, call (574) 234-2360, to learn about qualifying for their program.

Cervical screens and Breast exams: A physician will recommend which exams are considered necessary to maintain good health. Consult your individual insurance policy about when an examination will be covered. Students should consult with the University Health Service.

If you are not insured for certain exams, consider the following resources:

For Pap smears, which detect abnormalities of the cervix, and pelvic exams to detect abnormalities of the uterus, ovaries, fallopian tubes, bladder and rectum, or for a mammogram, to determine breast health: Call the local chapter of the American Cancer Society for a referral: 257-9789 or use the toll-free referral number: 1-800-227-2345

Below you will find sites with more about the importance of these exams for women. Pap smears no url | Breast exams

Men’s Health Care

At the age of 35, it is suggested that men begin to have regular prostate exams if there is a history of this type of cancer in the family, or beginning at the age of forty, regardless. More information can be found here.

For screens of Sexually Transmitted Diseases (note: for women these tests are often performed as part of the Pap Smear), St Joseph Co. Health Department – 235-9781

Children’s Health Care

To learn about health care programs and special insurance for children: Hoosier Healthwise Health Care Programs

Please see the link under “Dependents without Insurance” (above) for clinics that offer care to the uninsured on a sliding scale.

To assure that all Indiana families with infants and toddlers experiencing developmental delays or disabilities have access to early intervention services close to home when they need them, a coordinated statewide system of local interagency councils called First Steps has been implemented.

Eye Care

There are several eye care specialists listed in the phone book. Eye Care services are not provided under the University’s United Healthcare Insurance plan, and most medical insurance plans do not include provisions for eye care, so costs are usually your own responsibility. It is possible to go to an independent optician, however, where eyeglasses and vision care products are sold at a discount as long as you can present a current prescription issued by a physician. (Sometimes the Sunday newspaper will carry coupons offering further discounts on eye care products.)

You will encounter two main branches of vision care: optometry and ophthalmology.

Doctors of Optometry examine, diagnose, treat and manage diseases and disorders of the visual system, the eyes and associated structures as well as diagnose related systemic conditions.

Ophthalmologists are physicians who specialize in the medical and surgical care of the eyes and visual system and in the prevention of eye disease and injury. They can deliver total eye care (i.e., vision services, eye examinations, medical eye care and surgical eye care), diagnose general diseases of the body and treat ocular manifestations of systemic diseases.

Note: An Optician is someone qualified to fit and supply glasses and contact lenses, but not to examine eyes or prescribe corrective lenses.

Dental Care

Here again, it is rare that dental care is covered under a health insurance policy except in cases where healthy teeth have been affected because of injury. If you undertake to purchase your own dental insurance or a dental discount plan, take care to weigh the cost of the premiums against the cost of any and all services you are likely to require, and make sure there are participating dental care providers within a reasonable distance from your home! ( The International Student Organization offers the following dental insurance plan.)

For most general dental care, you can see a Doctor of Dental Science, DDS. There are many listed in the Yellow Pages or you might try a referral service:
Dental Referral Service:
800-511-8663
800-243-4444
If you require something called a “root canal”, which treats the nerve and associated tissue, you may be referred to an endodontist. For diseases of the gums, you would see a periodontist.

Glossary of Dental Terms

IUSB Dental Hygiene Clinic
For low-cost basic dental hygiene, such as cleanings and x-rays, it is possible to receive care through the Indiana University at South Bend Dental Clinic. It is located on the campus of IUSB in Riverside Hall, just off Northside Blvd. 237-4156

Memorial Neighborhood Health Center-Southeast [ No Url ] The clinic offers dental care on a sliding scale by appointment. See the following site for more information about how to set up an appointment.

The Chapin Street Clinic will provide dental exams, cleaning, extractions or whatever the need may be for just $10 per visit to those who meet the clinic guidelines. The clinic is at the Saint Joseph Health Center, 326 S. Chapin St., South Bend.

Children
If your children are enrolled in the public schools, you may be able to take advantage of a program that once a year offers dental check ups and basic dental hygiene for your children. Usually notice for this opportunity is sent home well in advance of the scheduled day.

If your children are enrolled in Hoosier Health Care, they may qualify for low-cost dental care under the provisions of that particular program. Following is a list of dental care providers in the area who accept this coverage.

Mental and Emotional Health

Students may seek counseling and support through the University Counseling Center, 631-7497.

Scholars may contact the Employee Assistance Program for referral to the appropriate mental health care provider. You may call a Lifeworks consultant directly at 888-267-8126 or go online: www.lifeworks.com. (The user ID is “notredame”, then “gond” for the password.)

Spouses may seek counseling thorugh the Madison Center by calling 234-0061 for an appointment. There is a cost for services provided through the Center, but the fee is adjusted according to income.

Special Needs

The Michiana community is home to many services and support groups to counsel and aid those with particular health needs and concerns. Some are listed in the phone book under “support groups” or “health agencies”. A list of meetings for many area support groups is published each week in the Monday edition of the South Bend Tribune. See the site above for the Step Ahead/United Way, as well.

University Contacts and Resources

On campus, there are several offices that may serve as a first point of contact, including the following:

For students:
Notre Dame University Health Center
http://www.nd.edu/~uhs/
631-7497

For students and family covered by United Healthcare Insurance:
Charlotte Bostic

Notre Dame’s Coordinator of Student Health Insurance
631-6114
Charlotte.M.Bostic.1@nd.edu
NB: Ms. Bostic can only assist those covered by United Healthcare Insurance. She is a University liaison to United Healthcare Insurance, but does not directly represent the interests of the company nor make final determinations in disputes you may have with the company.

General Questions:
Anne E. Kleva
Director of University Health Services
631-8286
Anne.E.Kleva.4@nd.edu

For students only:
Notre Dame University Counseling Center,
for Mental and Emotional Health
631-7336

Notre Dame Office of Alcohol and Drug Education
631-7970

Notre Dame Student Wellness Advisory Board
ISSA – International Student Services & Activities may serve as a further resource, along with representatives of the Office of Student Affairs and Campus Ministry. The Women’s Resource Center and the Graduate Student Union also offer information about local health care resources and support:

Campus Ministry-114 Coleman-Morse Center

Graduate Student Union-Mezzanine, LaFortune Center, Room 1

Women’s Resource Center-300 LaFortune Center, Room 1

University Village Community Center Office

Community Resources for Health Care

Keep in mind when seeking care from a clinic offering care on a sliding scale according to income that:

  • Some community clinics and financial aid programs for medical care are designed for the homeless and indigent who reside in this area.
  • As an international student or spouse, it is important to speak with Immigration Services about eligibility if you seek care from an agency that provides long-term health care services with public funds.

See the following link for clinics that provide services on a sliding scale:
http://www.stjosephcountyindiana.com/sjchd/uninsured.htm

Memorial Health Discovery Center : Described as a central access point for education, integrating and supporting complementary therapies as well as traditional medicine, the Memorial Health Discovery Center offers free consultations with a registered nurse on health and medical topics. Resources such as internet searches, books, videos and brochures are also available. You may gather information on your own or a staff member can help you.

Physician Referral Services

Ask-A-Nurse: 219-288-9977.
The Health Professionals: 219-284-6800.
http://www.qualityoflife.org/hlthprof.htm
St Joseph County Department of Health
The St. Joseph County Department of Health offers several clinics for various health needs. In particular:

Immunizations

The St. Joseph County Department of Health staffs an immunization clinic in The City-County Building in downtown South Bend, 227 W. Jefferson St.

See the following site [No url found] for more information about which immunizations are offered and how to make an appointment. (Page down on site.) Currently there is an $8 fee for childhood immunizations. Walk-ins on Wednesday afternoons are welcome, but otherwise you must phone for an appointment. Be sure to carry with you a current record of your child’s immunizations. Personal Checks are not accepted, but you may pay with a credit card or cash.

Free immunizations are administered through Healthy Family Center: 236-7100

Immunizations for cold and flu are administered free to students seasonally. Watch for announcements of the date and location on campus. Some of the local grocery stores also sponsor a day of free cold and flu immunizations.

Databases for Research on Care Providers, Health Issues, and Related Topics

Health Care Resource Sheet : (developed by PhD student in Theology Department—-needs update, but still useful)

St. Joseph Regional Medical Center Online Health Library : An online catalog of health issues with information and tips for preventing and treating illness and chronic conditions.

Health Resources Database , St. Joseph County Library A database including agency, hospital, health organization and care provider listings along with glossaries and other information resources (you must hold a valid library card in order to access this information)

Healthfinder – US Department of Health and Human Services Carefully selected health information websites from government agencies, clearinghouses, nonprofits and universities

National Institutes of Health]

Health Classes

Both Memorial and St. Joseph hospitals offer classes on a variety of subjects from stress management to birthing. Phone the hospitals for more information or see the home pages for each:

St. Joseph Regional Medical Center
Memorial Hospital and Health System

Health Fairs

The community also hosts a number of events sponsored by various health care agencies that promote and enhance good health. These events are often referred to as Health Fairs and are advertised mainly through the newspaper, flyers, posters and billboards around town. Often these fairs will feature free products, blood-pressure screenings, health care publications and displays, discount coupons for health care products and services, referrals for care and short presentations on issues such as stress management, etc.

Alternative Health Care Services

Remember that some health care services may not be covered by your insurance policy.

There are several listings in the local telephone book’s Yellow Pages for Acupuncture, as well as for Therapeutic Massage.

For Ayurvedic consultation, you would probably need to travel. Muncie, Indiana: Chicago area: Link 1 [No url found] | Link 2

Filling Prescriptions

Students and their families may fill prescriptions at the University Health Service Pharmacy. For hours and information about billing a prescription to your student account.

You should check with your insurance policy about where and how to fill a prescription. Though a few independent pharmacies are still in operation, many times a pharmacy will be part of a hospital or clinic system and often times you will find pharmaceutical services offered at grocery stores and shops that offer a variety of goods, referred to as “drugstores”. You should always present your insurance card when filling a prescription and save receipts. If you must file a claim for reimbursement yourself, do this promptly!

Sometimes a physician will be able to supply you with some of the medications prescribed at no additional cost. Ask whether he or she can provide you with “samples”, or whether a recommendation can be made for filling the prescription most economically.

For herbal remedies and supplements, try the natural food markets, listed under “Herbs” in the Yellow Pages.

Paying for Health Care

All international students at the University of Notre Dame must carry insurance, though you may choose between coverage under the university’s group policy, currently underwritten by United Healthcare Insurance, or select a company on your own that provides coverage comparable to this group policy. There is a deadline each year for enrollment, therefore it is important to have read all materials associated with the cost and coverage of any program you might choose before making a decision.

For dependents – spouses and children – you may choose coverage through United Healthcare Insurance, as well, with one of two plans offered for dependents, or again, choose your own insurance coverage. Dependents of students on J-1 visas must be insured. Those working or studying on other visas may opt to forego coverage for dependents, in which case you would be personally responsible for all costs.

Regardless of insurance coverage, remember that there will still be expenses associated with health care, as well as, record keeping and processing, for which you must assume responsibility.

Evaluating an Insurance Policy

There are several sites sponsored by university extensions and other consumer education organizations which emphasize key considerations in choosing insurance and include worksheets to aid in determining which policy option is best for your needs: Link1] | Link 2 | Link 3 (There are some details specific to North Dakota in the last site, but this is otherwise a good insurance primer.)

In addition to considering the cost and benefits of a policy, it is important to note the conditions and procedures for seeking care. In order to better understand your options and make sound decisions, please refer to the glossary of common terms associated with American insurance systems in your ISSA handbook or consult one of the following sites: Link 1 | Link 2

International students should make sure that a policy includes not only sound coverage for most anticipated health needs, but adequate benefits in the event that you require transportation to your home country due to serious illness or injury (medical evacuation), or transportation of your remains (repatriation).

Also, it is important to know more about the company’s experience and business practices before agreeing to pay the premium for coverage. Recently some of our international students discovered that a Web-based company in which they had invested for insurance dissolved without notice, leaving claims unpaid and the students without coverage. The following site is a connection to the Better Business Bureau, which maintains a record of companies and their practices. You can enter a phone number, web address or name in order to pull up a report on any particular company.

Indiana State Health Resources Bureau
The Indiana Department of Insurance (IDOI) regulates all companies offering insurance in the state of Indiana, as well as other entities, such as HMOs.

A word of caution: if you choose an insurance company with Web-based service, it may be that you will not be able to work with a local representative of this company and will need to make all claims and inquiries online.

The University of Notre Dame Group Policy United Healthcare Insurance

Each student receives, as part of the registration packet, a pamphlet outlining the coverage and cost of the University’s group policy. All graduate students and all international students are required to have insurance, and you will be automatically enrolled in the United Healthcare Insurance policy until you notify the University of alternate insurance.

It is important to have read the United Healthcare Insurance pamphlet before deciding on whether to choose the policy. You can access some information about the policy at sites for the University Health Service and for United Healthcare Insurance.

If you have not received a copy of the insurance pamphlet, you may request copies through the University Health Service (UHS) or through the ISSA. The insurance pamphlet is also linked from the UHS WEb site. If you have further questions, it is important to get satisfactory answers before deciding to enroll. Contact the company directly: 800-767-0700 or call Notre Dame’s Coordinator of Student Health Insurance: Charlotte Bostic, 219-631-6114, Bostic.1@nd.edu.

You may, of course, choose a policy other than the one offered through United Healthcare Insurance, but the coverage must be comparable.

Alternate Insurance for International Students and Scholars

As an international student or scholar, or as someone sponsored by a particular department or organization, you may be eligible for coverage under policies developed especially for you.

In addition to information pamphlets available in the ISSA and through your sponsoring department or organization, the following may serve as further resources. (The ISSA does not endorse of any of these companies, but only provides these links as a starting point for comparison of policy premiums and benefits). Some of the policies below offer only short-term or travel insurance; others offer coverage for the endurance of your studies.
International Student Organization
International Student Insurance
Hinchcliff International Group Services for Students
Harbour Group
HTH Worldwide
CMI International Travel Insurance
ISIS Insurance
Wallach and Company
New York International Group [No url]
Student Resources
Cultural Insurance Services International

Insuring your Spouse and Children

With the University’s group policy under United Healthcare Life, a student may choose coverage according to the standard plan. For dependents, however, you may choose between two options, but take care to understand the differences in each plan, noting that you may not shift from one plan to another in the course of the policy year and that there may be an “exclusion” and “waiting period” for so-called pre-existing conditions. (Consult the policy and/or a health care glossary for terms.)

If choosing the plan with lower initial premiums, note that the deductible and co-payments for each course of treatment will be substantially higher than for the plan with higher premiums and that there may be significant differences in total coverage.

Spouses and children may also be eligible for coverage under some of the policies linked above in the section on alternate insurance.

The Graduate School makes several grants through the following program to assist students with family in covering their medical expenses:

Graduate School Assistance Program: Materials outlining the application procedure for this program are distributed to all degree-seeking students in the graduate school each summer. Read these application materials carefully and be sure to follow the established guidelines. Remember that if you have received an assistanceship or intend to apply for one you must establish yourself as a patient through St. Joseph Hospital and its affiliated health care system. Always present the special membership card whenever you are seeking care. Other questions concerning the program may be directed to the Graduate School.

For children and pregnant women only you may want to consider the following coverage, granted through the State of Indiana. You must qualify according to your level of income:

Hoosier Healthwise for Children and Pregant Women

Hoosier Healthwise is a health insurance program for Indiana children, pregnant women, and low-income families. Health care is provided at little or no cost to Indiana families enrolled in the program. For details and the enrollment phone number, see the following site.

How to Settle your Medical Bills

The presumption is always that the patient is responsible for all fees, regardless of insurance.

You should always present your insurance card, if you have coverage, with every visit to a health care provider and retain all paperwork so that you can understand the charges, pay the balance when due in timely fashion, and file for possible tax credits.

For those who have insurance, the care provider’s staff will often file your claim with the insurance. On some occasions, however, you may need to file the claim yourself. Do this as soon as possible and be sure to retain a copy of the claim you submit along with copies of receipts.

In some instances, you will not be required to pay anything until your insurance has responded to any claims filed. Other arrangements might include co-payments where you pay a fixed amount or percentage at the time services are provided, and then pay the balance after the claim is fully settled. If you have no insurance, you may be asked to pay a percentage at the end of your visit and then you will receive a statement for the balance due.

If you have any questions about the amount of your deductible or how the insurance company has responded to your claims, call immediately for clarification. Sometimes you will need to check with the care provider, as well, about charges.

All insurance companies, hospital systems, clinics and physicians in private practice have staff that should be able to answer your insurance and billing questions effectively, however, if you feel that errors have been made and can not come to terms with representatives of the insurance company’s or care provider’s interests, ask to speak with a patient advocate or ombudsman. If you have the University’s group coverage, you may speak with Charlotte Bostic (Bostic.1@nd.edu, or 631-6114) about your concerns. You have the right to appeal.

At any time, should you have difficulties paying your bills, especially after insurance claims have been settled to the satisfaction of all parties, it is important that you inform the care provider of your circumstances. In most cases, you should be able to arrange a schedule of payments that do not further strain your finances. Because your health care services often include a variety of tests in addition to diagnosis and treatment, you may receive bills and statements from a number of different offices. You must contact each office separately to make arrangements for payment.

Remember!

You are not alone. If you have any questions or concerns about your health, about how to get care or how to make good financial arrangements, please see a member of the University Health Center’s staff or come to the ISSA and we will help you find the right resources!