A Message from Your Student Health Representatives at JHSPH

WHAT YOU SHOULD KNOW ABOUT YOUR

HEALTH CARE BENEFITS

IMPORTANT NUMBERS

University Health Services Clinic Appointments and Information: 410.955.3250 (M-F 8am-4pm) Carnegie Building Rm. 136 After-hours physician on-call: Medical/surgical: 410.955.4331 Psychiatric: 410.955.5964

University Health Services Benefits 410.955.3872 (M-F 8:30am-5:00pm) Blalock 144

Student Health Program (SHP) 888.400.0091 or 410.424.4485

(M-F 8am-5pm) Student Assistance Program 410.955.1220 550 Building, Rm. 507

Student Mental Health Services 410.955.1892 550 Building, Rm. 403

OVERVIEW

JHSPH students enrolled in the Student Health Plan receive health care coverage through two distinct entities. We are covered through an insurance program, the Student Health Program (SHP), which covers 80% of most health care and prescription claims. However, SHP does not cover preventive services such as yearly physicals and OB/GYN exams. Instead these services, as well as routine medical care and referrals, are available at no cost to students through the University Health Services (UHS) Clinic and Benefits Office.

If you are sick you therefore have the option of going to see the provider of your choice and paying 20% of charges, or going for free to the UHS clinic. The UHS Benefits Office will also pay the $100 deductible and the 20% SHP doesn’t cover for specialist visits if you are referred by the UHS clinic.

UNIVERSITY HEALTH SERVICES The UHS Clinic offers adult medical care,

gynecological care, obstetrical care, adult mental health (through the Student Assistance Program and Student Mental Health Services), pediatric care of covered dependents, adult immunizations (except travel shots), allergy desensitization, and HIV testing.

To get to the clinic: exit JHSPH on Monument Street and walk to your left towards the hospital. Cross Wolfe Street and take the first entrance on your left into the hospital (across the street from the bookstore). Inside the building take your first right. Go through the glass door, and Rm. 136 will be the second door on your right. Appointments

To make an appointment call 410.955.3250. Wait times for appointments are often on the long side (3-4 weeks). The staff at UHS knows this and tries their best to make it as short as possible but bear this in mind when making appointments.

Confidentiality Several of the MDs who staff the UHS clinic are

also students at the school of public health working on their MPHs as part of their internal medicine fellowships. In order to prevent your Epi 1 lab-mate from also doing your pap smear, when you make an appointment be sure to ask for someone who is not a student. You can also go into the clinic and look at the photos of the physicians on staff to see if you recognize any familiar faces. Be aware that insisting on seeing a non-student provider will likely increase the wait time for an appointment, as will requesting a female provider. Referrals and Billing

The UHS Benefits Office will only help pay for costs associated with referrals if the referrals are processed appropriately. The initial referral must be made by a UHS provider. Charges generated by referrals will be billed directly to SHP and they will pay their share(usually 80%). For UHS to pay the remaining 20% and the deductible, you must bring the provider bill and the insurance Explanation of Benefits (EOB) that you will receive in the mail to the UHS Benefits Office (Blalock 144, 410.955.3872). Make photocopies for your records as they will need the originals. Note that UHS Benefits does not help pay for surgical procedures or inpatient hospitalization and physician’s fees among other exclusions. See ‘Ambulatory Care’ brochure for details. Prescriptions

SHP covers 80% of most prescriptions including contraceptives. Family Eligibility

To be eligible for UHS benefits, spouses and dependent children must be covered by the Student Health Plan. Urgent/Emergency care

If you have an urgent care need during clinic hours, the clinic usually has walk-in slots available everyday. Call or go to the clinic and tell them you

need to see someone that day. You will probably be asked to wait, perhaps for a while, but eventually you will be seen, if not by a physician then at least by a nurse.

For after-hours urgent care, UHS has an on-call physician that you can call anytime (including weekends and holidays): 410.955.4331. If you need to go to the emergency room, call the on-call physician first otherwise UHS Benefits will not pay the 20% SHP doesn’t cover. As for referrals, when you get the bill and EOB in the mail, bring them to the UHS Benefits Office. In addition you must call SHP within 48hrs of going to the ER for them to cover their share of the visit (80%). Vision Care

UHS Benefits also pays for one free routine eye exam per calendar year at the Wilmer Eye Institute located in the hospital, past the cafeteria, on the left (M-F 9am-3pm 410.955.5080, www.wilmer.jhu.edu). Please note that you will receive a bill for this visit; bring it to the Benefits Office for them to pay it.. Eyeglass frames and lenses are 30% off at the Wilmer Vision Center in the Outpatient Center for all Hopkins students and their families (410.955.9373). More Information

For more information about UHS services call the Benefits Office (410.955.3872) or refer to the “Ambulatory Health Care Program for Students and Fellows, 2003-2004” brochure (on the web: www.hopkinsmedicine.org/som/PDF/UHS_Students_Booklet0304.pdf).

STUDENT HEALTH PROGRAM The Student Health Program (SHP) is a fee for

service plan. It permits access to any physician anywhere in the U.S. or abroad. You will have a deductible to meet; after the deductible is met, the plan pays 80% of most costs (technically 80% of usual and customary charges). For details please see the Summary Plan Description booklet you

received at orientation or call 410.424.4485 or 888.400.0091.

• Annual Deductible: $100 (individual), $300(family), can be paid by UHS Benefits if claim is referred through UHS Clinic.

• Maximum out-of-pocket per year: $3000 (individual), $9000 (family)

What is Covered

(Note that some services such as surgery may require pre-authorization in order to receive coverage. See booklet for more details) • primary and specialty care office visit (80%

covered after deductible) • diagnostic services and treatments (100%

covered, no deductible) • prescription benefits (80%, including prescribed

contraceptives, no deductible) • surgical procedures (80% after deductible) • hospitalization (100% for first 30 days, then

80%, after deductible) • urgent or emergency care in US or abroad (80-

100%, after deductible) • mental health and substance abuse treatment

(50%, after deductible) • prenatal care (80% of physician care, 100% of

hospitalization, after deductible) • mammograms if aged 35 w/ family history or

aged 40 (80% after deductible) What is Not Covered • Preventive health care services, including

gynecological annual checks, and adult immunizations, but you can get these free of charge through UHS.

• Lots of other things, check the booklet. Care Abroad

SHP covers you abroad just like it does in the US. Since it may be difficult for foreign providers to bill SHP directly you will probably have to pay upfront and then file claims to be reimbursed

yourself. Also note that since you cannot access the UHS Clinic, you will not be able to benefit from the supplemental benefits offered by UHS. Claims Information Forms can be found in the Student Accounts Office. For more information about how to file claims call SHP.

STUDENT ASSISTANCE PROGRAM (SAP) SAP provides counseling and referral services

for all student academic and personal concerns. 5 visits per year are covered at no charge. • 410.955.1220 or 410.516.3800 (M-F 8:30am-

5pm) • 550 Building, Rm. 507 (on Broadway and

Orleans, behind the outpatient center) or at Eastern High School, 1101 East 33rd Street, Suite C-100

• www.jhu.edu/~hr1/fasap/BSPHsap.html

STUDENT MENTAL HEALTH SERVICES • Appointments: 410.955.1892, real person only 3

days/week, otherwise it’s an answering machine. • 550 Building, Rm. 403 (on Broadway and

Orleans, behind the outpatient center). • 8 free visits per academic year, SHP covers 52%

for additional visits up to 20 per calendar year, after the deductible, and 50% of visits after 20.

• Can choose to see someone in Psychiatry Department or someone outside the school.

DENTAL CARE Dental care is currently not offered through

school. The Student Accounts Office has some suggestions of plans you can sign up for on your own.

Still confused? Email us at shprep@jhsph.edu

or visit www.jhsph.edu/studentgroups/shc