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Plan Info and Requirements

Benefits

The chart below shows how the plan pays your benefits for the major types of health care expenses. You can see the difference in your cost when you use preferred providers. A list of all preferred providers can be obtained using the Doc-Find tool. Click on the Doc-Find link to obtain more information on how to use it. The complete health plan brochure can be viewed by logging on to Aetna Student Health. Our health plan has a lot of different benefits available to those who are enrolled, like the Vital Savings Dental and Vision Plan and the Student Assistance Plan (SAP). Our school ID is IIT.

You may review our Summary of Benefits or Master Policy here.

Type of Service or Supply Benefit Level

Policy Year Maximum

Unlimited

Plan Deductible

Preferred Care: $300

Non-Preferred Care: $400

Annual Out-of-Pocket Limit

Preferred Care: $6,850

Non-Preferred Care: $ Not applicable

Preferred Care

Non-Preferred Care

Physician Office Visit Expenses

Plan pays 80%

Plan pays 60%

Inpatient Hospitalization Expenses

Plan pays 80%

Plan pays 60%

Emergency Room Expenses

Plan pays 80%

Plan pays 80%

Prescription Drug Expenses *

Plan pays 100%

Not covered

Rx Co-pays

$12/40/55/110 (please see brochure and below for details on co-pays)

Rx Annual Maximum

Unlimited

*There is a $12/40/55/150 co-pay for prescription drugs, a $12 co-pay for generic, a $40 co-pay for brand-name formulary, a $55 co-pay for brand name non-formulary, or a $150 co-pay for specialty drugs.

There is no coverage for prescription drugs filled at a non-preferred pharmacy.

Premiums

 

Annual

Spring

Summer

*Monthly

Student

$1,499

$883

$333

$125

Spouse

$1,499

$883

$333

$125

Child

$1,499

$883

$333

$125

Children

$2,998

$1,195

$666

$248

*Monthly rates are based on Qualifying Life events only. Contact SHWC for more information

Coverage Period

Annual

August 10, 2019 through August 09, 2020

Spring

January 06, 2020 through August 09, 2020

Summer

May 21, 2020 through August 09, 2020

Enrollment and Waiver Deadlines

Annual

September 1st

Spring

January 26th

Summer

June 1st - Deadline may change according to Aetna Student Health