- You may satisfy the insurance requirement through any private plan that meets University criteria for coverage or through enrollment in the Penn Student Insurance Plan (PSIP).
- Regardless of the coverage that you select, you must submit information about your insurance coverage each year. You do this by filing either a waiver or an enrollment in PSIP to the online system.
- You may do this at https://shs.wellness.upenn.edu/inreq https://shs.wellness.upenn.edu/inreq
- Before you submit your selection, be sure to secure a PennKey and Password.
- If you want to waive PSIP, be sure to have all of the information about your alternative coverage at hand.
- Enroll or request a waiver here https://shs.wellness.upenn.edu/inreq
- No. In order to ensure that your selection is properly recorded, you must use the online system. Documentation mailed, e-mailed or faxed will NOT be processed unless requested by the Penn Insurance Office.
- The online system is open from July 1, 2020 through August 31, 2020
- Yes, regardless of employment in the University, all full-time students are required to file a waiver showing their
Qualifying Life Events for dependents include:
- Marriage or establishment of a domestic partner relationship
- Birth or adoption of a child
- Entrance into the US (passport stamp required)
Please contact Student Insurance within 31 days of the occurrence of the event at 215 746 3535 or email@example.com
A Midyear Life Change Waiver is also accepted:
- We must receive the application before January 31, 2021.
- Your plan must be in effect as of February 1, 2021.
- Your plan must meet the University’s waiver criteria.
- Change in job
- Marriage/domestic partnership
- Change in employer sponsored plan
- Aetna will no longer automatically mail plastic insurance ID cards. To print your insurance ID card please go to www.aetnastudenthealth.com once your plan is in effect. To order a plastic ID card call Aetna Customer Service at 800.841.5374.
- Outpatient office visits
- Primary and specialty care office visits/referrals
- Mental health benefits
- Diagnostic studies
- Outpatient therapy/treatments
- Prescription medications
Three tiers of coverage:
Care at SHS:
- All office visits covered in full, no deductible or co-pays
- Most other charges are also covered in full
**Please note that the deductible can be applied for certain things at Student Health. Be certain to ask the Insurance Desk located in Student Health if you have any questions
In-network care (preferred provider):
- You are responsible for payment of allowable charges up to $400 (deductible) unless the deductible is waived for that particular service Please see the summary of benefits: https://www.aetnastudenthealth.com/students/student-connection.aspx?GroupID=724535.
There is a $1,500 out-of-pocket max for individual in-network coverage.Out of pocket max includes deductible and copays/coinsurance.
Out-of-network care (non-preferred care):
- You are responsible for payment of charges up to $1,500 (deductible)
- Provider balance may bill you for difference between actual charge and any PSIP payment
- After the deductible is met, the plan pays a percentage of reasonable and customary charges
- There is a $4,000 out-of-pocket max for individual out-of-network coverage. The out-of-network deductible is included in this cost
Key features of PSIP
- Unlimited lifetime maximum benefit
- Annual deductible of $400 In-network/$1,500 Out-of-network. in-network the deductible is waived for Emergency Room visits, pap smear screening, mammogram expense, immunizations, routine physical exams, routine screening for sexually transmitted diseases, routine colorectal cancer screening, routine prostate cancer screening, annual vision exam, pediatric vision care, pediatric dental exam, mental health, prenatal care/comprehensive lactation support and counseling services, breast feeding durable medical equipment, voluntary sterilization, contraceptives *Please see summary of benefits for details as exceptions may apply*
- Annual maximum out-of-pocket expense of $1,500 in-network/$4,000 out-of-network Co-pays (in-network)
- Emergency Room: $100
- Office visits: $35 after deductible satisfied
- Mental health visits: $10 (deductible waived)
- Lab/x-ray: $35 after deductible satisfied
- In-patient Hospital Room and Board $100 after deductible satisfied
- Surgical expenses inpatient $100, outpatient $100 after deductible satisfied
- Prescription coverage:
- 30-day supply of medication: $20 generic/$50 brand
- 90-day supply of medication (mail-order)): $50 generic/$150brand
Important: SHS referral is required for care within 25 miles of the University of Pennsylvania
*Referrals are not required for Emergency Room care, Mental Health visits, Women’s Health visits, eye exam or dental care
- Outpatient medical care is available to students through the Student Health Service.
- If you are within 25 miles of the University, you should first seek treatment at SHS. There is no deductible or co-pay for office visits to SHS
- If you need additional care outside of SHS, you will be given a referral by your provider.
- You are responsible for payment of deductible and/or co-pays for care outside SHS.
- If you are outside of the 25-mile radius, you may self-refer to any provider, but your costs will be significantly lower if you seek care from a participating Aetna provider.
- You are responsible for payment of any deductible and/or co-pays for care.
- Yes, the plan provides treatment for mental illness and substance abuse.
- You do not need a referral for any mental health visits.
- The deductible is waived for mental health visits.
- PSIP will only pay dental benefits in the event that you sustain an injury to a sound tooth or for the removal of an impacted wisdom tooth (referral not required).
- Routine dental care is not covered under the plan, unless you are age under the age of 19
- However, you are eligible to purchase additional dental insurance provided by the University of Pennsylvania, Dental School. Online applications and benefit descriptions are available at the My Penn Dentist website: https://www.mypenndentist.org/
- Please keep in mind that your dental insurance is independent to your health plan.
- PSIP will pay medical expenses for one routine eye exam per policy year at the negotiated rate of 90% for in-network treatment.
- You do not need a referral
- Glasses/contacts are NOT a covered benefit
- A complete listing of participating Preferred Providers and Pharmacies is available through the internet by accessing DocFind at: www.aetnastudenthealth.com.
- You may also contact Aetna Student Health Claims Administrators, Inc. at (800) 841-5374.
- Emergency Room Services – Important: all follow up treatment must be obtained through SHS or a referral from SHS must be obtained if the care is being obtained within a 25 mile radius of the University of Pennsylvania.
- Inpatient and Outpatient Mental Health and Substance Abuse Services
- Women’s Health Services (routine and non-routine) ‘ Annual Eye Examination
- Injury to Sound Natural Teeth or Removal of Impacted Wisdom Teeth.
- You do not need a referral for care outside the 25-mile radius of the campus.
- A referral is valid only for the specific medical condition defined by the SHS provider. One referral per conditions per policy year
- The referral can be valid up for the entire policy year (to July 31, 2021) per condition. However, if the SHS provider limits the number of visits, a new referral will be required once the allowed number of visits have been exceeded.
- Yes, you need a referral by a Student Health Service provider.
- You are responsible for payment of any relevant deductible and/or co-pay charges.
- No, you do not need a referral to see a women’s health provider.
- You are still responsible for payment of any relevant deductible and/or co-pay.
- Emergency Room care is covered. You do not need a referral for Emergency Room care.
- The Copay is $100. The deductible is waived for Emergency Room visits.
- Yes, all follow up treatment must be obtained through SHS, including referrals to outside specialists (unless the servicing provider(s) is outside the 25 mile radius of the University).
- This is true even if the Emergency Room providers refer and/or schedule you to see a specialist.
- Yes, while specimens for lab tests are obtained at SHS, they are sent to outside labs for processing and are subject to the deductible and applicable co-pay.
- X-rays are ordered and scheduled by SHS but are performed by outside radiology offices, and are subject to the deductible and applicable co-pay.
- Student Health is a department of the University, and is separate from HUP (Hospital of the University of Pennsylvania). Most of the providers at HUP are in the Aetna preferred provider network but please always double check at the Aetna Student Health DocFind. https://www.aetnastudenthealth.com/students/student-connection.aspx?GroupID=724535
- Insulin is covered through the Prescription Drug Benefit and not subject to the deductible.
- Yes, durable Medical Equipment is subject to the deductible.
- After the deductible is met, you are responsible for 90%of the Negotiated Charge for in-network care and 60% of the Reasonable Charge for out-of-network care
- You do not need a referral from Student Health for care outside of the Philadelphia area.
- Keep in mind that you are responsible for paying your deductible. Treatment by an Aetna Preferred Provider reduces your out-of-pocket costs.
- Yes, you are covered under the Penn Student Insurance Plan 24 hours, worldwide except for countries that have an economic or trade sanction issued by the United States..
- Coverage abroad is on a reimbursement basis and uses the in-network level of benefits.
- Coverage is also provided for Accidental Death and Dismemberment insurance up to $10,000.
- If you visit an In-network Preferred Provider, they will file a medical claim on your behalf.
- If you visit a Non-Preferred Provider, please request that they do so. If they decline, it will be your responsibility to do so.
- Please provide your Penn Student Health Insurance identification card at the time you receive services.
- Pre-certification is required for all inpatient admissions (including maternity and partial hospitalizations in a treatment facility or hospital)
- Pre-certification is obtained by contacting Aetna Student Health Claims Administrators, Inc. (Please note: pre-certification is not required for any outpatient services).