Checklist Before Waiving Coverage

Some students already have adequate health insurance coverage through their parent’s health insurance plans, but many other students on our four Washington, D.C. campuses may not. This checklist is designed to help evaluate the adequacy of other health insurance in relation to the special needs of students.

Coverage in the D.C. Metropolitan Area

Cost increases have caused many employers to adopt benefits through a health maintenance organization (HMO), preferred provider organization (PPO), or other managed care system. Some HMOs and PPOs limit access to non-emergency care to a specific geographic area. Students must have more than just emergency coverage while attending school in the D.C. metropolitan area. Adequate student coverage should provide full benefits for health care in the Washington area with an unlimited benefit maximum. For simple inexpensive tests, such as throat cultures or blood counts, HMO coverage often requires travel to an approved site. If you are uncertain about your benefits, request a Summary of Benefits and Coverage (SBC) from your insurance company. Link to the Premier Plan’s SBC (new window) for a comparison.  Please refer to the Waiver Approval process for specific waiver requirements.

Student Health Center (SHC) Coverage

The SHC is staffed by primary care physicians and nurse practitioners with particular training and experience in college health. They are dedicated to providing high quality health care to our students. Please check that your insurance plan includes the Medstar Georgetown University Hospital SHC providers in its network of providers.

Telehealth

The Premier Plan provides access to virtual medical and mental health services 24 hours a day 7 days a week, free of charge through Healthiestyou.

Study Abroad and Worldwide Coverage

The Premier Plan provides worldwide coverage with a national PPO network that offers deep discounts for medical, pharmaceutical, and mental health services. Georgetown University students in Study Abroad programs have an additional overseas policy to cover medical treatment rendered outside of the United States. The Study Abroad overseas policy will not be accepted as the only “other insurance” for purposes of meeting the waiver requirement to decline the Premier Plan. Because the additional overseas policy enhances the Premier Plan’s overseas coverage, students are encouraged to maintain enrollment in both plans.

Low deductible plans

The Georgetown University Student Health Center (SHC) charges students for visits.  Health insurance plans may provide limited benefits due to high deductibles, which may be insufficient for the needs of a student.  Students often live, study, and socialize within a confined community of peers.  Lower deductibles allow access to care necessary to respond to contagious colds and flu thus minimizing disruption to their studies.  Parents and students should make certain that their deductibles and coinsurance would not preclude them from obtaining appropriate health care services.

Dual Coverage Under the Premier Plan and Another Plan

You may want to remain covered under your current plan and purchase this Plan. However, this Plan would not necessarily be your primary plan. This Plan coordinates benefits with other plans to determine which plan pays first. Refer to the Coordination of Benefits explanation in the Premier Plan Certificate of Coverage, if you wish to be covered under this Plan and another.