Frequently Asked Questions on U.S. Healthcare and Health Insurance

The healthcare system in the United States can be confusing for all graduate students, especially those who have not used it before. We have compiled a list of frequent questions regarding healthcare. If you are on the Student Health Insurance Plan, you should also see this guide on the coverage and benefits of the Student Health Insurance Plan. If you have a question, but you were not able to find answer on this page, please send an email to gsa@cmu.edu.

What is the difference between co-pay and co-insurance?

Coinsurance, like a copayment, is a form of cost sharing for health services or prescription drugs between insurance companies and the insured. Unlike copays, which are predetermined fees, coinsurance is a percentage of the cost for a health service or prescription drug paid by a member after they have reached their deductible.

What are the dates during which the plan for current academic year is valid?

CMU’s Student Health Insurance Plan runs from August 1 through July 31.

What is the difference between preferred and non-preferred emergency care? How does it affect the deductible?

There isn’t a difference between preferred and non-preferred emergency care. Emergency room care is paid at 100% after a $125 copay. Patients need not worry about whether the emergency room is preferred or non-preferred when seeking emergency care.

Is there health center at other CMU campuses?

CMU’s Pittsburgh, PA campus is the only campus with a health center.

If I am visiting family or friends out of state or out of country and have a medical problem/emergency, will my insurance cover it?

Your insurance coverage remains the same throughout the United States. If you are out of the country, you would need to contact On Call at 1-866-525-1956 to coordinate and pre-approve arrangements for any benefit to apply. There is no coverage in your home country.

Are there any urgent care clinics close to CMU campus? What are the hours of operation?

There are two urgent care clinics close to CMU.

If I lose my insurance card, how do I get a new one?

Please send an email to shinsure@andrew.cmu.edu from your Andrew email account to request a replacement card.

What are the different types of health services UHS offers?

For a list of services and fees, please visit: http://www.cmu.edu/health-services/services-and-fees/index.html

If I have a health insurance related questions, Is there a helpline to contact? What are the hours of operation?

If you have questions, you may send an email to shinsure@andrew.cmu.edu, send a secure message through HealthConnect or call (412) 268-2157 and press option #3. An insurance specialist is available Monday through Friday, 8:30 am to 4:40 pm.

If I am visiting a doctor, do I have to contact insurance provider?

You do not need to contact Aetna.

I am in a 16 month program at CMU, should I renew my insurance for an entire year after 12 months?

Yes, you would need to renew for the entire year. When you graduate, you can submit a cancellation form to UHS. If Aetna has not paid significant claims on your behalf, you would be eligible for a pro-rated refund. You may also keep the plan through July 31.

If  have to get my wisdom tooth extracted, is it covered under general insurance plan or do I need to have a dental insurance plan?

Wisdom tooth extraction is considered medical and covered under the medical insurance plan.

What does vision insurance cover?

The summary of vision benefits can be found here.

If I have injured my eye, does the treatment gets covered by the general insurance or do I need vision insurance?

Eye injuries and disease would be covered by the medical plan. Vision insurance is for glasses and contact lenses.

I enrolled for dental plan, how do I pay for it?

Medical, dental and vision plan premiums are posted to your student account and would be paid the same way you pay your tuition and fees.

Can I pay for my insurance in installments?

Only available during the Fall Open Enrollment, The Tuition Management Systems Health Insurance option allow you to pay your insurance premiums in nine monthly payments (September through May). Please visit www.cmu.afford.com

Are driver’s physicals covered under insurance?

Yes.

What are the other places that can do driver’s physicals?

You can schedule with a doctor or go to one of the urgent care centers listed above. DO NOT visit the emergency room for a driver’s physical.

How do you get prescriptions filled? Is it covered by my plan?

Most prescriptions are covered by the plan. Prescriptions can be taken to any pharmacy or your provider at UHS can assist in having the prescription delivered to the health center.

What should I do when they don’t ask me to pay the co-pay amount?

You can offer to pay or wait until you receive the bill.

I missed the insurance enrollment deadline. How do I enroll again?

For dental and vision, you would need to wait until the next open enrollment period.

For medical, you would need to have a qualifying live event (loss of coverage) to be eligible to enroll midyear. Otherwise, you would have to wait for the next annual enrollment.

How do I find a doctor/dentist in the area?

There are links to provider directories on the UHS website.

When should I go to UHS instead of Urgent Care or emergency room? Is there someone I can call to help me decide?

You can call (412) 268-2157 and press option #2 for medical advice during UHS hours. After business hours, you may call the nurse line at (844) 881-7176.