FAQ's - AETNA-University Health Services - Carnegie Mellon University

Why did the university change Student Health Insurance Plan (SHIP) carriers?

The current dispute between UPMC and Highmark Blue Cross Blue Shield would have resulted in our students and their dependents not being able to access most UPMC facilities in the 2014-15 plan year.  UPMC facilities are highly utilized by students and, according to student feedback, remain a critical access point for care given the proximity of these facilities to the Pittsburgh campus. 

How was Aetna selected as the new carrier?

Five proposals were received and reviewed by University Health Services (UHS) administration and representatives from student government.  Aetna was selected because they offered access to UPMC and Allegheny Health Network providers and they have a broad national network of providers.  They also offered the lowest premium for essentially the same benefits currently offered in the Highmark Plan.

If I go to the Health Service for care, will the fees for service continue to be covered in full by the Aetna Plan?

Yes.  All fees for service will be covered in full and will not be applied toward your deductible.  Services and diagnostic testing, such as bloodwork, that are not provided on site at the Health Service will be subject to the deductible and any copays. Prescription medications will be covered at UHS at the same rate as an outside pharmacy.

If I am currently seeing a physician, mental health provider or allied health care provider for ongoing care, will they be covered under Aetna?

You will need to check with your current health care provider to see if they accept Aetna insurance.  If they are not in the Aetna network, you can continue to see them at the out-of-network rate or you can chose another provider who is in network. You can locate Aetna providers online and selecting Student Health Plans in the Select a Plan pull down. UHS is working with Aetna to invite health care providers who our students are seeing to join the Aetna network.

Does the SHIP meet Affordable Care Act (ACA) requirements for individual coverage?

Yes.  The CMU SHIP is fully compliant with ACA and meets the mandate for individual coverage.

How do the Standard and Enhanced Plans compare to the Metal Tiers on the Marketplace?

The Standard Plan is comparable to the Gold Tier and the Enhanced Plan is comparable to Platinum.  An Essential Benefit Comparison of CMU’s SHIPs and Marketplace Platinum, Gold and Silver Tier plans can be found here.

Will I be able to purchase a dental and vision plan?

Yes. Separate dental and vision plans will be offered by Aetna.  Students can select dental and/or vision in addition to the medical plan or as standalone products.