Understanding Northwestern University Student Medical Insurance Coverage

Navigating the world of student health insurance can be complex. This article breaks down the Northwestern University Student Health Insurance Plan (NU-SHIP) and related options, clarifying coverage details, costs, and access to care.

NU-SHIP Overview

The Northwestern University Student Health Insurance Plan (NU-SHIP) is designed to meet the healthcare needs of students while adhering to the Patient Protection and Affordable Care Act (ACA) requirements. This means the plan includes essential benefits and has no exclusions for pre-existing conditions. The NU-SHIP plan year runs from September 1 to August 31.

Key Features of NU-SHIP

Out-of-Pocket Costs: This refers to the amount you pay before NU-SHIP starts covering 100% of covered health benefits, keeping in mind any applicable benefit maximums or limits.
Copayments: These are fixed dollar amounts you pay for specific covered medical expenses. For some services, a copayment might be followed by the plan paying a percentage (e.g., 80%) of the remaining cost.
No Policy Year Deductible: NU-SHIP does not have a policy year deductible.

Accessing Care with NU-SHIP

NU-SHIP provides access to a range of healthcare services, but it's important to understand where and how to access them effectively.

Vision Coverage: DeltaVision

The DeltaVision plan offers access to the EyeMed Select national network. Key features include:

No Waiting Period: You can use your benefits immediately.
$10 Copay for Annual Eye Exam
$25 Copay for Standard Prescription Lenses
$80 Allowance for Contact Lenses
$100 Allowance for Frames
Discounts on LASIK and PRK
Up to 40% Off Additional Vision Care Purchases

An ID card is not required to use your benefits.

Dental Coverage: Delta Dental

Northwestern offers two Delta Dental plans: Delta Dental Premier PPO and DeltaCare USA DHMO.

Delta Dental Premier PPO

This plan offers access to a large network of dentists, both in Illinois and across the country, with in-network and out-of-network benefits. As a member of Delta Dental, you may participate in the exclusive free Smile Perks program and save on flights, gifts and groceries, to entertainment. You are also eligible to receive an Athletic Mouth Guard at a discounted rate.

DeltaCare USA DHMO

DeltaCare USA DHMO plan is a great option for students looking for a lower plan cost with fixed copayments. During the enrollment process, you will select a DeltaCare USA primary dentist that is located in Illinois. Highlights of the DeltaCare USA DHMO include:

No waiting period
No deductible or annual maximum benefit
Preventive and Diagnostic services covered at 100%.
Comprehensive coverage for orthodontic treatment including retainers
You must select a DeltaCare USA provider in Illinois

A referral is necessary to see a specialist.

Accident and Sickness Hospital Indemnity Plan (ASHIP)

ASHIP is provided by Federal Insurance Company, a Chubb company. It is a fixed indemnity policy, NOT health insurance. This plan pays cash benefits directly to you for unexpected expenses arising from a hospital confinement. These benefits can be used as you see fit and are not necessarily tied to provider payments. Your coverage begins on the 1st of the month following enrollment. Key features include:

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Cash benefits paid directly to you
No deductible
$250 for emergency room visit
$1,000 for hospital admission
$250 per day for in-hospital care
$500 per day for Intensive Care Unit
$500 for ground ambulance transportation
$2,000 for air ambulance transportation

To submit a claim, the Accident and Sickness Plan Claim Form must be submitted within 20 days of the occurrence.

Telehealth: MDLive

MDLive provides 24/7/365 access to doctors and mental health providers at a $0 copay. Consultations are convenient, private and secure. MDLive uses board-certified doctors with an average of 15 years of experience.

The Graduate School (TGS) and NU-SHIP

TGS works with the Student Health Insurance office and the Office of Risk Management regarding health insurance for graduate students. While TGS advocates for graduate students and participates in the Student Health Insurance Policy Committee, final decisions about University health insurance policy, requirements, and NU-SHIP plan design are not made by TGS. TGS often subsidizes the cost of the premiums for the NU-SHIP. Students registered for TGS 512 are also enrolled in the NU-SHIP annually and must waive NU-SHIP enrollment in CAESAR with comparable coverage during the open enrollment period.

NIU Health Services

The Student Health Fee covers offerings available through NIU Health Services, which provides a level of basic outpatient health care similar to what you might find at an urgent care facility or your primary care physician’s office. Basic lab work (some, not all). Medical services provided at the Student Health Center include*:

*General medical care, including cold, fever, flu, respiratory ailments*Women’s health appointments, including pap smears*NIU-required physical exams*Screening for sexually transmitted infections*Immunizations*Urgent care appointments (sick visits and minor injuries)*Referrals to specialists*TelePsychiatry

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*Not all services are covered by the Student Health Insurance and will be billed directly to your personal insurance and/or private health insurance plan.

Accepted Insurances at Northwestern Medicine

Northwestern Medicine accepts a wide variety of insurance plans, including a significant number of health insurance plans currently held by NIU students (including Aetna Student Health Insurance, Medicaid and many others).

Important Considerations

Understanding Coverage Details: Carefully review the NU-SHIP documents to understand what services are covered, copayments, and any limitations.
In-Network vs. Out-of-Network: When using the Delta Dental PPO plan, be aware of the cost differences between in-network and out-of-network providers.
ASHIP Limitations: Recognize that ASHIP is a fixed indemnity policy and not a comprehensive health insurance plan. It provides cash benefits for specific events but doesn't cover all medical expenses.

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