Insurance

Primary Plan Changes 2013-2014

Summary of Changes for 2013-2014 USF Voluntary/Primary Medical Insurance Policy

*The 2013/2014 USF Student Medical Insurance Plan has changed. This is an overview of changes; refer to Benefit Flyer and Brochure for full list of benefits and exclusions at www.gallagherkoster.com/usf

Modified Medical Expense Benefits for Injury and Sickness

  • Maximum Benefit per policy year increased to $2,000,000
  • In Network Annual Policy Deductible decreased to $250
  • Out of Network Annual Policy Deductible decreased to $500
  • In Network Out of Pocket Maximum increased to $7,500
  • Out of Network Out of Pocket Maximum increased to $12,000 – Covered at In Network level once Out of Pocket Maximum has been reached
  • Prescription Benefit Cap increased to $1,250,000
  • Prescription Co-pays of Tier 1 $15 (remaining the same), Tier 2 $40 (increased), Tier 3 $70 (increased)
  • Emergency Room co-pay increased to $150
  • Urgent Care modified; now covered only when billed as a Doctor's Visit
  • Outpatient Physician's Office Visits In Network co-insurance 80%, after deductible $250 and co-pay $25 (not applicable at Student Health Services, where Outpatient Physician's Office Visit covered at 100%)
  • Durable Medical Equipment modified with internal limits up to $500 maximum per policy year

New Policy Exclusions include:

  • Acne
  • Acupuncture
  • Nicotine addiction, except as specifically provided in the policy
  • Milieu therapy, learning disabilities, behavioral problems, parent-child problems
  • Attention deficit disorder
  • Conceptual handicap, developmental delay or disorder or mental retardation;
  • Biofeedback
  • Chronic pain disorders
  • Circumcision;
  • Custodial Care; see Benefit Flyer and Brochure for specific exclusion
  • Elective abortion
  • Podiatry; see Benefit Flyer and Brochure for specific exclusion
  • Injury or Sickness outside the United States except for a Medical Emergency when traveling for academic study abroad programs; see Benefit Flyer and Brochure for specific exclusion
  • Outpatient Physiotherapy; see Benefit Flyer and Brochure for specific exclusion
  • Services provided normally without charge by the Health Service of the Policy holder; or services covered or provided by the student health fee
  • Deviated nasal septum, nasal and sinus surgery; see Benefit Flyer and Brochure for specific exclusion
  • Sleep disorders

Refer to Benefit Flyer and Brochure for full list of Exclusions at www.gallagherkoster.com/usf