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