Stony Brook University, University Hospital, and Aetna
Student Health Insurance Plan (SHIP) FAQs
What's happening with the Aetna Student Health Insurance Plan (SHIP)?
Your SHIP, through Stony Brook University and Aetna Health, Inc. (Aetna), will continue through the end of the contract period, August 15, 2010. Meanwhile, Stony Brook University Hospital and Aetna have a contract that will expire February 15, 2010. Although they are currently negotiating a new agreement, if one is not reached by that date, the contract will expire and the Hospital will no longer be considered a "preferred care provider" under the rules of the University SHIP Plan.
What does this mean for me if I want to use the Hospital?
Stony Brook students enrolled in the University SHIP will not be covered the same way as before for services such as Emergency Room, laboratory testing, inpatient care, inpatient and outpatient surgery, and radiology, at the Hospital. These services will be paid as "non-preferred provider" benefits, some of them at a rate of 50% instead of 80%.
Will I still be able to receive services at the Hospital after February 15?
As stated above, you may continue to use all the Hospital services, but some of them will be reimbursed at a lower rate. Importantly, patients admitted to the Hospital before the contract expires, and still in the Hospital when the plan expires, will be covered under "preferred care provider" benefits. Outpatients who have already begun a continuing course of treatment will also be covered under "preferred care provider" benefits.
Will outpatient visits to doctors at the Hospital be affected?
Aetna contracts separately with attending physicians at the Hospital, and those doctors will remain "preferred care providers" in the Aetna plans. However, many physicians have privileges only at Stony Brook University Hospital, and Aetna could terminate those contracts. If this happens, you may still see those physicians at the Hospital on a "non-preferred care provider" basis.
Under the University contract with Aetna, your SHIP covers both preferred and non-preferred physician non-Hospital office visits the same way, so there should not be an issue with this.
Will I be responsible for any bills not paid by Aetna?
Stony Brook University Hospital will continue to bill Aetna on your behalf, but you will be responsible for some part of the bill. If this happens, please contact our Patient Accounts Department at (631) 444-4151 and we will work with you on various payment options and/or financial assistance. Based on your income and family size, you may be eligible for a reduction of your bill under the Hospital’s financial assistance program. If you receive a bill from a Stony Brook University Physician, please call (631) 444-4800.
What should I do if I have an appointment with a Hospital physician or an appointment for a test or treatment at the Hospital after February 15?
You might first try to schedule your visit for a date prior to February 15. This should be discussed with your own physician. On the other hand, you may keep this appointment, with the understanding that you may pay a greater portion of the bill.
Where can I get more information?
Please call the Student Health Insurance Office at (631) 632-6331 for information about benefit coverage. For the latest status on negotiations between Stony Brook University Hospital and Aetna, contact the Hospital at (631) 444-4392.