Changes to Student Health Plan (SHP) Benefits - Effective September 1, 2019
Effective September 1, 2019
This announcement highlights a number of benefit design changes to the Student Health Plan (SHP) that will take effect on the first date of the new plan year, September 1, 2019. Please take this time to review these important changes carefully so that you understand the impact they will have for undergraduate students, graduate students and student dependents enrolled on the SHP for the 2019-2020 academic year.
Preferred Care (In-Network) & Non-Preferred Care (Out-of-Network) Design Update1
We have heard from students enrolled in the SHP about their concerns related to out of pocket costs. In response to these concerns, we are increasing coverage under the SHP from 80% of the Negotiated Charge to 90% when you use a Preferred Care provider (In-Network). When using a Non-Preferred Care provider (Out-of-Network) the SHP coverage will decrease from 80% of the Recognized Charge to 70%.
Given this change, we encourage you to go to the Aetna Navigator Doc Find to determine which of your providers are In-Network with Aetna. Alternatively, you can call your provider’s office and ask them if they are In-Network with Aetna.
Maternity Plan Benefits
SHP enrollees have also let us know their concerns related to out of pocket expenses associated with Maternity Care. Maternity Plan Benefits, which include covered medical expenses for pregnancy, childbirth, and complications of pregnancy, will now be covered at 100% for enrollees who choose Preferred Care Providers (In-Network), up from the current 80% for both the mother and newborn. Non-Preferred providers (Out-of-Network) will be reimbursed at 70% of the Recognized Charge, down from the current 80%. As noted above, you can determine whether or not a provider is in-network by reviewing the Aetna Navigator Doc Find for participating providers, or by calling the provider and inquiring about their network status with Aetna. The 2019-2020 SHP benefit chart will appear as follows when the new plan document is posted, effective September 1, 2019:
|Maternity Benefits||Preferred Care||Non-Preferred Care|
Covered Medical Expenses for pregnancy, childbirth, and complications of pregnancy
|100% of the Negotiated Charge||70% of the Recognized Charge|
A Reminder about International Health Coverage
Students who are traveling internationally have access to Student Health Plan coverage at non-preferred care rates.
In addition, students traveling internationally have access to health coverage with Cigna. The University provides international health coverage for all faculty, staff, and students (with a current passport or student visa), who are temporarily traveling or residing outside of their home country of regular residence, as part of a University activity, program, research, or other sponsored travel. The plan covers medical expenses, including hospital room and board, inpatient and outpatient surgical procedures, emergency outpatient care, labs and x-rays, inpatient and outpatient mental health, physician office visits and prescription drugs. See policy schedule for a full list of benefits.
For more information, go to: https://travel.princeton.edu/undergraduate-students/student-international-travel-resources/student-travel-medicine
Complementary Medicine Expenses
Complementary Medicine Expense benefits offered through the SHP include: Pain Management, Chiropractic, Massage Therapy, Biofeedback, and Acupuncture. Following additional data gathering and discussion with students related to these benefits in the spring of 2019, these services will continue to be offered with the following modifications to coverage:
- For services received from a Preferred Care Chiropractor (In-Network), you will pay a $20 copayment per visit (new).
- For services received from other Preferred Care Providers (In-Network), the SHP will cover 90% of the recognized charges (new – changed from 80% previously).
- For complementary medicine services received from a Non-Preferred provider (Out-of-Network), the SHP will cover 50% of the Recognized charges (new - changed from 80% previously)
- Thirty (30) visits per year for Chiropractic services (no change) with 2 modalities per visit.
- Thirty (30) combined visits per year for Acupuncture, Massage Therapy and Biofeedback services (no change).
- Referrals are required for all complementary medicine services; a new referral is required every 10 visits (new).
The 2019-2020 SHP benefit chart will appear as follows when the new plan document is posted, effective September 1, 2019:
|Outpatient Expenses (continued)||Preferred Care||Non-Preferred Care|
Complementary Medicine Expense
Requires initial referral and after every 10 visits
Pain Management, Chiropractic (limited to 30 visits per year with 2 modalities per visit), Acupuncture, Massage Therapy & Biofeedback (limited to 30 combined visits per year).
90% of the Negotiated Charge
$20 visit copay for Chiropractic care
50% of the Recognized Charge
Contact Aetna with questions about coverage of specific benefits and services by calling 1-877-437-6511.
1 Please note, these changes will NOT affect the Exclusive Provider Network (EPN). If you are seeing an EPN provider for mental health services, you will still only have a copay, with the deductible waived and no coinsurance.