COVID-related coverage under the Student Health Plan (SHP)
Updated 12/15/2021
Due to the COVID public health emergency, insurance companies/health plans are being required by state and federal agencies to cover certain health care services related to COVID.
Over the last year and a half, the duration of these coverages has been updated multiple times by these governmental agencies, making it difficult to project their end dates. At this time, we can only list a projected end date, while noting that these dates may change and be extended.
Learn more about:
- COVID-related coverage changes
- Telehealth for outpatient mental health coverage
- Telehealth for a physician visit coverage
COVID-related Coverage Changes
| Coverage/Benefit | Date of Change / Anticipated Date of Change |
|---|---|
| Referrals from University Health Services for off-campus medical care will again be required. | 8/31/2021 |
|
COVID-19 testing, vaccines, hospitalizations and related expenses will return to the standard coverage for in-network and out of network services. |
7/31/2021 |
|
All telehealth/telemedicine, which includes all medical and behavioral health care, will return to the standard coverage for in-network and out of network services, as described below. |
7/6/2021 |
|
For those Out of Network Benefits currently covered at 80%, coverage will return to 70%. |
7/6/2021 |
Plan members should be aware that the following coverage is available under the SHP already and will continue to be available. It is unrelated to COVID:
Telehealth for Outpatient Mental Health Coverage
All telehealth visits or office visit expenses for outpatient mental health are covered as follows:
| Type of Outpatient Mental Health Provider | Copay/Coinsurance | Deductible |
|---|---|---|
| Princeton University Exclusive Provider Network participating provider | $20 Copay, after which the EPN covers 100% of the negotiated rate | Waived |
|
Aetna participating provider The technical term for this is “Preferred Care” or “In Network” |
$10 copay, after which Aetna pays 100% of the negotiated rate | Waived |
| Non-Participating/Non-Preferred / Out of Network provider | Patient is usually responsible for full payment upfront and responsible for submitting a claim to Aetna to obtain reimbursement of 70% of the recognized charge | Deductible Applies |
Telehealth for Physician Visit Coverage
All telemedicine visits or office visit expenses for a physician visit expense are covered as follows:
| Type of Physician Provider | Copay/Coinsurance | Deductible |
|---|---|---|
|
Aetna participating provider Technical term: “Preferred Care” or “In Network” |
$10 Copay, after which Aetna covers 100% of the negotiated rate. | Waived |
| Non-Participating/Non-Preferred / Out of Network provider | Patient is usually responsible for full payment upfront and responsible for submitting a claim to Aetna to obtain reimbursement of 70% of the recognized charge. | Deductible Applies |
Contact for Questions
If you have questions about these new changes or about coverage for other specific benefits and services, contact Aetna by calling 1-877-437-6511. You may also contact the SHP Office at: shpo@princeton.edu.