COVID-related coverage under the Student Health Plan (SHP)

Wednesday, July 21, 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. 

The following changes are reflected in the SHP Summary Guide (2020-21) and Student Health Plan document (2020-21) for complete information. 

Learn more about:

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