About the Plan
Eastern Illinois University provides a supplemental plan of medical coverage for injury and illness for which the fee is automatically assessed along with tuition and fees for all eligible students enrolled in an on-campus program taking 9 or more hours, all Graduate Assistants under contract to the University, and all international students enrolled in an on-campus program, taking 3 or more hours. Students enrolled part-time (any program format) with 5 or more hours may apply to purchase coverage.
The Plan coordinates with the student’s primary carrier and provides the student worldwide coverage, 24 hours a day. Student Insurance is an economical way to reduce or eliminate out-of-pocket expenses when family health plans do not cover 100% of medical costs because of deductibles, co-payment amounts, limitations on specific benefits, and out-of-network penalties.
The Plan has a $100 deductible per diagnosis and pays up to 70% of eligible expenses for physician and hospital expenses, lab and x-ray, surgery, ambulance transport, physical therapy, maternity expenses, mental health and substance abuse issues. It has an annual maximum of $15,000.
The Student Insurance Office is located on the 3rd floor of the Student Services Building, Room 5021.
The Plan covers the student anywhere off-campus and reduces copays for formulary prescriptions prescribed by Medical Clinic providers that are provided by Prairie Medical Pharmacy.
Unlike an HMO or PPO, the Plan does not have a network. This gives students a choice in their care and provides coverage for treatment they receive at home, at school, or wherever they may travel.
If the student has other coverage, the Plan coordinates with your primary carrier. Most students find it beneficial to carry both, particularly if the family plan has a deductible/coinsurance.
While the student is insured, they can print off their Student Insurance Card from their PAWS account. Click on the "My Health" tab. From here, they will find a link for Student Insurance Card that will take them to their new Student Insurance Card.
Coverage for each Term is based on enrolled hours as of Count Day (Census Day) per the University Academic Calendar. Dependent coverage is not available.
Annual Maximum - $15,000
A $100 deductible will be taken per injury or illness. All related conditions and recurrent symptoms, or injuries as a result of the same accident, will be considered one illness or one injury.
| Schedule of Benefits*C | |
|---|---|
| Hospital Outpatient/Inpatient | 70% |
| Lab and X-Ray | 70% |
| CT and MRI | 50% |
| Anesthesia | 70% |
| Surgery | 70% Usual and Customary |
| Physician Inpatient | 50% |
| Physician Outpatient | 70% |
| Ambulance | 70% up to $300 |
| Dental | $100 per injured tooth |
| Maternity | 70% |
| Mental Health and/or Substance Abuse | 70% |
*All benefits are subject to all Plan Limitations and Exclusions.
How to Submit a Claim
Contact the Student Insurance Office for verification of coverage.
Complete the Student Insurance Claim Form (pdf) and submit it to our office. If the form is not completed, the claim will be denied.
It is the Covered Student's responsibility to provide primary and secondary (if applicable) insurance information to all medical providers.
If the Covered Student is entitled to benefits under any other insurance policy, that policy is primary. An Explanation of Benefits (EOB) documenting payment/denial from the primary carrier is required before benefits are payable by the Plan.
The completed claim form and all required documentation, and any additional information requested by the Student Insurance Office must be received within 52 weeks from the date of the first medical expense.
For questions about the Plan's benefits, eligibility, provisions, limitations and exclusions, and other features, e-mail us, call us at 217-581-5290, or stop by our office located on the 3rd floor of the Student Services Building. Please note, we are unable to answer student specific claim or eligibility questions via email due to privacy laws.
Our office hours are 8:00 a.m. to 4:30 p.m. Monday through Friday during the regular academic year. During the summer our hours are 8:00 a.m. to 4:30 p.m. Monday through Thursday, and 8:00 a.m. to 12:00 p.m. on Friday.
