Health Center

Student Health Insurance

2011-12 Student Accident and
Sickness Insurance Plan Information

To ensure all full-time students have health insurance coverage, Hamilton College full time students are automatically enrolled in and billed for the Student Accident and Sickness Insurance Plan.

Not all insurance plans provide adequate coverage for students, ie: out-of state Medicaid plans, certain HMO's and managed care plans. If you have verified with your insurance carrier that you have adequate health insurance coverage, you can waive enrollment.

Benefits Summary:

Aggregate Maximum per cause:  

Mandatory Accident - 100% of R&C up to $2500 per injury
Basic Sickness - $2500
Major Medical Supplement- 80% of R&C up to $75000 (Basic + Supplemental)

Deductible:

In- Network: $100 Per policy year

Out of Network: $200 Per policy year

Deductibles are waived if health services referral provided.

Wellness Benefit:

Up to $400 per policy year and subject to the deductible

Benefits for: Routine physical exams, HPV vaccines, Hepatitis B vaccines, Meningitis vaccine, diagnostic cultures ordered in the diagnosis or ruling out of sexually transmitted diseases, and acupunture (when provided in a licensed physican's office).

Inpatient Hospital Miscellaneous Expense:

In Network: 80% of Preferred allowance

Out of Network: 60% of allowable charge

Surgical Expense (80th Percentile of MDR):

In Network: 80% of Preferred allowance

Out of Network: 60% of allowable charge

Outpatient Physician Expense:

In Network: 100% of Preferred allowance after $15 copayment

Out of Network: 60% of allowable charge

Medical Emergency Services:

80% Preferred allowance after $100 copayment if not admitted per visit

Inpatient Psychiatric Expense:

Paid the same as any other Sickness up to a maximum of 30 days

Outpatient Psychiatric Expense:

Paid the same as any other Sickness up to a maximum 20 visits per Policy Year

Outpatient Pharmacy (Prescription) Program:

Prescriptions must be filled at a Medco pharmacy. CVS Pharmacy is a participating Medco Pharmacy. For a list of additional participating pharmacies, please contact Medco at 1-800-711-0917 or www.medco.com
 

Retail - $10 co-pay for a 30-day supply of a generic drug and a $25 co-pay for a 30 day supply of a brand name drug up to the maximum benefit of $2500 per policy year.
 

Mail Order - 90 day supply for 2 co-payments for either generic or brand medicine. The policy per year maximum is maintained and will be combined with any separate retail prescriptions purchased and paid by the policy.

With enrollment of the student health insurance plan, you will also have access to: discounts for dental, eyewear, and fitness services.

For more information or questions regarding eligibility or benefits, contact Gallagher Koster customer service department at 1-877-308-0473 Monday-Friday, 8:30 a.m. - 6:00 p.m. EST or www.GallagherKoster.com/Hamilton.