The following information is provided to give a brief overview of the insurance plan. The information below is being provided as a summary only. In the event of any discrepancies between this summary and the policy brochure, the terms and conditions of the master policy shall apply.

The following listing of benefits is a partial listing only. This benefit listing applies to students only.

BENEFIT CATEGORY	Health Center	Preferred Provider	Non-Preferred
Basic Medical Benefits	$250,000 aggregate maximum per condition, per policy year	$250,000 aggregate maximum per condition, per policy year	$250,000 aggregate maximum per condition, per policy year
Prescriptions See limitations for mental health prescriptions	70% Accutane & Retin-A covered only if prescribed & filled at HC Pharmacy	50% of the Reasonable Charge	50% of the Reasonable Charge
Physician/Clinician Office Visits	100%	100% negotiated charge	75% of the Reasonable Charge
Emergency Room $50 copayment each visit	NA	100% negotiated charge	100% of the Reasonable Charge
Hospital Care - Inpatient	NA	100% negotiated charge	75% of the Reasonable Charge
Hospital Care - Outpatient	NA	100% negotiated charge	75% of the Reasonable Charge
Laboratory Tests	100%	100% negotiated charge	75% of the Reasonable Charge
Maternity Care Newborn nursery care charges limited to $750 maximum	NA	100% negotiated charge	75% of the Reasonable Charge
Mental Health - Inpatient	NA	100% for first 10 days	100% for first 10 days
Mental Health - Outpatient Counseling	100%	Maximum of $70 per visit $1,000 maximum per policy year for therapy and prescriptions	Maximum of $56 per visit $1,000 maximum per policy year for therapy and prescriptions
Physical Therapy $1000 maximum per condition, per policy year	100% Requires a physician referral every 30 days	100% up to $35 per visit Requires a physician referral every 30 days	75% up to $35 per visit Requires a physician referral every 30 days
X-rays, CT scans, MRIs	100%	100% negotiated charge	75% of the Reasonable Charge
Allergy testing, allergy serum, allergy injections	100%	100% negotiated charge	75% of the Reasonable Charge
Ambulance	NA	100% of the Reasonable Charge	100% of the Reasonable Charge
Contraceptives Only oral contraceptives covered & must be filled at Health Center Pharmacy	70% Each prescription or refill limited to a 90 day supply	Not covered	Not covered
Immunizations	Only measles & flu shot covered at 100%	Not covered	Not covered
Mammograms, diagnostic	NA	100% negotiated charge	75% of the Reasonable Charge
Mammograms, screening Covered on the following schedule: Ages 35 through 40 - 1 baseline mammogram After 40 - 1 annual mammogram	NA	100% negotiated charge	75% of the Reasonable Charge
Women’s annual GYN exam	100%	100% negotiated charge	75% of the Reasonable Charge

Pre-existing conditions - Covered medical expenses for a pre-existing condition are limited to a maximum of $2,000 during the first 6 months of coverage on the UO student insurance plan. Pre-existing conditions are any injury, sickness or condition that was diagnosed or treated within 6 months prior to beginning coverage on the UO student insurance plan. Treatment includes prescriptions for treatment of injury, sickness or a condition.

Type of Coverage - This plan provides coverage for treatment for illness and injury. The plan provides year round coverage including coverage during school breaks and over the summer. The plan does not include vision or dental coverage.

This plan attempts to balance benefit levels and premium affordability. Out-of-pocket expenses should be anticipated. The plan does not cover preventative or elective health care except as specifically noted in benefit details.

Area of Coverage -The plan provides coverage for treatment at the Health Center. Covers eligible medical expenses in the United States and abroad EXCEPT IN THE STUDENT’S COUNTRY.

University Health Center - The University Health Center provides a wide range of health care services at very affordable prices. There is no deductible for care received at the Health Center. Use of the Health Center can lower a student’s out-of-pocket medical expenses.

Preferred Providers - A Preferred Provider Organization (PPO) is a network of physicians, hospitals and other health care professionals who have contracted with an insurance company to provide care at a set reimbursement rate in an effort to reduce costs to patients. The Preferred Provider Organization for the UO Student Health Insurance plan is Aetna. It is always to your advantage to use Aetna Preferred Providers whenever you receive medical care outside the Health Center. The discounts granted by Preferred Providers saves you money. Click here to find Aetna Preferred Providers.

Medical Care when the University Health Center is Closed - There are many Preferred Providers in the Eugene area. If you receive medical care from a Preferred Provider, payment for covered medical expenses will be made at 100% of the negotiated rate. Payment for covered medical expenses will be reduced to 75% of the reasonable charge if a student receives care from a practitioner who is not a Preferred Provider. It will save students money if they return to the Health Center when it opens for any remaining follow-up care.

Physicians - When a student is outside the Eugene area, they may receive care from ANY licensed practitioner and payment for covered medical expenses will be made at 100% of the reasonable charge (after the deductible has been met). However, it is always to your advantage to use Preferred Providers when you receive care because it will save you money.

Hospitals/Surgery - If a student is going to have a non-emergency hospital stay or an elective surgery, they do need to find the hospitals or outpatient facilities in their area that are Preferred Providers. Benefits will be reduced to 75% of the reasonable charge if the student does not use Preferred Provider facilities.

Lab/x-rays/CT scans, MRIs, etc. - Students do need to find the hospitals, outpatient facilities, labs, imaging facilities, etc., in their area are Preferred Providers. Benefits will be reduced to 75% of the reasonable charge if the student does not use Preferred Provider facilities.

When a student is no longer eligible to use the University Health Center (because the student is no longer registered for classes and can no longer qualify to pay or do not wish to pay the “Stop-out” or “Summer Health Center” fee), the student will need to choose a Preferred Provider in the community as their Primary Care Provider. If a student receives medical care from a Preferred Provider, payment for covered medical expenses will be made at 100% of the negotiated rate. Payment for covered medical expenses will be reduced to 75% of the reasonable charge if you receive care from a practitioner who is not a Preferred Provider for this plan

University Health Center Access & Eligibility - Included in the tuition bill each term is a mandatory student health fee that all registered students must pay. The fee allows registered students to use all University Health Center services.

If a student graduates or takes off a term/semester, Health Center eligibility may be extended for ONE MORE TERM/SEMESTER through payment of the Health Center “stop-out” fee or summer fee.

The health insurance premium and the Health Center fee are two separate charges. Coverage under the University sponsored student health insurance plan does NOT automatically ensure access to the Health Center. It is possible for health insurance coverage to continue longer than a student’s eligibility to use the Health Center.

When a student is no longer eligible to use the Health Center, he/she must obtain their medical care outside the Health Center; regardless of whether the student is still insured on the student health insurance plan.

UO Student Insurance ◆ Phone (541)346-2832 ◆ Fax (541) 346-6579 ◆ E-mail - heainsur@uoregon.edu

Travel Assistance	This insurance plan will provide medical coverage for study/travel abroad. The coverage includes unlimited medical evacuation and repatriation coverage. This service is provided by Assist-America, Inc. Further details available in plan brochure.
Vision Care	The Vision One Discount Program offers access to savings on eye exams, eyeglasses and contact lenses. These discounts are ONLY available through “Vision One” providers. Further details available in plan brochure.

Acupuncture	Not a covered benefit.
Care in home country	Not a covered benefit
Chiropractic	Not a covered benefit.
Dental Care	Not a covered benefit. Treatment of TMJ (temporomandibular joint) conditions is specifically excluded.
Massage Therapy	Not a covered benefit.
Naturopathy	Not a covered benefit.
Preventative care	Not a covered benefit. Such as immunizations, STD screenings, well physicals, school physicals, sports physicals, travel physicals, travel immunizations & medications, nutrition counseling, etc.
Vision exams, glasses, contacts	Not a covered benefit.