FAQs About Insurance & Billing

lmu shs insurance billing female student discussing with shs staff member

Listed below are Aetna Student Health Plan's most commonly asked questions and answers.

  • Am I required to have health insurance?

    All students including undergraduate, graduate, and law school, enrolled in seven (7) semester hours or more are required to have health insurance. Full-time students are automatically enrolled in the Student Health Insurance Plan. However, students may waive out of the Student Health Insurance Plan (see below) if they have comparative health insurance coverage.

  • Who underwrites the University Endorsed Student Health Insurance Plan?

    The Aetna Student Health Plan is underwritten by Aetna Life Insurance Company and is administered by Chickering Claims Administrators, Inc.

  • Once I enroll, can I see any doctor and still be covered by the plan?

    No, only services from in network preferred providers are covered. This means the plan pays benefits only when you see a provider who is part of the Aetna network of preferred providers. However, non-preferred provider services for emergencies, ambulance, and accidental dental injuries are covered. Providers include doctors, hospitals, laboratories and pharmacies.

    You can use Aetna's DocFind tool to find a preferred provider.

  • What is the term for coverage for the university endorsed health insurance plan?

    The term coverage for insured students entering in the Fall Semester is from August 1, 2018 through July 31, 2019. For new students entering the university in the Spring Semester, the term coverage is from January 1, 2019 through July 31, 2019, or from dates that the insurance is purchased.

  • Is there a deadline to waive out of the University Endorsed Student Health Insurance Plan?

    Yes, there is a deadline.

    • Students enrolling for the Fall Semester - 10/05/18
    • Students enrolling for the Spring Semester - 02/01/19
  • Is there a separate accident plan?

    Yes, there is a separate mandatory accident plan for full time students. Students cannot waive out of this plan, except for those students who have purchased the University endorsed student health plan. The mandatory accident plan is administered by A-G Administrators, Inc. Plan management and brokerage services are provided by Mercer Health & Benefits, LLC, and is underwritten by QBE Insurance Corporation. The Master Policy may be viewed by request at the Office of Risk Management, University Hall, 4900, during business hours.

  • How do I waive out of the University Endorsed Student Health Insurance Plan?
    1. Visit the Aetna website
    2. Select Loyola Marymount University
    3. Select "enroll/waive" at the bottom of the page
    4. Select "enroll/waive" again on the next page
    5. Input your Student Identification Number and date of birth
    6. Continue with the process until you see the option to request a waiver

    Note: If you are not a full-time student (enrolled in 7 credit hours or more), you are not automatically enrolled in the student health insurance plan and therefore do not have to waive out.

  • How do I know if I am enrolled in the University Endorsed Student Health Insurance Plan?

    If you are a full-time student (enrolled in more than 7 credit hours per semester), you are automatically enrolled in the University Endorsed Health Insurance Plan through Aetna.

    If you are a part-time student (enrolled in less than 7 credit hours per semester), you are not automatically enrolled but can if you so wish (See "Can I enroll in the University Health Plan if I am not a full-time student?" in FAQ)

     

    If you don't know whether you are enrolled in the University Endorsed Student Health Insurance Plan or not, you can find this out (2) ways:

    1. Go to Aetna Student Health, select "Loyola Marymount University" in the drop-down menu, click "enroll/waive" until you are directed to input your student I.D. and date of birth. Once you do, a page will load that will tell you whether you are or are not enrolled in the plan and give you the option to opt-out if you are enrolled or enroll if you are not.

    2. If you are enrolled in the University Endorsed Student Health Insurance Plan, the charge will be present on your student billing account through PROWL. If you do not see a charge, you are not enrolled, however, should confirm via doing what is listed above in point 1.

     

    Note to Freshman who are starting full-time at LMU:

    If you already have insurance through your parents, it is up to you to make sure you opt-out of the University Endorsed Student Health Insurance Plan. If you do not opt-out, your student account will be charged and you will then be paying for 2 insurance plans.

  • Can I enroll in the University Endorsed Student Health Insurance Plan if I am not a full-time student?

    Yes, part-time students (those enrolled in less than 7 credit hours), can enroll in the University Endorsed Student Health Insurance Plan, they just aren't automatically enrolled.

    To enroll:

    1. Visit the Aetna website.
    2. Select "Loyola Marymount University" in the drop-down menu.
    3. Select "waive/enroll" at the bottom of the page.
    4. Select "enroll/waive" on the page that follows.
    5. Input your University Identification Number and date of birth when prompted.
    6. Your information should be loaded, and there will be an option to enroll. Click "enroll", and follow the directions from there.
  • How do I view and/or obtain my Aetna Student Health ID Card?

    Students can view and/or obtain their Aetna Student Health ID Card via the following methods:

    Mobile Device (via Aetna Mobile app)

    1. Download the Aetna Mobile App to your mobile device
    2. Log into your Aetna account
      1. If you have not yet registered with the Aetna Mobile app:
        1. Click "Register Now"
        2. Input your University Identification Number, first and last name, zip code on file with the Registrar's office, and date of birth
        3. Click "Continue"
    3. Click "ID Card Information"
    4. Verify member and date of birth information, then click "View Card"

    Mobile Device (via web browser)

    1. Visit the Aetna Student Health website for the university
    2. Click the "Print my ID Card" link on the right-hand side of the welcome page
    3. Enter your University Identification Number and date of birth
    4. Click "View Card"
    5. Select your ID card to display it on the screen
    6. Students can take a screenshot to save it into their phone

    Computer (via web browser)

    1. Visit the Aetna Student Health website for the university
    2. Click the "Print my ID Card" link on the right-hand side of the welcome page
    3. Enter your University Identification Number and date of birth
    4. Click "View Card"
    5. Select your ID card
    6. Select "Print your ID Card"

    Computer or Mobile Deveice (via Aetna Navigator in a web browser)

    1. Visit the Aetna Student Health website for the university
    2. Select the "member login" link on the right-hand side, which will open a new window
      1. If you have already registered for Aetna Navigator, you will log in from this screen
      2. If you have not yet registered for Aetna Navigator:
        1. Choose the "Sign up now" option
        2. Input your University Identification Number, first and last name, zip code on file with the Registrar's office, and date of birth
    3. Once you are logged into Navigator, click "Get an ID Card" on the left-hand side
  • How do I submit a claim under the University Endorsed Health Insurance Plan?

    Any services rendered at SHS will be billed to the patient's student account. It is the responsibility of the patient or patient guardian to submit documentation of SHS billing to Aetna. Student Health Services does NOT submit claims to insurance on behalf of patients.

    1. When submitting any bill or document to Aetna, include your name, University Identification Number, and date of birth. Indicate that you are a LMU student.
    2. Make copies of all bills and correspondence before you submit them to Aetna. Keep a record of all phone conversations, including the name of the person with whom you spoke to, date, time and probable outcome. If you need to correspond with Aetna over the phone, be prepared to refer to your documents and bills.
    3. While a referral is not required, when you seek medical care outside Student Health Services, it is recommended.
    4. To maximize your savings and reduce out-of-the pocket-expenses, select an Aetna Network Preferred Provider. It is to your advantage to use a preferred provider because savings may be achieved from the Negotiated Charges these providers have agreed to accept as payment for their services. Preferred providers are independent contractors, and neither employees or agents of Loyola Marymount University, Aetna Student Health, or Aetna.
    5. Not all procedures and costs are 100% covered. To verify your coverage type (injury or sickness), you may call Aetna at 877.409.7356 and provide your name and UID (see #1). Some illnesses or injuries may cost more to treat and you may be billed for what the plan does not cover.
    6. Please review the section on Exclusions and Limitations in your insurance pamphlet.
    7. For more information on your specific plan's policies and benefits, please go to Aetna's website: Aetna Student Health and go to "get started by searching your college or university," and enter Loyola Marymount University in the field "find your school."
    8. If you need to submit physical claims, please fax them to 859.455.8650 or mail them to:

      Aetna
      PO Box 981106
      El Paso, TX 79998

    Visit How to Submit an Aetna Claim Online for more information.

  • How do I submit a claim if I don't have the University Endorsed Student Health Insurance Plan?
    1. When submitting any bill or document to your insurance plan, please include your name, date of birth, and insurance number.
    2. Make copies of all bills and correspondence before you submit them to your insurance plan. Keep records of all phone conversations, including the name of the person(s) with whom you spoke to, date, time and probable outcome. If you need to correspond with your insurance plan over the phone, be prepared to refer to your documents and bills.
    3. When seeking a referral to an outside provider, please check to see that the new provider is part of your insurance plan's network, and accepts your plan. For more information regarding referrals, please check your policy or your insurance plan's web page.
    4. Not all procedures and costs are 100% covered. To verify your coverage type (injury or sickness), you may contact your insurance plan and provide your name and your plan and identification number. Some illnesses or injuries may cost more to treat and you may be billed for what the plan does not cover.
    5. Please review your insurance policy for the section on Exclusions and Limitations.
    6. Please check your insurance plan's web page to obtain copies of blank insurance forms that will need to be completed for reimbursement.
    7. If you require an itemized billing statement from LMU, please visit Student Health Services in person and complete a copy of "Loyola Marymount University Student Health Center Authorization to Release Patient Medical Information."

If you have questions about the benefit plan or about waivers, please contact Aetna Student Health or call 877.409.7356.

If you have any questions regarding the Aetna Student Health Insurance Master Plan, please review the Office of Risk Management policy or contact Doug Moore, Risk Manager, at 310.338.3071.