[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-355245-105":53,"doc-detail-355245-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","cornell-shp-checklist-2024-2025-pending-dfs","Cornell SHP Checklist 2024-2025 Pending DFS","","Checklist to help Cornell University students evaluate whether a health plan meets specific requirements for the Student Health Insurance Plan comparison. Includes criteria covering licensing and U.S. claims contact, unlimited annual and lifetime benefits, exclusions for Medicaid and catastrophic plans, suitable plan type and referral needs, coverage duration for the academic year, access to local providers, and required medical plus mental health services. 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To help you choose a health plan that provides the highest level of protection while studying at Cornell University, complete this checklist and compare.  \n\n|  | Cornell SHP | Your Plan |\n| --- | --- | --- |\n| My plan is provided by a company licensed to do business in the United States, with a U.S. claims [payment office and a U.S. phone](payment office and a U.S. phone) number; | 􀀻 | |\n| Has unlimited annual and lifetime benefits (i.e. , no policy maximum); | 􀀻 | |\n| Is not an out-of-state Medicaid plan; | 􀀻 | |\n| Is not a catastrophic (“young invincible”) plan; | 􀀻 | |\n| Is not an HMO without an away-from-home rider; | 􀀻 | |\n| Will be active for the duration of the 2022-2023 academic year or until my program ends; | 􀀻 | |\n| Provides access to local doctors, specialists, hospitals and other health care providers where the student is attending school; | 􀀻 | |\n| Provides coverage for inpatient hospitalization, surgery, ambulance and emergency room treatment where the student is attending school; | 􀀻 | |\n| Provides coverage for outpatient services such as office visits, lab work, diagnostic x-rays, physical therapy, chiropractic care, and prescription coverage where the student is attending school; and | 􀀻 | |\n| Provides coverage for inpatient and outpatient mental health, substance abuse and counseling services where the student is attending school | 􀀻 | |\n\n\n| Coverage Comparison | Student Health Insurance Plan | Your Plan |\n| --- | --- | --- |\n| Insurance Carrier | Medical: Aetna\u003Cbr>Pharmacy: OptumRx |  |\n| Annual (12 month) Premium | Estimate: $3,944- $4,058 (final rate pending approval by NYS) |  |\n| Plan Type | PPO |  |\n| Service Area (Does your plan have in network providers in the local area where the student will be studying?) | Yes Aetna National Network Cornell Health is In-Network\u003Cbr>International claims reimbursed at InNetwork cost share |  |\n| Do you need a referral to see a specialist? | No |  |\n\n\n| Cost Comparison | Cornell Health | SHP In Network Provider | Out of Network with Student Health Plan | In Network with your Plan | Out of Network with your plan |\n| --- | --- | --- | --- | --- | --- |\n| Deductible |  | $0 | $400 individual $800 family |  |  |\n| Out-of-Pocket Limit |  | $3,000 individual $6,000 family | $3,000 individual $6,000 family |  |  |\n| Mental Health counseling visit | $10 | $10 | 30% after deductible met |  |  |\n\n\n| Cost Comparison | Cornell Health | SHP In Network Provider | Out of Network with Student Health Plan | In Network with your Plan | Out of Network with your plan |\n| --- | --- | --- | --- | --- | --- |\n| Physician Office visit | $10 | $25 | 30% after deductible met |  |  |\n| Required Immunizations | Billed to Insurance | No cost | 30% coinsurance |  |  |\n| Physical Therapy | $10 | $25 | 30% after deductible met |  |  |\n| Emergency Room visit | NA | $100 | $100 |  |  |\n| Emergency medical transportation | NA | No charge | No charge |  |  |\n| Lab services sent out by Cornell Health | Billed to insurance | 10% | 30% after deductible met |  |  |\n| Radiology (x-ray) | $10 | 10% | 30% after deductible met |  |  |\n| Radiology (MRI, CT, advanced imaging) | NA | 10% | 30% after deductible met |  |  |\n| Inpatient admission, Surgery, Anesthesia | NA | 10% | 30% after deductible met |  |  |\n| Prescription Drugs 30-day supply | Billed to insurance | Generic: $12\u003Cbr>Preferred: $40 Non-preferred: $60 Specialty: $60 | 30% deductible does not apply |  |  |\n| Office Visit for Allergy Injections | 10% | 10% | 30% after deductible met |  |  |","cbCaisHQnkwuUxrZ","https://ap.wps.com/l/cbCaisHQnkwuUxrZ","pdf",151589,"English","# Coverage criteria\n# Coverage comparison\n## Insurance carrier and plan details\n## Service area and referrals\n# Cost comparison\n## Deductible and out-of-pocket limits\n## Copays and coinsurance by service","[{\"question\":\"What checklist items determine whether a student plan is comparable to Cornell SHP?\",\"answer\":\"The checklist verifies licensing for U.S. business, U.S. claims payment office and phone, unlimited annual and lifetime benefits, and that the plan is not out-of-state Medicaid, not catastrophic, and not an unsuitable HMO without an away-from-home rider.\"},{\"question\":\"What coverage duration does the checklist require?\",\"answer\":\"The plan should be active for the duration of the 2022-2023 academic year or until the student’s program ends.\"},{\"question\":\"What cost and coverage information is compared in the document tables?\",\"answer\":\"It compares annual premium estimates, plan type, service area and in-network status, deductibles, out-of-pocket limits, and sample costs such as mental health counseling visits, physician office visits, physical therapy, emergency room visits, and prescription drug tiers.\"}]","Cornell SHP Checklist 2024-2025 Pending DFS | PDF",1790117051]