This information applies to students who are using the Erika Insurance provided through EF Foundation. Students not using this insurance should check with their independent provider for any questions regarding coverage.
When seeking medical care, always try to find an Aetna provider. CLICK HERE to find local Aetna network providers. Aetna is a common insurance provider and most likely your host family’s regular doctor will be listed, but ALWAYS CHECK first!
When calling a doctor’s office to schedule an appointment, say the student has “Aetna Student Health.” Do not say s/he has Erika Insurance – they will most likely NOT recognize the name.
The doctor’s office should call Aetna directly at 1-800-783-7447 if they cannot find the student’s name in the system. The office can then confirm coverage and benefits; have them call while the student is in the office, so that the insurance can pay for the visit. If the doctor’s office cannot reach someone, take the name of the person in the doctor’s office and someone from the Boston office can contact them during the next business day to confirm the student’s insurance coverage.
If Aetna doesn’t have the student’s name, call the EF Foundation office at 1-800-447-4273 and someone there can confirm the student’s eligibility with Aetna. All students DO have insurance coverage while in the program!! Any mistake is most likely a clerical error.
If the doctor does not send Aetna their bill, they will bill the student instead. Tell the doctor to send bills to:
Aetna Student Health
PO Box 14101
Lexington, KY 40512
Students must have their insurance card with them at the doctor’s office. If you have lost your card, contact EF Foundation at 1-800-447-4273.
- Your insurance ID number is the EF Booking Number on the insurance card. This usually begins with 3 letters (for example, DEB1234567) and is found towards the bottom of your card. Do NOT give them the policy number (10463.RWS) as your ID number because all students have the same policy number!
- Give the doctor’s office your FULL FIRST AND LAST NAMES as they appear in your passport! Do NOT include middle names or nicknames.
IN CASE OF EMERGENCY:
If a student has a medical emergency:
- German, Swiss, Austrian or Dutch students should contact AXA Assistance – 1-800-847-3948
- Italian students should contact Inter Partner Assistance – 1-800-472-6705
- All other nationalities should contact Falck TravelCare – 1-800-871-9211
These companies are available to provide assistance 24 hours a day, 7 days a week. In any case of medical emergency, the IEC or EF Foundation should also be contacted.
A deductible is an amount the patient is responsible to pay that the insurance does not cover. Students with Erika Insurance are responsible for paying a $35 deductible for doctor visits within the Aetna network; the deductible is $95 if the doctor is NOT in the Aetna network.
There is an extra deductible of $50 if the student goes to the Emergency Room. Therefore, they would pay the $35 deductible (in-network) + $50 if they visit the hospital. If the hospital is NOT in the Aetna network, the student would pay the $95 deductible + $50.
Routine care is not covered by this insurance. Therefore, physicals, check-ups and inoculations would NOT be covered. If a student goes to a doctor because they do not feel well or something is wrong, the visit will not be covered and the office must send Aetna a bill explaining why the student needed treatment (this does not guarantee that the visit will be paid for!).
If a student needs a prescription, they must first pay and then send a claim form to Aetna Student Health for reimbursement. Both the cash register receipt AND the medication information label attached to the prescription MUST be included. Students WILL be reimbursed for most medications; exceptions include acne medication, birth control or medication taken for a pre-existing condition – costs of these medications are NOT reimbursed. If you wish to check if your prescription will be covered, call Aetna directly at 1-800-783-7447.
Dental coverage is provided up to $200 during the insurance period for non-accidental treatment. Treatment for an injury as a result of an accident is usually covered in full.
If you receive a bill at home (your host family’s home), review it carefully. If you did not pay the deductible up front OR if you had a routine or otherwise non-covered doctor’s visit, you are most likely receiving a bill that you must pay.
If the bill is for more than the deductible amount, contact Aetna Student Health at 1-800-743-7447 to be sure that the insurance company received the bill to pay it AND that the condition is covered. Otherwise, the doctor will expect payment from you and you may start receiving collection notices. To prevent this, call Aetna immediately if you receive a bill!!
OTHER BENEFITS AND COVERAGE:
Students may choose to purchase additional insurance coverage for sports. The Sports Supplement Insurance can be purchased up to three weeks after arrival in the U.S. This additional coverage allows students to participate in activities that would not normally be covered, should injury occur. The following activities are ONLY covered with the Sports Supplement:
Australian football, lacrosse, wrestling, martial arts, rodeo, dirt biking, car racing, motorcycle racing, four-wheeling, horse racing, hang gliding, sail flying, bungee jumping, boxing, bobsledding, ski jumping, short track speed skating, skydiving, air ballooning, parachuting, motor competitions, mountaineering, mountain climbing, whitewater rafting, jetskiing, snowmobiling and any training or competing with a professional club or regional/national sports association.
If you are planning to participate in any of these activities, confirm that you DO have proper insurance coverage.
EMERGENCY TRIP HOME:
Erika Travel Insurance may cover a round trip flight in case of death or grave illness of an immediate family member. The policy defines “immediate family members” as: parents, legal guardians and siblings of the students. Grandparents are NOT considered immediate family (unless they are legal guardians of the student).
If a student has a family emergency and wishes to return home, contact the appropriate emergency assistance program (AXA, Inter Partner or Falck) listed under “In Case of Emergency” above, as well as your IEC and EF Foundation.
If you have any additional questions regarding insurance or coverage, contact EF Foundation at 1-800-447-4273 OR Aetna Student Health at 1-800-783-7447.