Insurance Definitions

Claim: A request for payment for Benefits received or services rendered.

Co-insurance: The amount you are required to pay for medical car in a fee-for-service plan after you have met your deductible.  The coinsurance rate is usually expressed as a percentage.  For example, if the inusrance company pays 80 percent of the claim, you pay 20 percent.

Copay: A flat fee every time you receive a medical service (for example, $15 for every visit to the doctor).  The insurance company pays the rest after the deductible is paid by you.

Deductible: The amount of money you must pay each year to cover your medical care expenses before your insurance policy starts paying.

Exclusions: Specific conditions or circumstances for which the policy will not provide benefits.

Inpatient: Service provided after the Member is admitted to the hospital.  Inpatient stays are those lasting 24 hours or more.

Maternity Care: Services that generally include prenatal care, normal delivery services and routine newborn nursery care.

Maximum Out-of-Pocket:The most money you will be required to pay a year for deductibles and coinsurance.  It is a stated dollar amount set by the insurance company, in addition to regular premiums.

Network: The doctors, clinics, hostpitals and other medical providers the insurance company contracts with to provide health care to its Members at negotiated rates.

Outpatient: A Member who is receiving care at a hospital, physician’s office or other health facility without being admitted overnight to the facility.  The term “ambulatory” is often used to describe Outpatient care.

Preferred Provider: A doctor who is referred by your insurance company.  When you use the doctors and hospitals that are preferred providers, you can have a larger part of your medical bills covered.  You can use other doctors, but at a higher cost.

Preexisting Condition: A health problem that existed before the date your insurance became effective.

Primary Care Doctor: Usually your first contact for health care.  This is often a family physician of internist, but some women use their gynecologist.  A primary care doctor monitors your health and diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed.

Provider: Any person (doctor, nurse, dentist) or institution (hosptial or clinic) that provides medical care.

Urgent Care: Services received for an unexpected illness or injury that is not life threatening but requires immediate Outpatient medical care and cannot be postponed.  An urgent situation requires prompt medical attention to avoid complications and unnecessary suffering or severe pain.

Usual, Customary and Reasonable: The amount charged or the amount determined to be the reasonable charge, whichever is less, for a particular Covered Service in the geographical area in which it is performed.

Frequently Asked Questions

What does our policy include?

  1. $100,000 for each accident.
  2. $100,000 for each illness (for women, this must include maternity/pregnancy care).
  3. $50,000 for medical evacuation to your home country.
  4. $25,000 for repatriation to your home country.
  5. $500 maximum deductible per accident or illness.

Where and when can I buy IU health insurance?

All international students in F-1 and J-1 status are automatically enrolled in IU’s International Student Health Plan as they begin their programs of study. This automatic enrollment continues each semester throughout a student’s studies. Students may waive out each Fall and Spring/Summer semester if they take the steps described in the Insurance Waiver section of this site. Once the waiver period concludes each semester (on the 10th day after the start of classes), the Bursar will bill the student account. Dependents are required to carry coverage, as well, but the F-1 or J-1 student must take additional steps to bring the dependent under coverage.

Where can I find more information about the IU health insurance plan?

For information on the current IU health insurance, visit our health insurance page.

Can I bring the health insurance from my home country instead?

You may contact the OISS by emailing OISS@IUSB.EDU to be waived out of the policy if you have insurance coverage provided through one of the following and if it meets IU's terms:

    • your sponsoring organization (SACM, Kuwaiti Cultural Mission, etc.)
    • a US-employee benefits package for you or a family member
    • graduate assistantship or fellowship that provides insurance coverage

Am I eligible to stay on this policy while working under Optional Practical Training (OPT)?

Yes. If you are not offered health insurance by your OPT employer, you are eligible to remain on your IU Anthem policy. Please contact the OISS for more information about how to enroll.