Wheaton College Recommended Coverage Guidelines
The following are strongly recommended guidelines to ensure that students are adequately insured.
- Adequate coverage within a 4 hour driving radius of the College or the Wheaton College external location of study for emergency, urgent, and non-emergency (retail clinics) illness and injury including follow-up care to emergency room treatment. For example, if the student fractures their arm, will their immediate care in the emergency department be covered? Many fractures will need an orthopedic consult and maybe physical therapy. Check to see if your health insurance will cover for these services so that care is not interrupted.
- Adequate primary medical care coverage within a 4 hour driving radius of the College or the related external site, which provides access to a physician, physical therapy, laboratory, diagnostic imaging, prescription medication and wellness services. If you are a student with a chronic illness, such as diabetes, Crohns disease for example, will your insurance provide access to specialists within the Wheaton College community?
- For all HMO plans, a Primary Care Provider (PCP) within 4 hours of Wheaton that can be pre-authorized before arrival on campus or related location of study. Any restrictive HMO that does not provide coverage for a PCP within 4 hours of location of student may restrict care for the student. If you are an intercollegiate athlete will your primary coverage be accessible within the Wheaton College community if an injury occurs?
- Coverage for both in and outpatient mental behavioral health and substance use services
- Health insurance coverage for the whole academic year.
- Coverage anywhere in the world, including medical evacuation or repatriation benefits.
- A nationwide network of providers for primary and specialty care.
- Annual deductible less than $13,000 for family, $6,000for individual
When viewing a health insurance product be sure to ask about the recommended coverage guidelines as well as the following questions:
- What is the monthly cost of this plan?
- What is the deductible? Is the deductible per illness/injury or the full time period of purchase?
- What networks are in my community for this type of insurance?
- Does this plan comply with the ACA requirements to avoid the penalty?
- Does this plan cover pre-existing conditions? Pharmaceuticals? In and outpatient mental health needs?
- How do I track my claims?
- Will this insurance be valid if I travel nationally or overseas?
- Is there a limit on covered benefits?
- What are the benefits that are covered and at what percentage?
- How do I pay for an insurance plan? Ask the agent if you can pay by credit or debit card. Ask if you purchase 6 months versus 1 month will the price be reduced. Ask the agent about the frequency of payments for the plan.