{"id":31,"date":"2021-07-08T15:38:10","date_gmt":"2021-07-08T15:38:10","guid":{"rendered":"https:\/\/offices.vassar.edu\/case-management\/?page_id=31"},"modified":"2025-09-18T14:12:07","modified_gmt":"2025-09-18T14:12:07","slug":"health-insurance-101","status":"publish","type":"page","link":"https:\/\/offices.vassar.edu\/care\/resource-library\/health-insurance-101\/","title":{"rendered":"Health Insurance 101"},"content":{"rendered":"<!-- Inserted by Dropdownizer plugin. Forces video embeds contained in dropdowns to have a size --><style>.dropdownizer__dropdown iframe { width: 100% !important; height: 100% !important; }<\/style>\n<p><a href=\"https:\/\/www.uhcsr.com\/\">Access the Vassar Student Health Insurance Plan Information<\/a>.&nbsp;Enter Vassar as the school name and it will take you directly to the plan for Vassar Student Health.<\/p>\n\n\n\n<p>How to get your Vassar Student Health Insurance ID Card: Visit&nbsp;<a href=\"https:\/\/idp.uhcsr.com\/core\/Login?ReturnUrl=%2Fcore%2Fconnect%2Fauthorize%2Fcallback%3Fclient_id%3DmyAccount%26redirect_uri%3Dhttps%253A%252F%252Fmyaccount.uhcsr.com%252FauthToken%26post_logout_redirect_uri%3Dhttps%253A%252F%252Fmyaccount.uhcsr.com%252FauthToken%26response_type%3Did_token%2520token%26scope%3Dopenid%2520MyAccountApi.Secure%26state%3Dhome%26nonce%3D5724\">ID Card Access<\/a> to create an on-line account to access your health insurance card and benefits.<\/p>\n\n\n\n<p>Below are a variety of short videos to help you understand health insurance:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/youtu.be\/6cFf6Ua7C24\">What are deductibles, coinsurance and copays<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/youtu.be\/g-2pJJY-uCA\">How to request an ID card<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/youtu.be\/cQq9uIYzfj8\">What is an EOB (explanation of benefits)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/youtu.be\/SuDpKDcDgIo\">How to create an account<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/youtu.be\/F8sbZcJm818\">How to search for a provider and cost estimator<\/a><\/li>\n<\/ul>\n\n\n\n<p><strong>Not on a Vassar Student Health Plan?<\/strong> Submit a question for Erika via the <a href=\"https:\/\/forms.gle\/Ycsp4kGsgtpa3Grq6\">Ask Erika Form<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Lowering Prescription Costs Resources<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.goodrx.com\/?c=homepage-lander-sem-6&amp;gclid=Cj0KCQiApY6BBhCsARIsAOI_Gjae-BYY8c4CvC6Qk_It6V2qBnC2lZZ7n87N3M6ikh3Xh6CXUUPpUpwaAqN1EALw_wcB\">GoodRx<\/a>: allows you to compare costs of prescription medications, as well as provides coupons<\/li>\n\n\n\n<li><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\">Single Care<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">General Health Insurance Terms<\/h2>\n\n\n\n<p>There are some basic insurance terms that students should know and understand in order to best utilize their insurance benefits.&nbsp;These include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Behavioral Health<\/strong>: term used interchangeably with mental health. Some insurers will use mental health, others will use behavioral health, to describe services.<\/li>\n\n\n\n<li><strong>Benefits<\/strong>: The health care items or services covered under a health insurance plan. Covered benefits and excluded services are defined in the health insurance plan\u2019s coverage documents. In Medicaid plans (like OHP), covered benefits and excluded services are defined in state program rules.<\/li>\n\n\n\n<li><strong>Claim<\/strong>: A request for payment that you or your health care provider submits to your health insurer when you get items or services you think are covered.<\/li>\n\n\n\n<li><strong>Co-insurance<\/strong>: the percentage of a medical expense that you are responsible for paying. This usually applies after a deductible has been met. For example\u2014if you have a 20% coinsurance, and the cost of services is $200, your cost would be $40.<\/li>\n\n\n\n<li><strong>Co-payment<\/strong>: a fixed amount paid for covered services like doctors visits. Some insurance companies have different co-payments for different types of service or doctors. Please note that mental health providers may be considered \u2018specialists\u2019 by some plans, and could have a higher co-payment.<\/li>\n\n\n\n<li><strong>Deductible<\/strong>: the amount you must pay before your insurance company starts to pay for covered services each year. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. This amount resets each year on January 1. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services. Your insurance company pays the rest.<\/li>\n\n\n\n<li><strong>Explanation of Benefits<\/strong> (EOB): Every time services are provided, doctors and other medical professionals will submit claims to patients\u2019 insurance companies to receive payment. The insurance company will then sent out an EOB to the member, which provides details about a claim that has been processed and explains what portion was paid to the health care provider and what portion of the payment, if any, is the patient\u2019s responsibility. The EOB is not a bill. Generally, EOBs are sent to the primary subscriber of the insurance plan.<\/li>\n\n\n\n<li><strong>Formulary<\/strong>: A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list. Covered medications generally fall into three categories:<\/li>\n\n\n\n<li><strong>Generic:<\/strong> These drugs are copies of brand-name drugs that have been on the market for a number of years and are often offered at very cheap prices.<\/li>\n\n\n\n<li><strong>Preferred:<\/strong> These drugs are name brand but are available to you at a price below the retail price.<\/li>\n\n\n\n<li><strong>Non-Preferred:<\/strong> These drugs are name brand but are not offered at a very large discount.<\/li>\n\n\n\n<li><strong>Member<\/strong>: someone with insurance coverage from a particular company.<\/li>\n\n\n\n<li><strong>Network<\/strong>: The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.<\/li>\n\n\n\n<li><strong>\u2018In Network\u2019 provider<\/strong>: providers whose services are contracted with\/covered by your health plan<\/li>\n\n\n\n<li><strong>\u2018Out of Network\u2019 provider<\/strong>: providers whose services are not contracted with your insurance plan. Some plans offer \u2018out of network\u2019 benefits, meaning that the plan will cover some of the cost of these providers. Please note that the initial payment for the full cost of services is the responsibility of the individual receiving services, and is paid at the time services are rendered. This can be a large expense. Out of network providers may offer a \u2018super bill\u2019 that can be submitted by the member for insurance reimbursement.<\/li>\n\n\n\n<li><strong>\u2018Out of pocket\u2019 costs<\/strong>: expenses for medical care that aren\u2019t reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance, and co-payments for covered services plus all costs for services that aren\u2019t covered.<\/li>\n\n\n\n<li><strong>Pre-Authorization<\/strong>: depending on your insurance plan, you may need to obtain authorization\u2014get approved\u2014for services before starting treatment.<\/li>\n\n\n\n<li><strong>Premium<\/strong>: the amount paid for your insurance plan. This may be paid monthly, quarterly, or yearly.<\/li>\n\n\n\n<li><strong>Provider<\/strong>: these are the doctors, nurses, hospitals, treatment facilities and practices and that provide medical care.<\/li>\n\n\n\n<li><strong>Subscriber<\/strong>: If you have insurance through your parent\u2019s, spouse\u2019s, or registered domestic partner\u2019s employer, the parent\/spouse\/ or domestic partner who is covering you as a dependent under his or her health insurance plan would be the <strong>primary subscriber<\/strong>, sometimes called <strong>primary<\/strong> enrollee.<\/li>\n\n\n\n<li><strong>Super Bill<\/strong>: an itemized form used by healthcare providers for reflecting rendered services. It is the main data source for creation of healthcare claim, which will be submitted to payers (insurances, funds, programs) for reimbursement.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Access the Vassar Student Health Insurance Plan Information.&nbsp;Enter Vassar as the school name and it will take you directly to the plan for Vassar Student Health. How to get your Vassar Student Health Insurance ID Card: Visit&nbsp;ID Card Access to create an on-line account to access your health insurance card and benefits. Below are a [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":14,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-31","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/pages\/31","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/comments?post=31"}],"version-history":[{"count":3,"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/pages\/31\/revisions"}],"predecessor-version":[{"id":128,"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/pages\/31\/revisions\/128"}],"up":[{"embeddable":true,"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/pages\/14"}],"wp:attachment":[{"href":"https:\/\/offices.vassar.edu\/care\/wp-json\/wp\/v2\/media?parent=31"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}