Eligibility and Coverage

This is a brief description of the Student Health Plan.  The plan is available for Case Western Reserve University students and their eligible dependents.  The plan is insured by Aetna Life Insurance Company (Aetna).  The exact provisions, including definitions, governing this insurance are contained in the Certificate issued to you and may be viewed online at www.aetnastudenthealth.com.  If there is a difference between this Plan Summary and the Certificate, the Certificate will control.

The fee for the 2020 - 2021 Student Medical Plan is $1367 per semester. The fee for the Student Medical Plan is automatically billed each fall and spring semester to students registered for at least one credit hour. The fee will appear on the student's tuition bill each semester. Payment is due in accordance with the University's tuition schedule.

Students who waive the Plan (see waiver option) will receive a credit of $1367 on their account.

Eligibility

To Receive Coverage:

  1. Students of Case Western Reserve University registered for at least one credit hour.
  2. Students of The Cleveland Institute of Art and The Cleveland Institute of Music registered for at least one credit hour.

Not Eligible To Receive Coverage:

  1. Students cross-registered for classes at Case Western Reserve University or its affiliates.
  2. Employees of Case Western Reserve University who are eligible for Benelect. 
  3. Students enrolled in virtual classes - please call  Student Medical Plan Department at (216) 368-3049 for a list of these programs.

Enrollment

Eligible students will be automatically enrolled in this Plan, unless a waiver is submitted by the deadline dates listed in page 2 of this Plan Design and Benefits Summary. Under certain conditions, the Student Medical Plan fee may be waived.

All registered students are required to have medical insurance that is comparable to the Case Western Reserve University Student Medical Plan. Insurance coverage must meet the following criteria in order to be deemed comparable.  

  • Plan must be fully compliant with all coverage and consumer protection requirements outlined under the Patient Protection and Affordable Care Act (PPACA).
  • Coverage is currently active and the student agrees to maintain health coverage throughout the entire policy year.
  • Coverage for pre-existing conditions with no waiting period.
  • Plan provides coverage in Northeast Ohio or where enrolled in CWRU classes.
  • Plan provides emergency and non-emergency inpatient and outpatient (laboratory, diagnostic services, primary and specialty care and physical therapy) and inpatient and outpatient mental health/substance abuse as any other condition.

In addition to meeting the above criteria, international students must:

  • Have coverage for emergency medical evacuation in the amount of at least $50,000 (medical evacuation is emergency transportation to the nearest, most qualified treatment facility).
  • Have coverage of at least $ 25,000 for repatriation (repatriation provides transportation to the student’s home country in the event of death).

Periods of Coverage

For Students Attending Case Western Reserve University School of Medicine, Case Western Reserve University School of Dental Medicine (MSD), and Cleveland Clinic Lerner College of Medicine:

  • Fall Semester: July 1, 2020 (12:01 a.m.) to January 10, 2021 (11:59 p.m.)
  • Spring Semester: January 11, 2021 (12:01 a.m.) to June 30, 2021 (11:59 p.m.)

For All Students (Except Those Listed Above):

  • Fall Semester: August 1, 2020 (12:01 a.m.) to January 10, 2021 (11:59 p.m.)
  • Spring Semester: January 11, 2021 (12:01 a.m.) to July 31, 2021 (11:59 p.m.)

If a student registers after September 4, 2020 for Fall Semester and after January 22, 2021 for Spring Semester, the Student Medical Plan will become effective on the date the student registers (not on the effective date listed above).

Dependent Coverage

Eligibility

Covered students may also enroll their lawful spouse or domestic partner and dependent children up to the age of 26. 

If the plan covers dependent children, then any dependent unmarried child, who will terminate coverage because he/she meets a limiting age under the policy, shall not terminate coverage if the child continues to be incapable of self-sustaining employment by reason of mental retardation or physical handicap and primarily dependent upon the student for support and maintenance. Proof of such handicap and dependency may be required upon initial continuation and every two years thereafter.

Enrollment

Medical coverage for spouse, domestic partner, and dependent children may only be purchased if the student has purchased the Student Medical Plan coverage for students. 

  • Coverage may be purchased on a per semester basis or on an annual basis. ENROLLMENT IS NOT AUTOMATIC. You must renew the coverage each semester or each year.
  • All students enrolled at Case Western Reserve University refer to page 2 for coverage dates and enrollment dates.

Dependent Verification 

Dependents who enroll in the Case Western Reserve University Student Medical Plan must be eligible for coverage. In order to verify your dependents eligibility, you must provide the required documents. Please visit www.case.edu to access the list of eligibility rules and document required to verify your dependent(s).

Newborn Dependent

  • A newborn child - Your newborn child is covered on your health plan for the first 31 days from the moment of birth. 
    • To keep your newborn covered, you must notify Student Medical Plan Department at (216) 368-3049 or medicalplan@case.edu of the birth and pay any required premium contribution during that 31 day period. 
    • You must still enroll the child within 31 days of birth even when coverage does not require payment of an additional premium contribution for the newborn. 
    • If you miss this deadline, your newborn will not have health benefits after the first 31 days. 
    • If your coverage ends during this 31 day period, then your newborn‘s coverage will end on the same date as your coverage.  This applies even if the 31 day period has not ended.

 Adopted Child Coverage

  • An adopted child or a child legally placed with you for adoption - A child that you, or that you and your spouse, or civil union partner [or domestic partner] adopts or is placed with you for adoption is covered on your plan for the first 31 days after the adoption or the placement is complete. 
  • To keep your child covered, we must receive your completed enrollment information within 31 days after the adoption or placement for adoption. 
  • You must still enroll the child within 31 days of the adoption or placement for adoption even when coverage does not require payment of an additional premium contribution for the child. 
  • If you miss this deadline, your adopted child or child placed with you for adoption will not have health benefits after the first 31 days. 
  • If your coverage ends during this 31 day period, then coverage for your adopted child or child placed with you for adoption will end on the same date as your coverage.  This applies even if the 31 day period has not ended.
  • If you need information or have general questions on dependent enrollment, call Student Medical Plan Department at (216) 368-3049.

Medicare Eligibility Notice

You are not eligible to enroll in the student health plan if you have Medicare at the time of enrollment in this student plan.  The plan does not provide coverage for people who have Medicare.