Frequently Asked Questions

Frequently Asked Questions

Eligibility & Enrollment:

  1. How do I enroll in the NIU Student Health Insurance Plan?
  2. Is coverage available for my dependents?
  3. If I cancel the NIU insurance and then lose my other insurance, can I sign up for the NIU plan?
  4. Is there a deadline to enroll in the NIU plan?
  5. Is coverage available for over the summer?

Canceling:

  1. If I have other health insurance coverage, why should I keep the Student Health Insurance Plan?
  2. How do I waive enrollment in the NIU insurance plan?
  3. If I waive the insurance, is that waiver good for the entire time I am at NIU?
  4. What happens if I miss the deadline to waive the NIU plan?
  5. May I still go to Health Services if I waive the NIU plan?

Coverage:

  1. What does the NIU plan cover?
  2. Are pre-existing conditions covered?
  3. Can I go to any doctor or hospital I want?
  4. What happens if I get sick or hurt while I am traveling?
  5. Where do I get an ID card?

Costs:

  1. What is a deductible?
  2. Does it cost extra to go to the emergency room?
  3. Will the NIU plan pay all my medical bills?

 Claims:

  1. How do I file a claim?
  2. How do I file a claim for birth control?
  3. Where do I submit claims?
  4. How do I check on the status of my claim?

Eligibility & Enrollment:

  1. How do I enroll in the NIU Student Health Insurance Plan?
    Students registered for 9 or more on-campus (DeKalb) hours are automatically charged for the NIU Student Health Insurance Plan.  Any student registered for 6 or more credit hours, whether on or off campus, may enroll in the NIU insurance plan by filling out the online enrollment form by the 15th calendar day of the semester.  International students and students studying abroad are required to carry the NIU student insurance.  These students are automatically charged the fee for student insurance if they register for at least 1 semester hour by the 15th calendar day of the semester.
  2. Is coverage available for my dependents?
    Spouses, domestic partners, and children may be added to the plan as long as the student is covered by the NIU plan.  The enrollment form must be submitted every semester that coverage is needed.
  3. If I cancel my NIU insurance and then lose my other insurance, can I sign up for the NIU plan?
    Yes – when you receive notification that you are losing your current coverage, fill out the Qualifying Event Form and return to the student insurance office along with proof from the prior insurance company that you are losing or lost coverage.  Your NIU policy will be effective on the day we receive both forms. Because we do not prorate, you will be charged for the full semester.
  4. Is there a deadline to enroll in the NIU plan?
    Yes, you must sign up for the insurance within the first 15 days of classes, unless you lose coverage from your insurance company.
  5. Is coverage available for over the summer?
    If you are enrolled for the spring semester, you are covered for the summer at no additional cost.  If you do not have spring coverage, you may enroll for summer-only coverage as long as you are enrolled in at least 6 credit hours, or if you are a continuing student at NIU. 

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Canceling:

  1. If I have other health insurance coverage, why should I keep the Student Health Insurance Plan?
    You should consider keeping this as supplemental coverage.  Very few group plans cover all medical expenses.  The NIU plan is designed to coordinate benefits with your primary coverage to reduce or eliminate many out-of-pocket expenses that you would be responsible for without additional coverage.
  2. How do I waive enrollment in the NIU insurance plan?
    During the waiver process period, you must go to our online waiver request form to waive the insurance.  Completing the waiver request form does not guarantee that the waiver will be accepted.  Once we verify coverage, we will notify you if the waiver is approved or denied.
  3. If I waive the insurance, is that waiver good for the entire time I am at NIU?
    No!
      When you waive the insurance, a fall waiver is only good for 1 year.  Each fall you are required to cancel the insurance for that school year.  A spring waiver is only good through August of that year. 
  4. What happens if I miss the deadline to waive the insurance?
    If you miss the deadline to cancel the insurance, you may file an appeal.  Please note, there is a deadline to file an appeal.  Filing an appeal does not guarantee that the appeal will be approved.  For more information on Appeals, please go to the Appeals page.
  5. May I still use Health Services if I waive the NIU plan?
    Yes!
       You are eligible to use Health Services whether you have Student Health Insurance or not. All NIU students who are enrolled in at least one on-campus credit hour are assessed on-campus student fees and are eligible to use Health Services.

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Coverage:

  1. What does the NIU plan cover?
    This is a Participating Provider Options (PPO) plan. It covers preventive care, well-care, doctor’s visits, hospitalization, diagnostic and lab services, physical therapy, maternity, mental healthcare and birth control.
  2. Are pre-existing conditions covered?
    Effective 8/17/12, we have a 6-month pre-existing condition clause for students and dependents 19 years old and older.  This is waived if you have had at least 6 months of consecutive coverage or creditable coverage.
  3. May I go to any doctor or hospital I want?
    Yes, you may.  If the provider is part of the Blue Cross Blue Shield network, you will have lower out-of-pocket costs for covered medical expenses.  This simply means that if you go to a doctor or hospital in the Blue Cross Blue Shield network, your out-of-pocket costs will be less than if you go to a doctor or hospital not in the network.  However, the NIU Student Health Insurance Plan will cover you even if the doctor is not in the Blue Cross Blue Shield network.
  4. What happens if I get sick or hurt while I am traveling?
    You may call Academic Emergency Services, and they will make all the arrangements to get you medical treatment or to get you home.  For more information please go to Academic Emergency Services. 
  5. Where do I get an ID card?
    You can either call or stop by the Student HealthInsurance office, or you can print out a temporary ID card at https://www.academichealthplans.com/niu/2013-2014/ - under Benefits, 6th line down.

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Costs:

  1. What is a deductible?
    A deductible is the amount you pay before the insurance company begins paying.  The plan has an annual deductible of $250.
  2. Does it cost extra to go to the emergency room?
    Yes – you will have to pay the extra emergency room co-pay each time you go there, and then 20% of the remaining bill.  Only go to the emergency room for emergencies!  If you are sick, go to Health Services – it won’t cost you for most services there.
  3. Will the NIU plan pay all my medical bills?
    No – you will have to pay your $250 deductible and co-insurance costs, usually 20% of your bill if you see an in-network physician.

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Claims:

  1. How do I file a claim?
    The doctor’s office or hospital will usually file a claim directly with Blue Cross/Blue Shield.  If they don't, you can file a claim directly with Blue Cross/Blue Shield.  Claims must be submitted one year (52 weeks) from date of service to be eligible for benefits.
  2. How do I file a claim for birth control?
    If you are getting your birth control at Health Services, you don’t have to do anything except pick up the prescription!  There is no cost to you.  We submit the paperwork on your behalf. 

    If you are getting the prescription filled at an outside pharmacy, you will have to pay for the prescription in full and then submit a claim to Blue Cross/Blue Shield. You will be reimbursed for the entire cost of the prescription.  Submit the prescription receipt or computer printout from the pharmacy which should include the name of the medication, the date it was dispensed and the price with the name of the student, the student’s Blue Cross/Blue Shield ID number and their address to the address listed below.
  3. Where do I submit claims?
    Claims should be mailed to:

    Blue Cross/Blue Shield of Illinois
    P.O. Box 805107
    Chicago, IL 60680-4112


  4. How do I check on the staus of my claim?
    You can call Blue Cross/Blue Shield directly at 1-855-267-0214, or call NIU Student Health Services at 815-753-0122.  You can also register for Benefits Access for Members (BAM) to access information online.

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