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Drexel University
2016-2017
Drexel University Student Health Insurance Plan
www.aetnastudenthealth.com
Student Health Insurance HowPlan
much does it cost?
Aetna Student Health, working with Drexel University offers a
student-focused health insurance plan that helps protect students

2016-2017 Student Health Insurance Plan

at school, at home, and while traveling* or studying abroad. Term Deadline Dragon Dragon
Rate Preferred Rate
What is the Plan All About?
August Start Only 8/31/16 $2,481 $3,197
Your Student Health Insurance Plan offers you access to:
www.aetnastudenthealth.com 8/1/16-8/31/17
Aetnas nationwide network of doctors, hospitals, pharmacies Annual 9/30/16 $2,290 $2,950
and specialists throughout the country. 9/1/16-8/31/17
An award-winning online secure member website, Aetna Winter
Aetna Student
Navigator
. Health, working with Drexel University offers a
How much does it1/30/17
cost? $1,538 $1,977
1/1/17-8/31/17
student-focusedhealth insurance plan that helps protect
Informed Health Line Call our toll-free number to talk to Spring 4/30/17 Dragon $971Rate $1,244
students at school, at home, and while traveling or studying Term Deadline Dragon
registered nurses. They can share information on a range of 4/3/17-8/31/17
abroad. Preferred Rate
healthy topics*.
Summer
Annual 7/15/17
9/30/16 $453
$2,290 $574
$2,950
Access to savings on vision, fitness, weight management,
What is the Plan All About? 6/26/17-8/31/17
9/1/16-
books and many more!
8/31/17
*The rate above includes both premiums for the student health
TravelStudent
Your Health
Assistance Insurance
Services Plan offersMedical
and Worldwide you access to:
Coverage plan underwritten by Aetna Life Insurance
while
Aetnastraveling or studying
nationwide network abroad**.
of doctors, hospitals, pharmacies Winter 1/1/17- 1/30/17 $1,538 Company,
$1,977 as well as
Drexel Universitys administrative fee.
8/31/17
Dand
entalspecialists
PPO Plan throughout
(comprehensive the country.
dental plan with **Visit www.aetnastudenthealth.com for dependent rate information.
preventative, basic, and major
An award-winning online secure member care benefits)website,
on this Aetna Spring 4/3/17- 4/30/17 $971 $1,244
optional
Navigator .plan,
available on a voluntary basis. Please visit 8/31/17
www.aetnastudenthealth.com for more plan information.
Who is eligible?
Informed Health Line Call our toll-free number to talk to

Summer 7/15/17 $453 $574
Students
6/26/17-
Vregistered
ision Carenurses.
Plan (comprehensive
They can shareexams, lenseson
information and frames,
a range of
contacts) optional
healthy topics*. voluntary Plan. Please visit 8/31/17
All students are eligible.
www.aetnastudenthealth.com for more plan information. Mandatory - As a full-time student if you fail to waive
Access to savings on vision, tness, alternative health care, The ratesinabove includewith
bothDrexels
the premium for the student health
accordance requirements you will be
weight management,
Important books
Plan benefit and many
payment more!
definitions: plan underwritten by Aetna Life Insurance Company,
automatically enrolled in the Dragon Plan. as well as
Negotiated Charge: theServices
Travel Assistance maximumand charge a PreferredMedical
Worldwide Care Provider or
Coverage Drexel Universitys administrative fee.
Undergraduate International students will be
Designated Provider hasor
while traveling** agreed to make
studying as to any service or supply for the
abroad. automatically enrolled (onlyfor
Visit www.aetnastudenthealth.com Embassy sponsored
dependent rate
purpose of the benefits under this Policy
Dental insurance plan available. Visit insurance
information. will be accepted in lieu of this).
Recognized Charge: Only that part of a charge which is recognized is
www.aetnastudenthealth.com for more details.
covered. The recognized charge for a service or supply is the lowest of: Dependents
The
Voluntary
providersVision Care for
usual charge Plan (comprehensive
furnishing it; and exams, lenses and Students
Spouse residing with the insured student.
Quality
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determines to be appropriate; based on factors such as the Children under 26 years of age, regardless of whether
cost of providing the same or a similar service or supply; and the manner in All students
or notare eligible.
they Mandatory
are married, or a full- or
Aspart-time
a full-timestudent,
student
Healthier living if you failortodependent
waive in accordance with Drexels requirements
which charges for the service or supply are made; and upon the parent for financial support.
Financial
The chargewell-being
Learn More!
Intelligent
Aetna determines to be the recognized charge percentage made
solutions
for that service or supply
you will be automatically enrolled in the Dragon Plan.
Undergraduate International students will be automatically
877-409-7361 enrolled (only Embassy sponsored insurance will be accepted in
Learn More! 1-877-409-7361
www.aetnastudenthealth.com
www.aetnastudenthealth.com
lieu of this). Students being automatically enrolled will
participate in the Dragon Plan level of coverage.
Please check here to view all of the 16/17 plan changes.

Drexel University
* Not all topics may be covered expenses under your plan. While only your doctor can diagnose, prescribe or give medical advice, the Informed Health Line nurse can provide information on
more than 5,000 health topics. Contact your doctor rst with any questions or concerns regarding your health care needs.
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Aetna Student
15.03.473.1 HealthSM is the brand name for products and services provided by Aetna Life Insurance Company and its applicable affiliated companies (Aetna).Fully insured student213917
B (01/15)
health insurance plans are underwritten by Aetna Life Insurance Company. Self-insured plans are funded by the applicable school, with claims administration services provided by Aetna
Life Insurance Company.
15.03.473.1 B (04/16) 213917
 Heres what the plan offers for students
Policy Year Maximums Dragon Plan Dragon Preferred Plan
Out of Pocket Maximum Preferred: $5,000 Non-Preferred: $10,000 Preferred $3,000 Non-Preferred $10,000
Here's what the plan
Here's whatoffers
the plan offers
Annual
Here Deductible
is a brief description
Here Preferred:
is a briefofdescription
the plan of the$100
benets. plan benets. Preferred: $100
Non-Preferred: $500 Non-Preferred: $100
Benefits at a Glance Full plan details available in the 2016-2017
Student Health Insurance Plan Design and Benefits Summary
**Please note the definitions of Negotiated and Recognized rates on front page.
*Preferred providers are in network and have negotiated contract rates with Aetna.
PLEASE READ CAREFULLY
PLEASEBEFORE DECIDING BEFORE
READ CAREFULLY WHETHER THIS PLAN
DECIDING IS RIGHTTHIS
WHETHER FORPLAN
YOU:IS RIGHT FOR YOU:
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read the Drexel
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of benets
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Please view your full plan description,
Please view your fullwhich
plan is contained which
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Master Policyinissued
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school, youcontact us atit 877-409-7361.
may view at or contact us at 877-409-7361.
Non-Preferred: 50% of Recognized Charge Non-Preferred: 50% of Recognized Charge
Outpatient Mental Preferred: 100% of Negotiated Charge after a Preferred: 100% of Negotiated Charge after a
Health Visit $20 copay $15 copay
Non-Preferred: 50% of Recognized Charge. Non-Preferred: 50% of Recognized Charge
Physicians Office Preferred: 100% of Negotiated Charge Preferred: 100% of Negotiated Charge
Visit-Preventative Deductible waived for Preferred Care Non-Preferred: 50% of Recognized Charge
Non-Preferred: 50% of Recognized Charge
Inpatient Preferred: 80% of Negotiated Charge after a $250 per Preferred: 100% of Negotiated Charge after a
Hospitalization-Health admit copay $500 per admit copay
Non-Preferred: 50% of Recognized Charge Non-Preferred: 50% of Recognized Charge
Emergency Room 80% of Negotiated or Recognized Charge after a 100% of Negotiated or Recognized Charge after a
$150 per visit copay (waived if admitted) $100 per visit copay (waived if admitted)
Ambulance Coverage Preferred: 100% of Negotiated Charge Preferred: 100% of Negotiated Charge
Non-Preferred: 100% of Recognized Charge Non-Preferred: 100% of Recognized Charge
**Please see the definition of negotiated rates on the front page.
X-ray and Lab Preferred: 80% of Negotiated Charge Preferred: 100% of Negotiated Charge
Non-Preferred: 50% of Recognized Charge Non-Preferred: 50% of Recognized Charge
Prescription Drug After $15 generic/$30 brand/$45 Non-Preferred After $15 generic/$30 brand/$45 Non-
Brand copay: 100% of Preferred brand copay:
Negotiated or Recognized Charge. 100% of Negotiated or Recognized Charge.
Please Note: You are required to pay in full at the time of service for all prescriptions dispensed at a Non-Participating Pharmacy. Contraceptive
coverage at 100% except for Brand drugs with Generic equivalent. Dispense as written penalty (member chooses Brand when Generic available)
Aetna Dental PPO Plan* Preventive service 100% in network/80% out of network $264.00 Student Annual Rate
Basic Services 80% in network/60% out of network
Major Services 60% in network/50% out of network
Orthodontics not covered
Annual Maximum $1,000
Individual Deductible $50/ Family Deductible $150
*This is an optional voluntary plan. Students must be on the Student Health Insurance plan to purchase. For complete plan and pricing
information please visit www.aetnastudenthealth.com
Aetna Vision Plan* Eye exams $10 copay in network
Eye glass lenses $25 copay in network
$59.28 Student Annual Rate
$105 allowance for contact lenses
$130 allowance for Frames
*This is an optional voluntary plan. Students must be on the Student Health Insurance plan to purchase. For complete plan and pricing
information please visit www.aetnastudenthealth.com
PLEASE READ CAREFULLY BEFORE DECIDING WHETHER THIS PLAN IS RIGHT FOR YOU:
Please read the Drexel University brochure during business hours, carefully before enrolling located at Office of Counseling & Health, Suite 215, Creese Student Center, 3210
Chestnut Street, Philadelphia, PA or Health Insurance and Immunizations-Center City, New College Building, Suite 1106, 245 North 15th Street, Philadelphia, PA
View the full plan description, which is contained in the Master Policy issued to the school, you may view it at Office of Counseling & Health, Suite 215, Creese Student Center,
3210 Chestnut Street, Philadelphia, PA or Health Insurance and Immunizations-Center City, New College Building, Suite 1106, 245 North 15th Street, Philadelphia, PA.
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15.03.473.1 B (01/15)
15.03.473.1 B (01/15)