Health Insurance For Cal Poly Pomona Visiting Scholars (J1 Visa)

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Insurance 101:

Medical care in the US is expensive.

If you don't have insurance many doctors won't treat you or might make you pay costs up front.

We can help you understand how to use insurance and keep your costs as low as possible.

Health insurance helps you pay for your medical care, including doctor visits and prescription medicine.

The cost to buy insurance is called a premium.

You will pay your premium whether or not you see a doctor or need prescription medicine.

When you visit the doctor your insurance usually pays some of the costs and you pay some of the costs.

The costs you pay are called:

• Deductibles
• Copays
• Coinsurance

To help keep your costs low it's important to understand how insurance works and how to find doctors.

If your campus has a health center, that is a great place to go for non-urgent medical services and prescriptions.

If you have a life-threatening emergency, go to the emergency room or call 911.

The emergency room usually sees the most urgent patients first.

If it is not life-threatening and you cannot wait to schedule an appointment for another day you can go to an urgent care center which will usually save you money.

Your insurance plan has agreements which certain doctors and hospitals called a PPO Network.

You can find the PPO network list on the insurance company website.

It's less expensive to use doctors or hospitals on the list.

You can go to a doctor or hospital who is not on the list but your cost will be higher!

When you receive medical services or medicines it's important to have your medical ID number or show your insurance ID card.

Your ID card will be emailed or mailed to you after the start of the Fall term or Spring if you are newly enrolled.

If your term has started and you have not received a card.

You can contact the insurance company.

During your doctor visit your doctor might prescribe medicine that you can get at a pharmacy.

In the United States there are some different versions of the same medicine called generic or brand medicine.

If you get the generic medicine you will pay less.

After you receive services, the doctor will send a bill to the insurance company.

The insurance company will pay for some or all of the bill and they will always send you an explanation of the benefits or an EOB afterward.

An EOB is not a bill.

It is your notification that payment has been sent to your doctor and it states if you owe your doctor any payment.

The doctor will send you a bill for any amount you owe.

You must pay for anything the insurance company doesn't pay for.

It is always your responsibility to make sure your bill is received by the insurance company.

If you visit a doctor and do not get an EOB from your insurance company within about six weeks, you should call the insurance company to see if they got the bill.

In most cases, the doctor will bill the insurance company for you, but if you are asked to pay up front then you will need to complete a claim form to be reimbursed by the insurance company.

Keep copies of all the documents you submit for reimbursement.

You can get more information about how to submit a claim by visiting the insurance company website or calling them.