Aetna Health Insurance Coverage for International Students

Navigating the healthcare system in a new country can be daunting, especially for international students. Understanding health insurance options is crucial for ensuring access to necessary medical care and avoiding unexpected financial burdens. Aetna, a well-known health insurance provider, offers plans tailored to the needs of international students. This article provides a comprehensive overview of Aetna health insurance coverage for international students, drawing upon specific examples from Seattle University and New York Institute of Technology (New York Tech), as well as general information about Aetna's international student plans.

Mandatory Health Insurance and Enrollment

Many universities in the United States, like Seattle University and New York Tech, require international students to have health insurance as a condition of enrollment. At Seattle University, all international students are automatically enrolled in the Student Health Insurance Plan (SHIP) through Aetna. This plan offers nationwide and international coverage, protecting students both in the Seattle area and while traveling within the United States or abroad. Similarly, New York Tech requires health insurance for students enrolled at its New York campuses. This requirement aligns with practices at many other schools in the New York metro area and is supported by the university's academic, student, and health services divisions.

Enrollment Continuity and Termination

At Seattle University, enrollment in the Aetna SHIP continues each term a student is registered for classes. However, coverage ends if a student graduates, takes a leave of absence, or withdraws from the university. The policy terminates with the last term of enrollment. At New York Tech, if a student is enrolled for the fall semester, their enrollment is automatically renewed for the spring semester. It is important to note that students may not waive coverage midyear at New York Tech.

Waiver Options and Medicaid Considerations

While many universities mandate health insurance, some may offer waiver options for students with comparable coverage. At New York Tech, domestic students with existing health insurance, such as through a parent's plan, may be eligible to waive the university's plan. However, international students face different considerations. New York Tech specifically advises international students against enrolling in Medicaid, as it does not meet the requirements for waiving the health insurance plan and does not cover services outside of New York state. Furthermore, enrollment in Medicaid could potentially be viewed negatively by the U.S. government, potentially leading to denial of future changes of status or benefits. Therefore, international students at New York Tech cannot waive insurance coverage based on Medicaid enrollment.

Limited Waiver Options

A limited number of international students can currently waive out of the SHIP plan through a waiver process. Students must review the international student waiver criteria and process to notify HR that they meet the waiver criteria. Students must submit a waiver request to AHP each semester.

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Understanding Costs: Premiums, Deductibles, and Co-pays

Health insurance involves various costs, including premiums, deductibles, and co-pays. Health insurance premiums are typically billed directly to the student's account. A deductible is a set amount of money a student must pay for covered services before the insurance begins paying claims. For the Seattle University Student Health Plan, the deductible is $100. Many services, such as lab work, x-rays, MRIs, ambulance rides, and surgeries, apply to this deductible.

Waiving the Deductible at the Student Health Center

For services received at the Seattle University Student Health Center (SHC), the deductible is waived, and benefits are paid at 100% for eligible health services, including lab work performed at LabCorp if referred by the SHC. The cost for a visit with a Nurse Practitioner in the SHC is a $5 administrative visit fee, and insurance is not billed. However, some in-clinic tests, procedures, supplies, medications, and vaccines carry an additional cost that is paid at the time of the visit. The SHC does not bill insurance for these additional costs with the exception of the Aetna Student Health plan when enrolled through Seattle University. For students with insurance other than SHIP, a receipt is available if you would like to submit to your insurance company requesting reimbursement if it is a covered benefit.

Explanation of Benefits (EOB)

An Explanation of Benefits (EOB) is a statement that provides a breakdown of the services billed to the insurance company, the amount paid by the insurance, and the patient's responsibility. It is crucial to keep track of EOBs when receiving lab services or visiting a physician off-campus, as billing is based on these EOBs. The most important section to pay attention to on the EOB is the "Patient Balance" portion.

Access to Quality Care

Through the health plan, students have access to quality health care through hospitals, physicians, and affiliated health care professionals in the Aetna provider network.

Key Dates for Coverage

Understanding the start and end dates of insurance coverage is essential. At New York Tech, fall semester insurance coverage typically begins on August 1 and ends on December 31. Spring semester coverage starts on January 1 and ends on July 31. At MSU, Health insurance coverage for the Fall 2025 semester begins on August 16, 2025. MSU students entering the United States before August 16 may buy early arrival health insurance coverage to ensure they have access to health care the entire time they are inside the country.

Read also: Understanding Aetna Student Health

Additional Resources and Support

Aetna offers various resources and support services to help international students navigate their health insurance plan. These may include pre-trip support, global access to care, and 24/7 assistance. Students can also contact Aetna directly with questions about their plan or coverage.

Aetna WorldTraveler

International travelers currently covered on an Aetna plan with Cornell can access help for emergency medical attention through Aetna WorldTraveler. This travel policy communicates in over 30 languages, has five regional offices worldwide and offers 24/7 live phone access anywhere in the world. Your regular Aetna medical plan provides urgent, non-urgent, routine and medically necessary services while you are abroad. Please note there may be specific medical coverage and visa requirements when traveling.

WorldAware

WorldAware provides a personal and portable service, offering members invaluable safety and security advice and assistance. Registration for WorldAware is not necessary to utilize the evacuation benefit.

Aetna Clinical Policy Bulletins (CPBs)

Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits.

CPB Content

The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental, investigational, unproven, or cosmetic. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs).

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CPB Updates

Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. New and revised codes are added to the CPBs as they are updated. When billing, you must use the most appropriate code as of the effective date of the submission. Unlisted, unspecified and nonspecific codes should be avoided.

Plan Coverage

Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.

CPB Review

Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. Under certain circumstances, your physician may request a peer to peer review if they have a question or wish to discuss a medical necessity precertification determination made by our medical director in accordance with Aetnaâs Clinical Policy Bulletin.

Coverage Decisions

While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater.

CPT Codes

The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPTÂ®), copyright 2015 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied.

OPT and Health Insurance

For international students on Optional Practical Training (OPT), maintaining health insurance is highly encouraged, even though it may not be federally mandated. The high cost of medical services in the United States makes being uninsured a significant financial risk. ISO offers OPTima plans designed to provide flexible health insurance coverage for F1 OPT international students. These plans offer comprehensive nationwide coverage, allowing access to providers in all 50 states. F-1 visa holders who have graduated and are on post-completion OPT or STEM OPT are eligible for these plans.

ISO: A Leading Provider

ISO is a leading provider of health plans for international students and visa holders in the USA, and prides itself on being a pioneer in serving international students with health insurance.

Alternative Health Insurance Options

Besides university-sponsored plans like Aetna SHIP and ISO OPTima plans, international students may explore other health insurance options:

Health Insurance Marketplace plans: Plans that meet Affordable Care Act (ACA) requirements can be purchased through your stateâs Marketplace. You can visit the Health Insurance Marketplace or call (800) 318-2596 to see if you qualify for subsidies on ACA plans or free or low-cost coverage. You can apply at Michiganâs MI Bridges portal to see if you qualify for Michiganâs Medicaid or CHIP programs.
Short-term health plans: You can get 185-day plans that arenât ACA-compliant.
Your parentsâ health care plan: You can be added to your parentâs plan during the annual Open Enrollment Period (or during a Special Enrollment Period if you qualify).

General Information and Disclaimers

It's important to remember that Aetna does not provide care or guarantee access to health services. Not all health services are covered. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a health care professional. Always refer to plan documents for a complete description of benefits, exclusions, limitations, and conditions of coverage.

Additional Tips

You donât need a Social Security number to get your card.
Always bring your ID card when you visit a doctor, pharmacy, or hospital. It helps providers verify your coverage and ensures youâre billed correctly.
Dental and vision care are not included in standard health insurance plans. Some schools offer dental plans or vision plans.
If you need help understanding your plan, get in touch with Aetna.

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