What is a co-payment?
A co-payment is the amount of money you pay your provider (doctor/hospital) each time you receive medical care. Your co-pay for a doctor visit is $25.00 and $100.00 for a hospital visit. These fees are non-refundable.
What is a deductible, and do I have one?
A deductible is the amount of money you must pay out of pocket for your medical services before the insurance company starts paying. You do not have a deductible; you only have a co-payment.
Why doesn’t the insurance cover vision and dental care?
Because PCC is required by law to provide F-1 visa students with medical care coverage, not dental and vision. They are recognized as separate plans.
What if I don’t have my insurance card when I need to see a doctor?
Your medical insurance card may not be mailed to you before you need medical care. Don’t worry-you have insurance. Explain to the doctor that you have not yet received your insurance card and that you can be billed at home. Please see Cha in C215 for an explanation on what to do next.
What is a Claim Form? Do I need to fill one out?
A Claim Form is a form you must fill out with each medical condition you have. It must be filled out completely and you send it to the insurance company. Cha Mancini in room C215 can provide you with a Claim Form and will help you fill it out. If you receive medical treatment and do not fill out a Claim Form, your medical bill will not be paid.
Can I go to any doctor I choose?
Blue Cross has an extensive list of doctors and/or hospitals from which to choose. If you go to the providers on the list, the insurance will pay at a greater percentage of the bill. However, you don’t have to go to the doctors/hospitals on the list. Please note that if you choose a doctor or facility outside the network, the insurance company will only pay 75% of your bill, leaving you responsible for the other 25%.
Are all medical services covered?
No. There are exclusions listed in your pamphlet that will tell you what is not covered. Most services are covered, as you have excellent medical coverage. The exclusions listed in your pamphlet are typical of most medical plans.
What if I go to the doctor and then get a bill sent to my home?
There are many reasons why you may receive a bill at home. It may be that the doctor’s office is not aware that you have medical insurance, or it may be because you did not file a Claim Form with Blue Cross. See Cha Mancini in room C215 for assistance.
Does my medical insurance cover me if I go to my home country for a visit?
Yes. As long as you are a full-time student enrolled at PCC, your medical insurance is good anywhere you go.
Do I need to go to the PCC Health Center for a referral to an off-campus doctor?
No, you do not need a referral. It is, however, a good idea to go to the PCC Health Center for some of your medical needs, as the Health Center’s medical fees are usually lower than your co-payment. They will not bill the insurance company.
If I am in an automobile accident, will my insurance cover me?
Yes, but you must file the claim with your auto insurance company first. Blue Cross will be billed only if there is a remaining balance on your medical bills. See Cha Mancini for additional help.
Are medical prescriptions covered?
Yes, medical prescriptions are covered at 50%. You must submit your prescription ticket and receipt to Blue Cross with your Claim Form. You will be reimbursed by mail.
Why does the insurance company send me papers in the mail? What are they?
You must read all correspondence mailed to you from Blue Cross. It is very important information to which you need to respond. If you do not understand the information mailed to you, please take it to Cha Mancini (C215) (626) 585-7283.
