Is your student ready for college?

Do you have a son or daughter getting ready to start college in August? If the answer is yes, chances are you already have a to-do list of things to buy and errands to run before the big day when you load up the car and make the trip to campus.

There are some important health benefits matters to take care of before sending your son or daughter to college miles from home. The following checklist is designed to help you have everything ready by the time your new freshman leaves for campus.  

• Empire Plan enrollees should obtain a booklet called "On the Road with the Empire Plan 2009." See your Health Benefits Administrator (HBA), who is usually located in the Personnel Office. You can also download a copy from the Civil Service web site www.cs.state.ny.us. Click on Benefit Programs, then select NYSHIP Online. Choose “I am a NYS Active Employee” then your group (PEF) and plan (Empire Plan or HMO). Then choose Using Your Benefits and Publications. Scroll down to find “On the Road with the Empire Plan.” This booklet tells enrollees what they need to know about using the Empire Plan when away from home. 
• If you are enrolled in the Empire Plan and need an identification card for your son or daughter, contact your agency Health Benefits Administrator, who is usually located in your agency Personnel office. You can also request a new ID card through MyNYSHIP, the self-service employee portal at NYSHIP Online. Follow the directions above to reach NYSHIPOnline, then select the link for MyNYSHIP. If you are enrolled in an HMO, contact the HMO directly to request a card.  

• Check with your child’s doctor to make sure all immunizations, including hepatitis, tetanus and meningitis are up to date.

• Obtain any new prescriptions or refills needed.

• Schedule dental or vision appointments if needed. Dependents have nationwide access to participating vision care providers, so they don’t have to wait until they come home to use this benefit. 

• If you are enrolled in the Empire Plan and your son/daughter will need to see a physician while at college, visit the Empire Plan participating provider directory on the Civil Service web site (www.cs.state.ny.us) to search for a conveniently located provider by specialty. From the Civil Service home page, follow the prompts for NYSHIP Online, then Find a Provider. Scroll down to find the type of provider you need. Always call to verify the provider's status. You can also print a list of providers by zip code.
• Empire Plan enrollees have guaranteed access to network hospitals, mental health/substance abuse clinicians, Managed Physical Medicine Program (physical and occupational therapy and chiropractic services), lab services and retail/mail pharmacy services. Only medical-surgical providers are not available nationwide.
• If a par medical-surgical provider is unavailable, another option is to use a non-participating provider who is part of MultiPlan. Your out-of-pocket expense will, in most cases, be reduced. Your share of the cost will be based on the lesser of the MultiPlan fee schedule or the reasonable and customary charge
• The MultiPlan provider will submit bills and receive payments directly from UnitedHealthcare. You are only responsible for the applicable deductible and coinsurance amounts. To find a provider, call The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) and choose UnitedHealthcare, or visit the MultiPlan web site at www.multiplan.com/netsearch/empire.

·  If you are enrolled in an HMO, contact the HMO to find out what services will be covered if your son or daughter’s college is located outside the HMO’s service area. The toll-free number for each HMO’s member services department is at www.pef.org/healthbenefits/hmos.htm.   

• If your son or daughter is age 19 or over, be prepared to submit documentation that s/he is a full-time student. Each insurer is responsible for verifying that a dependent is eligible for coverage before providing benefits. Dependent student verification forms are posted in the Health Benefits section of the PEF web site. Go to www.pef.org/healthbenefits/index.htm. Select the link at the top of the page for Forms.

• Some colleges offer health insurance policies to students. If you are enrolled in an HMO and your son or daughter will have benefits only for emergency services while at college you may want to consider purchasing a policy. Remember that you also have an opportunity to change health plan options in November.   

• In order to resolve any claim problems for your son or daughter, you may need authorization from him/her in the form of a signed Health Insurance Portability and Accountability Act (HIPAA) waiver. Criteria nay differ depending on your HMO or Empire Plan insurer.You can download the appropriate form from the Department of Civil Service web site at www.cs.state.ny.us/ebd/. Click on the link for HIPAA Privacy Information, and then print the HIPAA Authorization Form.  

• If you are enrolled in the Health Care Spending Account, remind your son or daughter to save receipts from any health-care related expenses such as prescription drug copays or over-the-counter medications (see a list of reimbursable items at http://flexspend.state.ny.us/otc.asp).