Student Health

Health Insurance

Open Enrollment for Fall 2014 Has Ended

The open enrollment/waiver period for Fall 2014 has ended. If you did not enter a decision by September 15, 2014, you will be automatically enrolled in the Student Medical Insurance Plan for the period from August 1, 2014 to July 31, 2015. The insurance charge will remain on your Bursar account and you will receive your enrollment information and card after September 15, 2014. If you did not enter a decision and are automatically enrolled, you will NOT be able to waive the SMIP.

Health Insurance Requirement

All students are required to maintain adequate medical insurance during their enrollment at Duke University. You must complete either the enrollment or waiver process within the open enrollment period (see below). Failure to do so will result in a delay in coverage or a charge for insurance you do not need.

Duke offers a Student Medical Insurance Plan (SMIP) designed to meet the needs of students who have no insurance or who have inadequate insurance coverage in the Durham, NC area. Please review your coverage. While it may be acceptable for a waiver, it may not provide the kind of security and coverage provided by our student plan, which is tailored to a Duke student’s specific needs.

If you are an international student holding an F1 or J1 visa, enrollment in the SMIP is mandatory.

The 2014-15 Duke SMIP is underwritten by Blue Cross Blue Shield (BCBS) of North Carolina. Student insurance plans with BCBS are identified as Student Blue.

 

Waiver Criteria & Review

Students may petition to waive the SMIP if the following criteria are met (“policy” and “plan” below refer to the plan the student will use in lieu of the SMIP):

  • The student does not hold an F1 or J1 visa.
  • The claims administrator of the plan is based in the United States and has a U.S. telephone number and address for submission of claims and the insurance policy has not been issued outside the U.S.
  • The policy is not a traveling policy.
  • The plan provides both emergency and non-emergency health care and mental health benefits in the Durham, NC area to include Duke Medicine.
  • The plan provides inpatient and outpatient mental health care (with at least 30 visits per year) and chemical dependency benefits are comparable to the coverage provided by the Duke SMIP.
  • The plan provides coverage for prescription medication.
  • The lifetime benefit is at least $500,000 or more.

Out-of-state Medicaid and state Children’s Health Insurance Plans, HMOs, and Kaiser Permanente plans do not cover non-emergency care in Durham and DO NOT qualify for a waiver.

Please contact your medical insurance carrier to confirm that your insurance covers non-emergency care at all Duke Medicine Clinics and that you have a deductible small enough to allow you to afford your portion of the bill.

International students holding an F1 or J1 visa may not waive the SMIP. Please note that traveling insurance or medical insurance policies issued from your country of origin or outside the U.S. will not be acceptable as means to waive the Duke SMIP.

In addition to waiver approval by the automated system, please note that all waiver requests will be reviewed by a Student Health representative. If the waiver submitted does not meet the waiver criteria, you will be enrolled in the SMIP.

Cost of Coverage

The annual cost of coverage for all eligible students for the 2014-15 plan year is $2,100.*

For dependents, the annual premium rates are as follows:

  • Add Spouse, $3,837* (in addition to the student premium)
  • Add Child(ren), $2,178* (in addition to the student premium)
  • Add Family, $6,015* (in addition to the student premium

A portion of the cost of the SMIP is retained by Duke University to pay for administrative costs incurred by the University and for reserve funds. Any portion of the cost of the plan retained by Duke University is encumbered solely for the purpose of funding plan expenses or the equitable and non-discriminatory benefit of plan participants.

*Rates pending regulatory approval

Plan Benefits

The Duke SMIP continues to provide excellent benefits at a reasonable cost. The plan has received a platinum tier rating under the new Affordable Care Act (ACA) rating system.

Significant benefit enhancements for the 2014-15 plan year include a revision to the out-of-pocket limit rules and a change in age banding (both as a result of the ACA). All out-of-pocket costs (coinsurance, copayments, and deductible amounts) will apply to the out-of-pocket limit. In addition, all students will be charged the same rate regardless of age.

For a summary of plan benefits and other details, click here to access the applicable Student Blue website.

 

Other Miscellaneous Information

Enrollment Exceptions

Students newly enrolled at the University after the start of the Fall 2014 term, or students who have lost individual coverage, may enroll in the SMIP during the Fall 2014 term.  Please complete a Duke Exception Form and send to Student Health Insurance at insurance@studentaffairs.duke.edu. Alternatively, you may print the form and fax to 919-681-2874.

Contact Information

If you have any questions about your enrollment information or insurance ID card, please contact Student Blue at 1-800-579-8022 or send an email temail@studentbluenc.com.

If you have any questions not answered by the information on this website, please send an email to insurance@studentaffairs.duke.edu. Alternatively, you may call and leave a message at 919-684-1481.

Medical Evacuation and Repatriation Coverage

Please click here for details on the BlueCard Worldwide program, which provides benefits for medical evacuation and repatriation.

Dental Insurance

Although dental services are not available through Duke Student Health Center, all students enrolled in the Student Health Insurance Plan are eligible for discounted dental visits through BASIX (see website for participating practices).

DentalBlue dental insurance is available for purchase here.

Patient Protection and Affordable Care Act and the Duke SMIP

At Duke University we understand Patient Protection and Affordable Care Act (PPACA) has been challenging and confusing!