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Student Health Care Handbook Summary of Benefits 2020-2021

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Student Health Care Handbook Summary of Benefits 2020-2021 STUDENT HEALTH CARE HANDBOOK SUMMARY OF BENEFITS 2020-2021 www.msh-intl.com LIVE WITH CONFIDENCE LIVE WITH CONFIDENCE TABLE OF CONTENTS 1 What general principles guide the plan? ...................................................... 4 2 Highlights of the AUP student health care plan .............................................. 6 3 Consulting a doctor or medical specialist ..................................................... 9 4 Whom do I call in the event of an emergency? ............................................ 10 5 How long does the coverage last?............................................................ 14 6 How do I enroll in the AUP plan? .............................................................. 14 7 What is health care like in France? ............................................................ 14 8 What do I do in case of hospitalization or surgery? ...................................... 16 9 How do I get reimbursed? ...................................................................... 16 10 Access your MSH International account online ........................................... 18 All students at the American University of Paris are required to have health care insurance. The French government also requires health insurance for all non-French students. The American University of Paris has contracted with AXA Group (Mutuelle complementary insurance) administered by MSH International to provide our students with full coverage. 2 3 LIVE WITH CONFIDENCE LIVE WITH CONFIDENCE For psychologists, please contact the Health Office or AUP Guidance Couselor at What general principles guide the plan? [email protected] or [email protected] for a list of therapists who accept direct billing (no 1 payment out of pocket). The Plan reimburses all essential medical expenses, as the ceilings are set sufficiently Medical repatriation is provided when AXA Assistance physicians are convinced that repatriation ATTENTION high to cover nearly all medical practitioners in is possible and absolutely necessary on medical grounds. It is important to note, however, France. There is no maximum overall ceiling, Coverage outside of France is limited that French doctors and hospitals provide excellent service and situations where a medical no deductibles, no medical screenings and to unexpected emergency treatment. repatriation is absolutely necessary are rare. No medical repatriation is covered unless AXA no waiting period. The plan also covers Emergency coverage also includes Assistance agrees to it in advance and handles all the arrangements. psychological services up to 90 euros for the USA for emergency hospitalisations 15 sessions per semester and alternative and Emergency Room only, which In general, if you have any questions or problems, or simply need general advice and support, medicine at 100% up to 10 sessions per will be covered in full in line with get in touch with the Health Office (01 40 62 05 77) or with MSH International (01 44 20 48 15). semester. The table on page 6 gives the "reasonable and customary costs". specific reimbursement for each treatment Call MSH International (01 44 20 48 15) If you call the MSH International offices, you will be able to discuss your problem with native or service. Worldwide coverage is available within 72 hours of admission. speakers of English, French, and nearly all the European languages, as well as others. for emergencies only. MSH International will send a pre- certification agreement. A complete description of the benefits and the full terms and conditions will be found Certain procedures may not be covered, in in the Master Policy issued to The American University of Paris. Payments of benefits particular cosmetic surgery, elective surgery, will be made under the terms of the policy. If any statement in this brochure and any orthodontic care and treatment which are not recognized by the French Social Security System. provision in the policy differ, the policy will govern. If in doubt, do not hesitate to contact AUP Health Office or MSH International. Should you need hospital treatment in France, you should contact MSH International ten days before entering the hospital or undergoing non-emergency surgery as well as the Health Office at [email protected]. If an emergency hospitalization occurs, MSH International MUST be contacted within 72 hours of admission. Please also contact the AUP Health Office. Pre-certification is required by MSH International for: • treatment for psychiatric, alcohol, and drug abuse disorders when costs exceed 600 € • dental treatment, surgery, and crowns when costs exceed 600 € • childbirth • repetitive and serial medical procedures (5 or more) Remember that the telephone and fax numbers of MSH International are on the back of your MSH International insurance card. Failure to obtain a pre-certification agreement from MSH International may result in a refusal of a claim or reduction in reimbursement up to 50% of total reimbursement by MSH International. Services which are not medically necessary are not reimbursed. 4 5 LIVE WITH CONFIDENCE LIVE WITH CONFIDENCE Maximum plan reimbursement Treatment or services Care outside Highlights of the American University Care in France 2 of France of Paris student health care plan VISION CARE Maximum plan reimbursement Eyeglass frames One pair of eyeglasses up to 350 € per calendar year Eyeglass lenses Treatment or services Care outside Care in France MSH can pay the optician directly. of France Contact lenses (daily or extended wear) Ask for a quote (devis) from your optician. HOSPITALIZATION AND SURGERY REPATRIATION Hospital charges, including emergency room, room limited to 200% Medical repatriation 100% of cost and board, operating facilities, private room, the daily of the FSST except in the Repatriation of body in the event of death 7,623 € per person "Forfait Journalier", convalescent facilities, surgeons’ event of an accident or and doctors’ fees, Ambulance 100% of reasonable and major medical emergency, PRESCRIPTION CONTRACEPTION customary costs in which case the coverage Only 1st and 2nd generation of pills are refundable. up to 120 € per calendar year Be aware that some private hospitals such as the is limited to 100% of the Ask your doctor what generation your pill is. American Hospital and are non-conventionnés so you real charges limited to will not be fully reimbursed if you choose to go there. 30 days in the USA PRESCRIPTION DRUGS While French Social Security authorities have set up a maximum tariff scale used for 100 % of costs reimbursement, not all the health practitioners charge within these limits. The chart below OUTPATIENT MEDICAL may refer to amounts or percentages greater than the French Social Security maximum Physicians Fees, Routine Medical, Psychiatry, amount (FSST). This will often allow you to be reimbursed at 100%, even if the charge is Examinations, Physical Therapy, Nursing and 100% of reasonable and when there is no accident Paramedical Fees, Diagnostic Laboratory Analyses, customary costs or major medical far higher to the official scale. X-ray Exams, Orthopedic Fees, Eye Examinations, up to 400% of the FSST emergency, Prosthetic Appliances other than Dental reimbursements 100% of costs, up to are limited to 200% Some detailed examples of reimbursements Visits, consultations and medical procedures provided 90 € per visit, consultation of the FSST by non-State-registered health practitioners or medical procedure MATERNITY Treatment Package Social Package Full 100% of reasonable and or services Security+MSH coverage MSH limited to 200% customary costs up to of the FSST Inpatient and Outpatient Medical Treatment for 400% of the FSST Social Security: 15,10 € Pregnancy and Childbirth GP 25 € MSH: 9,90 € MSH: 25,00 € AGGREGATE MAXIMUM OF 2,000 € Remainder to pay: 0 € Remainder to pay: 0 € PER PREGNANCY ALTERNATIVE MEDECINE Social Security: 16,10 € Specialist secteur 2 90 € MSH: 73,90 € MSH: 90,00 € Acupuncture, Osteopathic care, Chiropractic care, 100% of costs, up to 10 sessions Remainder to pay: 0 € Remainder to pay: 0 € Homeopathic care per semester in aggregate PSYCHOLOGICAL SERVICES Social Security: 0 € Therapist session 120 € MSH: 90,00 € MSH: 90,00 € 100% of costs, up to 15 sessions/semester*, Psychological Therapy Remainder to pay: 30,00 € Remainder to pay: 30,00 € limited to 90 € per session DENTAL CARE Social Security: 15,24 € Glasses 420 € MSH: 350,00 € MSH: 350,00 € Preventive Treatment, Teeth Cleaning, Diagnostic Remainder to pay: 54,76 € Remainder to pay: 70,00 € Examinations, X-rays, Necessary Basic Care, inclu- when there is no accident ding Fillings, Extractions, Root Canals, Oral Surgery, 100% of reasonable and or major medical emer- Crowns, and Dental Prostheses customary costs gency, reimbursements An agreement is needed for crowns or wisdom tooth. up to 500% of the FSST are limited to 200% of the Ask a quote (devis) from your dentist prior to the FSST treatment. *The semester dates for PSYCHOLOGICAL SERVICES are as follows: Spring semester: January 1st until June 30th, Fall semester: July 1st until December 31st 6 7 LIVE WITH CONFIDENCE LIVE WITH CONFIDENCE Some examples of reimbursements (full coverage and complementary to French Social Security plan) 3 Consulting a doctor or medical specialist French MSH Int. maximum social French Social Security reimbursement for students with Benefits security reimbursements complementary to the French Choosing a doctor abroad may seem like a challenge, but there are a few helpful tips to scale Social Security and full coverage
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