Eligibility and Coverage

The Medical Plan benefits described herein are subject to the provisions of the Plan Document. The Plan Document may also be reviewed at the University Health Services, 2145 Adelbert Road.

The fee for the 2019-2020 Student Medical Plan is $1165 per semester. The fee for the Student Medical Plan is automatically billed each fall and spring semester to students registered for at least one credit hour. The fee will appear on the student's tuition bill each semester. Payment is due in accordance with the University's tuition schedule.

Students who waive the Plan (see waiver option) will receive a credit of $1165on their account.

Eligibility

To Receive Coverage:

  1. Students of Case Western Reserve University registered for at least one credit hour.
  2. Persons associated with special programs on the campus of Case Western Reserve University may be eligible for this student coverage.
  3. Students of The Cleveland Institute of Art and The Cleveland Institute of Music registered for at least one credit hour.

Not Eligible To Receive Coverage:

  1. Students cross-registered for classes at Case Western Reserve University or its affiliates.
  2. Employees of Case Western Reserve University who are eligible for Benelect.
  3. Students enrolled in virtual and online classes.

Periods of Coverage

For Students Attending Case Western Reserve University School of Medicine, Case Western Reserve University School of Dental Medicine (MSD), and Cleveland Clinic Lerner College of Medicine:

  • Fall Semester: July 1, 2019 (12:01 a.m.) to January 12, 2020 (11:59 p.m.)
  • Spring Semester: January 13, 2020 (12:01 a.m.) to June 30, 2020 (11:59 p.m.)

For All Students (Except Those Listed Above):

  • Fall Semester: August 1, 2019 (12:01 a.m.) to January 12, 2020 (11:59 p.m.)
  • Spring Semester: January 13, 2020 (12:01 a.m.) to July 31, 2020 (11:59 p.m.)

If a student registers after September 6, 2019 for Fall Semester and after January 24, 2020 for Spring Semester, the Student Medical Plan will become effective on the date the student registers (not on the effective date listed above).

Dependent Coverage

Eligibility

Covered students may also enroll their lawful spouse or domestic partner and dependent children up to the age of 26. 

If the plan covers dependent children, then any dependent unmarried child, who will terminate coverage because he/she meets a limiting age under the policy, shall not terminate coverage if the child continues to be incapable of self-sustaining employment by reason of mental retardation or physical handicap and primarily dependent upon the student for support and maintenance. Proof of such handicap and dependency may be required upon initial continuation and every two years thereafter.

Enrollment

Medical coverage for spouse, domestic partner, and dependent children may only be purchased if the student has purchased the Student Medical Plan coverage for students. Coverage may be purchased on a per semester basis or on an annual basis. ENROLLMENT IS NOT AUTOMATIC. You must renew the coverage each semester or each year.

Newborn, Infant and Adopted Child Coverage

A child born to a Covered person shall be covered for Accident, Sickness, premature birth, and congenital defects, for 31 days from the date of birth. Well Baby Care coverage will not be covered unless officially added to the plan. At the end of this 31 day period, coverage will cease under the Case Western Reserve University Medical Plan. To extend coverage for a newborn past the 31 days, the covered student must: 1) enroll the child within 31 days of birth, and 2) pay the additional pro-rated premium, starting from the date of birth. Coverage is provided for a child legally placed for adoption with a covered student for 31 days from the moment of placement provided the child lives in the household of the covered student, and is dependent upon the covered student for support. To extend coverage for an adopted child past the 31 days, the covered student must 1) enroll the child within 31 days of placement of such child, and 2) pay any additional premium, if necessary, starting from the date of placement.

If coverage is desired, complete and return to University Health Services the enrollment form and appropriate premium, in the form of a check or money order, (payable to Case Western Reserve University) to University Health Services, 2145 Adelbert Rd., Cleveland, OH 44106-4901. The completion of an Affidavit is necessary for the enrollment of a domestic partner. Forms are available at University Health Service. Once paid, no portion of the premium for dependent coverage is refundable.

Medicare Eligibility Notice

If a covered person becomes eligible for Medicare after he or she is enrolled in the Policyholder's plan, such Medicare eligibility will not result in the termination of medical expense coverage and prescribed medicines expense coverage under the plan. As used within this provision, persons are "eligible for Medicare" if they are entitled to benefits under Part A (receiving free Part A) or enrolled in Part B or Premium Part A.