America is a complicated place. Pop culture and the explosion of the medical drama have increased awareness of the need for medical insurance in order to avoid catastrophe.

However, students arriving from other countries do not instinctively realize the need for insurance in this non-socialistic society.

Without causing any concern, we want to help you embrace the benefits of your medical insurance plan before you incur unnecessary costs. Always feel free to ASK your health care provider if the services he or she is about to perform are COVERED by the medical insurance that you have provided. Additionally, only go to medical facilities or emergency rooms that honor the insurance that you have selected for yourself. If you carry the insurance offered by Biola University, then go into the Health Center on campus and get the most up-to-date information on urgent care or local doctors that can serve you and keep your costs to a minimum.

In addition to viewing the following links, the Department of International Student Services also offers periodic workshops on medical insurance in America. Check your BUBBS account or send an email to lisa.derby@biola.edu



Comparison of Biola Insurance vs. Home Country Insurance

During the 2003 ­ 2004 academic year, one of our graduate students compared the benefits that she would receive from the $309 per semester charge of the Biola Health Insurance to the $190 per semester fee of the Thomas Cook Insurance sponsored through her home country of India. She discovered that her needs were best suited through the less expensive plan which even had a provision for emergency airfare to return her to India if necessary.

This will not always be the case, but we suggest that students research the types of medical insurance available in their respective countries that are valid here in the US. This extra time spent in investigation can save you money while providing a health plan that may be even more beneficial to you as an international student.



Emphasis on Schedule of Benefits and Definitions

While the Health Center offers brochures detailing the health insurance offered by the university, it is very important that you understand that the insurance company is very happy to pay for expenses that fall WITHIN the benefits that they have outlined. They will never pay for something that is outside of those benefits. So, as you seek medical attention, make sure before you go to an urgent care facility or a doctor’s office that the expenses incurred will be covered by the benefits in your plan.

Here are the benefits for the Biola Health Insurance and afterwards are listed critical definitions as used by the insurance company to determine which procedures are covered and which are not.

Download Schedule of Benefits



DEFINITIONS

Benefit Period B
egins when the Insured experiences a Loss due to a Covered begins when the Insured experiences a Loss due to a Covered Injury or Covered Sickness. The benefit period terminates at the end of thepolicy period (plus Extension of Benefits, if applicable).

Covered Charge or Expense
As used herein means those charges for any treatment, services or supplies that are: (a) for Network Providers, not in treatment, services or supplies that are: (a) for Network Providers, not in excess of the Preferred Allowance; (b) for Non-Network Providers, not in excess of the Reasonable and Customary Expenses; (c) not in excess of the charges that would have been made in the absence of this insurance; and (d) incurred while this Plan is in force as to the Insured Person except with respect to any expense payable under the Extension of Benefits Provision.

Doctor as used herein means: (a) a legally qualified doctor licensed by the state in which he or she practices; or (b) a practitioner of the healing arts performing services within the scope of his or her license as specified by the laws of the state of residence of such practitioner; or (c) a certified nurse midwife while acting within the scope of that certification.

Injury means bodily injury caused by an Accident, which is the sole cause of the Loss. All injuries due to the same or a related cause are considered one Injury.

Insured Person means an Insured Student and his/her Dependents while insured under this Plan.

Lifetime Aggregate Maximum means the total amount of benefits payable for all Injuries and Sicknesses combined under this Student Health Insurance Policy or Policies issued to the Policyholder immediately before this Policy.

Loss means medical expense covered by this Plan as a result of Injury or Sickness as defined in this Plan.

Medical Emergency Means the unexpected onset of an Injury or Sickness means the unexpected onset of an Injury or Sickness which requires immediate or urgent medical attention which, if not provided, could result in a Loss of life or serious permanent damage to a limb or organ or pain sufficient to warrant immediate care. A Medical Emergency does not include elective or routine care.

Medically Necessary means that a service, drug, or supply is needed for the diagnosis or treatment of an Injury or Sickness in accordance with generally accepted standards of medical practice in the United States at the time the service, drug or supply is provided. A service, drug or supply shall be considered needed if it: (a) is ordered by a licensed Doctor; and (b) is commonly and customarily recognized through the medical professions as appropriate for the particular Injury or Sickness for which it was ordered. A service, drug or supply shall not be considered as Medically Necessary if it is investigational, experimental, or educational.

Preferred Allowance means the amount a Network Provider will accept as payment in full for Covered Charges.

Reasonable and Customary (R&C) Expenses means fees and prices generally charged within the locality where performed for Medically Necessary services and supplies required for treatment of cases of comparable severity and nature.

Sickness means sickness or disease which is the sole cause of the Loss. Sickness includes both normal pregnancy and Complications of Pregnancy. All sicknesses due to the same or a related cause are considered one Sickness.