Eligibility and plan benefits will be determined at the time of service or upon receipt of the claim. In addition, during academic breaks, we may be unable to confirm the student's eligibility prior to receipt of the spring, fall, or summer eligibility information.
IN NETWORK PRESCRIPTION DRUG BENEFITS
Benefits are provided through Express Scripts (ESI), a point-of-service provider, if you are enrolled in the student injury and sickness insurance plan. If an Insured Person incurs prescription claims within the first 4 weeks of the semester before eligibility is loaded with the insurance carrier, the Insured Person must pay for the prescription and submit a claim to Express Scripts after the 4th week at:
ATTN: Commercial Claims
P.O. Box 2872
Clinton, IA 52733-2872
EXPRESS SCRIPTS CLAIM FORM
After 4 weeks, the Covered Person may go to any network pharmacy with their SHIP/ESI Card (see printing instructions in the menu on the left).
To request a manual update of your SHIP eligibility during the first 4 weeks of the semester send an email to email@example.com stating you intend to remain enrolled in SHIP for the semester of your request (fall or spring). Please include your full name, student identification number, the name of the pharmacy you are using and the names of the medications you will be filling. That information will be forwarded to the claims administrator to update your record. An email notification will be sent to you when the processing is complete and you can fill your prescription.
We will provide a general description of the benefits only, it is not a guarantee of payment. Benefits are based upon the master policy, medical necessity, and the patient's eligibility at the time of service. If the participant chooses a brand name drug when a generic drug is available for new prescriptions and/or refills, the co-pay for the generic equivalent plus the difference in cost between the generic and brand name drug will be applied.
See applicable off-campus brochure
for benefits outside of the Student Health Clinic.