SMCCME

All students enrolled in 9 or more credits per semester are required to have health insurance as a condition of enrollment. This policy is designed to better protect students and their families from the rapidly escalating costs associated with illness or injury. Prior to instituting this policy, many SMCC students incurred bills at local emergency rooms for non-emergent care because SMCC does not have a student health center and they did not have access to their primary care physician locally. In addition, NEASC accreditation requires colleges with full-time or residential students to provide "access to health care." Requiring insurance for these populations is how SMCC meets this accreditation standard. 

Students will be automatically enrolled in and billed for SMCC’s Student Accident and Sickness Insurance Plan; however, families and/or students will be able to waive the SMCC coverage if students are covered under an existing U.S. based health insurance plan of comparable coverage and complete the online waiver by the published deadline. 

Students can be insured by more than one plan. Families may choose to maintain their private insurance as well as the SMCC Plan for access to care and coverage. In such cases, the SMCC Plan will be secondary to any other insurance plan.  This is a particularly good idea if your private plan has a high deductible.

What is the Cost of SMCC's Health Insurance Plan and What is Covered?

For those who purchase the SMCC Plan for the 2009-2010 academic year (coverage from August 16, 2009, to August 16, 2010), the annual cost will be $331. Students who pay in the fall do not need to pay again in the Spring; however, because insurance coverages change, they will need to waive annually each Fall.

For students who enroll in nine hours or more beginning in January (new students or students who were previously enrolled in fewer than 9 credits), coverage will be effective from January 1, 2010 until August 16, 2010, and cost $221. These students will need to waive again the following Fall, then annually in the Fall thereafter. 

Please note that the SMCC Plan is an accident and sickness plan, and will not cover routine exams or preventative care services except as mandated by state and federal laws.  There are a few exceptions to this.  For more information, please refer to the SMCC Student Health Insurance Waiver and Enrollment Brochure (for a broad overview) or the SMCC Master Policy (for more detailed information).

• Enrollment in this Plan will provide coverage for 100% of eligible charges up to a maximum benefit of $2,000 for medical expenses incurred as a result of a covered accident or sickness. Payments will be made as allocated for certain covered medical expenses incurred for an injury or sickness while covered on this plan.
• Supplemental Expense Benefit: after the basic benefit maximum of $2,000 per sickness or covered accident, remaining eligible expenses are payable at 80% up to a policy aggregate maximum benefit of $10,000 for any one sickness or covered accident. Hospitalization, including room and board, general nursing care, diagnostic testing, surgery and medicines. Outpatient diagnostic testing and lab work, outpatient hospital services, including emergency care and surgery.
• Mental Health and Substance Abuse services; Prescription Drug Coverage up to $500.00.

In addition, students may insure a spouse or child or "buy up" to $50,000 worth of coverage for an additional fee. These options are available when waiving or enrolling at www.aetnastudenthealth.com. 

How Do I Know if I am Eligible to Waive SMCC's Health Insurance Plan?

In order to be eligible to waive SMCC's policy, you must be covered by a U.S. based health insurance plan that provides:

1. Access to local doctors and other health-care providers
2. Diagnostic testing/lab services
3. Prescription drugs
4. Outpatient mental health
5. Inpatient and outpatient hospital services
6. Emergency services

In addition, the policy must be in effect from August 16, 2009 to August 16, 2010.

What is the Process for Waiving SMCC's Health Insurance Plan?

1. Go to www.aetnastudenthealth.com.  
2. Select Southern Maine Community College from the drop-down menu at the top right of the page, and click "Go."   
3. Click on "Plans and Products offered to You" in the menu on the left.
4. Click on "Enroll or Waive: Student Health Insurance Plan" and follow the instructions.  You will need to have details regarding your current coverage available in order to fully complete the online waiver.  
5. SAVE THE CONFIRMATION PAGE FOR YOUR RECORDS!

Q & A

What if I need to see a doctor right away?

If you need to see a doctor right away but have not yet received your card from Aetna, you can go to www.aetnastudenthealth.com and enroll in the policy. This will allow you to register as a member on the web site and gain access to a copy of your ID card, the provider finder directory and in the future, your claims.

I am having trouble completing the waiver/enrolling in the policy. What do I do?

If you cannot login at www.aetnastudenthealth.com, it is likely because SMCC has not confirmed that you are an eligible student (i.e. enrolled in 9 credit hours or more). Please wait one week after you register in your ninth credit hour for your login to become active on the Aetna site. Three weeks prior to the waiver deadline, SMCC will upload active student lists to Aetna's site on a daily basis, Monday through Friday. During this period, please wait 24 business hours before trying to enroll/waive.

I don't have 9 credit hours. Can I enroll in the policy?

Unfortunately no. SMCC's policy is a group policy that requires students to be full-time students, which SMCC defines for insurance purposes as 9 credit hours or more.  However, if you go to www.aetnastudenthealth.com, Aetna may have other insurance policy offerings that you can purchase from them directly.

I am trying to see a doctor and/or resolve a claim with SMCC's former insurance carrier, Gallagher-Koster. What should I do?

The 2008 - 2009 Annual Policy and Spring 2009 Policy are still active until August 31, 2009. SMCC students covered under these policies may still access all the benefits in those policies in the same way they always have.

All SMCC students covered under prior year (before Fall 2009) policies who are trying to resolve claims may still do so by contacting Gallagher-Koster directly. Gallagher-Koster has a robust web site that will likely include much of the information you are seeking: www.gallagherkoster.com. SMCC students may also call Gallagher-Koster at 1-800-406-4517. In addition, students may contact the Claims Company, Pioneer Management Systems, Inc. by email at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or by phone at 877-868-9060.  Pioneer's web site is www.pioneeerhealth.com.

I have a question that I cannot find the answer to in the printed materials (above) or at www.aetnastudenthealth.com.  Who can I ask?

Please contact Cross Insurance. The Cross Agency is the insurance agency that manages SMCC's policy with Aetna. You can contact either of SMCC's representatives, Lisa Farrington or Michael Parkin, during business hours by calling 1-800-537-6444.