Student Medical Assistance

Description: The Pacific Union College Student Medical Assistance policy is not a student insurance plan. A portion of student tuition fees is allocated to the Health Services department and with prior approval these funds can be accessed as an adjunct to the student’s own primary insurance plan. This is done in an effort to offset the costs of primary insurance plans which often cover only a portion of medical expenses. College funds are accessed only after the student’s or parent’s own primary insurance plan have been billed.

Pacific Union College’s funds are only a supplement to the student’s primary plan after initial billing has occurred.

Eligibility You must meet one or more of the following:

• Enrolled for a minimum of six credit hours (Exception: Those students enrolled for the fall quarter and who are working on campus during the summer recess).
• Those students that have reported their injury to a staff/faculty member in authority that has initiated the accident reporting process. The college must have a report filed to become involved in the payment of any outside services. (Exception: In the case of an emergency prior authorization is waived. Authorization must be obtained as soon as is possible after the situation has been stabilized).

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Coverage The student may receive assistance when one or more of the following occurs (please refer to description of student medical assistance above):

• Traveling to and from school for a two-day period prior and subsequent to the first and last day of each term (see College Bulletin for a listing of the quarter schedule).
• Injuries obtained during organized school activities either on or off campus.
• Dental treatment due to accidental injury specific to the extent of damage to natural teeth only.
• Organized intercollegiate sports.
• Any and all services not available through the college Health Services department.(Please note that any outside services MUST have prior authorization. Filing of an accident report is not sufficient to process a request and does not automatically authorize payment of a claim).

Over-all Assistance

• Total payment up to a maximum of $2,000.00 for authorized medical, surgical, and hospital expenses for injuries and any complications within fifty-two weeks of date of injury.
• Total payment up to a maximum of $500.00 per accident for dental expenses for repair of damage to natural teeth within fifty-two weeks of date of injury.
• Total payment of $150.00 per episode for any outpatient or consultation services within the $2,000.00 limit when requested and approved by the Health Services physician as determined reasonable and necessary.

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Exclusions

• Any known congenital or pre-existing conditions.
• Pregnancy, childbirth, miscarriage, abortions or complications arising therein.
• Nervous emotional or mental illness.
• Treatment in any Veteran’s Administration or other federal hospital.
• Any illness or injury covered by MediCal, MediCare or any other insurance protection assistance plan.
• Preventative medicine
• Serums or vaccines
• Injections
• Medications(unless dispensed while hospitalized)
• Medical care required due to the use of illegal drugs and/or alcohol
• Venereal disease treatment
• Skateboarding/rollerblading
• Two or three-wheeled vehicles
• Air travel (even if within the two day travel rule--see “Coverage” above)
• Invasion or acts of war
• Parachuting
• Hang-gliding
• Intentional self-inflicted injuries
• Injuries sustained while committing or attempting to commit a crime

Termination

Termination of eligibility to request accessing of any assistance will be the last day of the final exams of any quarter except where the student has completed financial pre-registration for the following quarter.

Any expenses for services rendered outside of the Health Services Department which are available through the Health Services Department (except in the case of emergencies) will become the responsibility of the party accessing services unless the policy is followed and authorization procedures are followed as outlined above.

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