Important Considerations for Intercollegiate Athletes
2015-2016 Academic Year
Occidental College Student Health Insurance, similar to your own private health insurance, is subject to specific policy terms and conditions, and may include restrictions/limitations with regards to intercollegiate sports injuries of which you should be aware. The Oxy Student Health Insurance plan covers intercollegiate sports injuries at 90% of usual & customary charges for in-network providers; and 70 percent of usual and customary charges for out of network providers. There is a $ 100 deductible per policy year. This plan also has a $30 co-pay per physician visit, and a $150 co-pay per emergency room visit. Dental injuries are covered up to a maximum of $1,000 if the injury occurs to sound, natural teeth.
Oxy purchases a Sports Excess accident insurance policy that covers NCAA intercollegiate sports injuries at 100% of usual & customary charges, up to $90,000 per injury. This policy acts as a secondary policy, and has a $4,000 coordinating/disappearing deductible. This deductible coordinates with your primary insurance; by that, the deductible is considered satisfied as long as you or your primary insurance (Oxy Student Health Insurance or your private insurance) pay at least $4,000 or more on a given injury. In short, this means that you (with your primary insurance) will be responsible for the first $4000 in injury claims, after which the Sports Excess policy will kick in for claims above $4,000 that are not covered by your primary insurance. The Sports Excess policy has a maximum benefit of $90,000. All NCAA athletes have coverage above $90,000 through the NCAA Catastrophic Insurance policy.
Occidental College Athletics and the Sports Medicine Department strongly encourage all student-athletes and their parents/guardians to look closely at their current primary health insurance policy as well as the Oxy Student Health Insurance policy when deciding which plan will provide the most comprehensive and appropriate access to care and benefits during the student’s athletic career. Athletic participation can lead to athletic-related injuries that require specialty medical services and diagnostic tests administered in a timely manner. With the Student Health Plan, a student-athlete will have at least $4,000 of sports coverage, which will satisfy the deductible under the Sports Excess policy. Coverage under the Oxy Student Health Insurance will also help to expedite referrals to off-campus providers such as team physicians, team therapists, and MRI centers. If you elect to waive the student plan, you are subject to the plan specifics and benefits of your private health insurance. This may include high coinsurance, high deductibles and copays, and lengthy pre-authorization processes. To ensure the most streamlined and efficient operation for athletic-injury medical care, the Oxy Sports Medicine department recommends that our student-athletes enroll in the Oxy Student Health Insurance plan.