Student Gold Health Insurance

• Coverage for services provided by Wardenburg Health Services
• Local and national coverage (co-pays, deductible and coinsurance apply)
• Prescription benefit
• Out-of-pocket maximum of $5,000 for in-network and $10,000 for out-of-network per plan year
• Unlimited policy maximum
• The plan is underwritten by Aetna and administered by AmeriBen
• To view the full policy brochure click here

The premium will be included on your tuition bill each semester.

Note: Enrolling in the Gold Plan for fall and spring semesters provides a full year of coverage. Spring coverage extends through August 17, 2017 regardless of whether the student graduates in May or takes summer classes.

Eligible students must actively attend classes for at least the first 31 days after the date for which coverage is purchased.

• Degree-seeking undergraduate students enrolled in six or more credit hours and graduate students enrolled in one credit hour or more are eligible and are automatically enrolled in the Gold Plan.
• Non-degree seeking Continuing Education students enrolled in six or more credit hours, Study Abroad (including Semester at Sea) students, Evening MBA students and students enrolled exclusively in Be Boulder Anywhere course and paying the base student fee and Wardenburg Health Center fees, may be eligible to enroll in the Gold Plan and must do so by visiting Wardenburg Health Center.
• Students approved for the Leave of Absence Program are eligible to enroll in the Gold Plan for one semester that they are not registered for classes and must do so by visiting Wardenburg Health Center.

No co-pay or deductible for covered services provided by Wardenburg Health Services including:

Medical Care

• 20 primary care visits per policy year including:
  • Treatment for illnesses and injuries
  • Travel Clinic services excluding specialty travel immunizations
  • Men’s health services including one annual exam
  • Sexually Transmitted Infection testing and treatment
• Routine vaccinations
• Allergy shots antigen not provided by health center

Nutrition Services

• 20 nutrition counseling visits per policy year

Lab & X-Ray

• Coverage for lab and X-ray services ordered and managed by a Wardenburg provider

Counseling and Psychiatry

• 20 counseling and psychiatry visits per policy year including:
  • Individual counseling
  • Couples counseling
  • Medication management
  • Crisis care
• Unlimited group therapy
• 50% coverage of psychological testing ordered by a Wardenburg provider; subject to availability

Physical Therapy and Integrative Care

• 20 physical therapy visits per policy year
• 10 chiropractic visits per policy year
• Orthopedic surgeon consultations

Note: CU Sports Medicine at the Champion Center is not part of Wardenburg Health Services.

Women’s Health

• 20 visits per policy year including:
  • Gynecology services
  • One annual exam 
  • Birth control consultations
  • Sexually transmitted infection testing and treatment
• Human papillomavirus (HPV) vaccinations

Please note: Students who require a higher level of care than we can provide will be referred to an outside provider and the deductible and coinsurance will apply.

Specialist Visits

A referral from a Wardenburg provider is required for coverage off campus. Please contact Patient Services at 303-492-5107 before scheduling an appointment with a specialist. This plan also includes international coverage.

In-Network Providers

• $40 co-pay per visit for (co-pays do not apply to the deductible)
• A $500 deductible per person per policy year will apply for some office visit procedures; surgeries; imaging such as MRIs, ultrasounds, and CTs; and lab services.
• Coinsurance applies once the deductible is met; patient pays 20 percent up to a $5,000 out-of-pocket maximum per policy year
• For a complete list of in-network providers visit www.aetna.com/asa

Out-of-Network Providers

• A $1,000 deductible per person per policy year will apply.
• Coinsurance applies once the deductible is met; patient pays 50 percent up to a $10,000 out-of-pocket maximum per policy year

• $25 co-pay for generic medications
• $45 co-pay for formulary medications
• $75 co-pay for non-formulary medications

The Gold Plan includes:

• Hormone therapy available in the Women's Clinic
• Counseling and pre-approval letters provided by CAPS
• Gender Confirmation Surgery Benefit Information
• Gender Confirmation Procedural Benefit Codes

Surgery must be pre-approved by Ameriben. Please call Patient Services at Wardenburg for more information at 303-492-5107.

For more on transgender and gender affirming care at Wardenburg click here.

• $75 co-pay per urgent care visit; coinsurance will apply
• $150 co-pay per emergency room visit; deductible and coinsurance will apply
• $200 charge for hospitalization per admission; deductible and coinsurance will apply

Vision

Annual Eye Exam

Gold Plan students are entitled to one routine eye exam per policy year at no additional cost through College Optical in Boulder. This includes visual fields testing, glaucoma screening, refraction, and a dilated exam if needed. 

Eye glass frames, lenses, contacts and contact fittings are available with a discount and are the patient’s responsibility. 

College Optical: 303-444-3092  |  www.collegeopticalboulder.com

Aetna Vision Discount Program

Gold Plan students are enrolled in the Aetna Vision Discount Program which provides discounts on glasses, contacts, and LASIK with participating providers. College Optical participates in this discount program.

For a complete list of participating providers click here.

Dental

Annual Dental Exam, Cleaning and X-Ray
Gold Plan students are entitled to one dental exam, cleaning and x-ray per policy year at no additional cost through PERFECT TEETH™. 

PERFECT TEETH™ Locations:

• Boulder: Folsom St.
• Boulder: Broadway St.
• Erie
• Longmont

PERFECT TEETH™ Discount Plan
Gold Plan students are entitled to receive additional dental services at the same discounted rates available through the PERFECT TEETH Dental Plan. These expenses are the patient’s responsibility.  

For more information click here.

Accidental Injury to Sound Natural Teeth and Removal of Impacted Wisdom Teeth 
Limited benefits for these services are covered by the Gold Plan. Please provide your Gold Health Insurance Card to the dental provider for billing purposes.

Contact Patient Services at 303-492-5107 for questions relating to benefit limits and patient financial responsibility.