ATHLETIC INSURANCE COVERAGE
Intercollegiate Athletic Insurance coverage is for injuries sustained during supervised practice, contests, or travel. The insurance is “excess type" coverage. All claims must first be submitted to your parent's or guardian’s insurance company for payment. Our insurance carrier will then pay any unpaid portion of the bill within the limits of the policy. If a student-athlete does not have personal coverage under a parent's or guardian's plan, then our insurance plan becomes the primary coverage. No outside treatment is covered by our insurance plan without referral by our team physician. All referred bills will be paid within the limits of our policy. For further information, contact the Athletic Insurance Coordinator, located in the Sports Medicine Office at (732) 445-6261.
Benefit payment will be made within the limits of the athletic insurance policy. In-network providers will be paid at 100%. Out-of-network providers will be paid at the reasonable and customary rate. The reasonable and customary rate is the maximum allowance the insurance carrier will consider for the service rendered. If an out-of-network provider is used, Rutgers University will not be responsible for paying any balance that exceeds the reasonable and customary rate, even if the injury occurred at Rutgers or the team physician referred the athlete to an out-of-network provider.
All non-athletically related injuries can be submitted to the Rutgers Student Insurance Policy (which is included in each student's fee). Please review your student health benefits for further information or contact the Student Insurance at the Hurtado Health Center (732) 932-7201, x266. Additional major medical insurance coverage is recommended for those athletes who lack primary insurance. Please contact Student Insurance for further information.
All student athletes must maintain full-time status to be eligible for Athletic Insurance and Student Health Insurance coverage. If you drop below 12 credits you must purchase the Student Insurance policy. The student athlete is individually responsible for coordinating this with the Student Health Services at Hurtado Health Center located on the College Avenue Campus.
If you are enrolled in summer sessions and utilize the Health Services, a summer “fee” will be charged to the student-athlete. However, a fee will not be charged if you utilize the Sports Medicine office located at the Hale Center. This service is for student-athletes only.
MEDICAL BILLS / INSURANCE PROCEDURES
Injury Claim Form:
1. All injuries must be documented with an Injury Claim Form. This form may be filled out by any athletic trainer, team physician, or coach.
2. All injuries must be reported to an athletic trainer, medical staff member or coach within 72 hours of the injury. If you do not report the injury you will be held responsible for any expenses incurred as a result of treating the injury.
For those who have personal primary and/or secondary insurance:
1. Medical bills should first be sent to your primary and/or secondary insurance carrier
2. Your primary and/or secondary insurance carrier will send you an Explanation of Benefits (EOB) for the medical services provided. Even if there is a denial of benefits, your primary and/or secondary insurance carrier will send you a denial Explanation of Benefits (EOB)
3. If there is a remaining balance after the medical bill has been sent to your primary and/or secondary insurance carrier, the bill and the EOB from your insurance carrier should be sent to the Rutgers University Sports Medicine office (see contact information listed below)
4. Our office will then submit the medical bill and the EOB for balance payment that is within the limits of the athletic insurance policy. The medical bill must be submitted for claim within 90 days after the injury has occurred or as soon as reasonably possible.
For those who do not have personal insurance:
1. The medical provider should submit the bill to the Rutgers University Sports Medicine office (see contact information listed below).
2. Our office will then submit the medical bill for payment that is within the limits of the athletic insurance policy. The medical bill must be submitted for claim within 90 days after the injury has occurred or as soon as reasonably possible.
Claims can be faxed to 732-445-3462 or mailed to Rutgers University, Hale Center, Attn: Athletic Insurance, One Scarlet Knight Way, Piscataway, NJ 08854
BILLING: PERSONAL INSURANCE
Rutgers University will be billing personal primary and/or personal secondary medical insurance companies for specific medical treatments/problems. You will not be asked to personally pay money for the athlete’s care when your insurance is billed by our office. Medical care will be handled through the Hale Center at Rutgers University. You will need to bring your medical insurance card to the Sports Medicine office when you have an office visit or receive medical treatment. Our office will require your insurance information for billing purposes.
Your insurance company will be billed for medical treatment that Rutgers University Sports Medicine supplies to the student athlete. This may generate an Explanation of Benefits (EOB) from your insurance company, which you may receive in the mail. You should not receive a bill from the provider for these services.
RESPONSIBILITIES OF STUDENT-ATHLETES
Student athletes are expected to be aware of and comply with the requirements described above. If you sustain an injury during a supervised practice or competition, or during travel, report to an athletic training room for an evaluation. Should your medical problem require further testing or generate medical bills, then feel free to discuss them with the athletic insurance office located in the Sports Medicine Office. The athletic insurance office can help familiarize you with the claims process or check on the status of pending claims.
It must be understood by student-athletes and their families that medical expenses are not “automatically taken care of” by the athletic department or the university. Athletic scholarships do not cover medical expenses. Your medical expenses are “real world” debts and you are responsible for ensuring their settlements. Paying athletic related medical expenses requires cooperation of the student-athlete and his/her family and coordination between various offices and departments in and around the Rutgers’ community. The ongoing responsibility and cooperation of student-athletes and their families are both necessary and expected.
Student-athletes are expected to understand that if they receive medical bills they should be presented to the Athletic Insurance office and not taken or sent to the coach or athletic trainers. This creates delays in filing a claim. With due respect to varying health care provider billing cycles, statements for athletic related medical expenses that are presented to the athletic insurance office 30 days or more after their issue date may not be suitable for payment consideration. Claims must be filed within 90 days of the injury date.
