Emory University Athletic Insurance Policies
Participation in intercollegiate athletics involves the inherent risk of injury. The NCAA does not require member institutions to purchase insurance to cover the cost of athletic related injuries. However,
I.
If a student athlete’s medical insurance is not in compliance with the insurance requirements of Emory University, then additional coverage provided by the Athletic Department‘s policy will not be made available.
In order to maximize Atlanta- and Emory Healthcare-based insurance coverage for intercollegiate athletics-related illnesses and injuries, Emory University Department of Athletics strongly recommends enrollment in the Emory University Student Health Insurance Plan. For an overview of the University’s student plan, offered by Aetna Student Health, go to http://studenthealth.emory.edu/hs/hs_fees_insurance.php. Effective 2009-10, the Emory/Aetna Student Plan includes 100% coverage at all Emory Healthcare facilities, in-patient and out-patient, with no annual deductible (after a $25 co-pay at specialists and $50 at the Emergency Department, waived in the event of admission to the hospital).
It is the student athlete’s responsibility to notify the Emory University Sports Medicine Department of any changes with his/her insurance plan.
II.Excess Medical Costs:
III. With the exception of the catastrophic injury insurance, the NCAA does not presently require member institutions to purchase insurance or cover the cost of athletic related injuries. However,
IV. Insurance Claims:
A student-athlete (or his/her parent or guardian) will be responsible for initially paying all medical or surgical expenses not covered by the student-athlete’s primary insurance company (except those from Emory Clinic and/or Emory Physical Therapy, which Emory Athletics will handle directly with Emory Healthcare). After covering the initial excess medical or surgical costs, the student-athlete (or his/her parent or guardian) will forward the necessary documentation to Emory Athletics (at the contact address below). Upon receipt of the appropriate initial payment documentation, the student-athlete (or his/her parent or guardian) will be reimbursed for all medical and surgical costs not covered by their primary insurance company (minus any annual deductible or co-payment amounts required under their insurance plan), up to the $3,000 maximum per injury.
In order to receive reimbursement, the following documentation is required. Only original documentation (NOT COPIES) of the following should be forwarded. However, the student athlete should also keep a copy of these documents for his/her own records:
-medical or surgical bills
-corresponding insurance statement (Explanation of Benefits or EOB)
-receipts/canceled checks/credit card statements verifying initial payment by the student-athlete, parent or guardian
-name, address and social security number of person to be reimbursed
The original documents noted above should be mailed to:
Joan Reed MAT, ATC
Athletic Department
26 Eagle Row
V. Not Covered:
Costs associated with injuries/illnesses incurred during participation in sport clubs, intramurals or any other activities that are not related to varsity competition will not be covered. This includes but is not limited to pre-existing conditions and any tests required as the result of issues or concerns raised during pre-participation physicals.
VI. Other Limitations of Coverage:
- Once a student athlete finishes his/her athletic career at Emory University, he/she will have 6 months to resolve any participation-related medical issues. After this time frame, the Athletic Department will not cover any additional medical/surgical expenses.
- Athletes who choose not to follow treatment plans set forth by the Emory University Sports Medicine Staff will not receive Athletic Department financial coverage for medical or surgical complications that arise as a result of that non-compliance with physician, athletic trainer and/or other Emory healthcare professional recommendations.
- The Athletic Department will provide coverage for excess expenses incurred as a result of varsity-related injuries to sound natural teeth, up to a maximum of $200 per injured tooth. Other dental expenses, including the creation of dental appliances, will not be covered. Non-tooth related maxillofacial injuries will be covered as any other varsity-related injury. Emory athletes are strongly advised to wear mouth guards during participation in all varsity contact sports.
VII. Contracted Services:
Contracted services include biomechanical assessment and orthotics, chiropractic, dental, massage therapy, nutritional consultation, and physical therapy. The athletic training staff will be happy to coordinate these services for all varsity athletes.
Physical Therapy in the Emory University Athletic Training room will be provided by a licensed physical therapist from Emory Healthcare. This is a contracted service and the student athlete’s insurance will be billed as primary.
VIII. Criteria for Physical Therapy Referral:
- Pre-existing conditions
- Injuries that occur outside of sanctioned varsity practices and competitions
- Post-operative conditions requiring specialized physical therapy care
- Back and neck conditions
- Other orthopedic conditions that, in the opinion of team physicians and/or varsity athletic trainers, would best be served by evaluation and treatment by the physical therapist
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