Student Medical Insurance Plan - For complete information about your medical insurance coverage, visit the Student Health Programs web site.Springfield Medical Students:
Springfield Student Health Insurance
In Springfield, the SIUMED FCM clinic is your primary care provider. It functions just like the Student Health Center in Carbondale.
Medical students pay two fees for healthcare. The first fee covers your primary care, including labs and simple x-rays. The second fee covers referrals, ER visits and more expensive tests. The second fee (extended care fee) may be refundable if you show proof of other insurance coverage.
Primary Care: Dr. Careyana Brenham is your primary contact at SIUMED FCM. To schedule an appointment call 757-8100, and be sure to identify yourself as a medical student. You should not be evaluated by another student or resident unless you waive that right. You will have to pay the co-pay of $6.00 to go to SIUMED FCM.
If a provider orders labs or simple x-rays, you should get these at Memorial Medical Center, and show them your insurance card. Billing for these tests should be sent to SIUMED FCM, not Carbondale.
Specialty Care, ER Visits and Expensive Tests: In order to have any of these paid for, you must have prior approval from SIUMED FCM. If approved, there is a $100.00 per year deductible you must pay. After that, your insurance will cover 80% of the agreed cost. You will be responsible for the remaining 20%. All bills should be directed to SIUMED FCM--NOT Healthlink.
|Ambulance||80% up to MOOP*, then 100% to Plan maximum||80% up to MOOP*, then 100% to Plan maximum|
|Emergency Room**, Urgent Care Clinic, Hospital Charges, Physician Surgery, Anesthesia, Diagnostic Lab and X-ray and Maternity||80% up to MOOP*, then 100% to Plan maximum||60% up to MOOP*, then 100% to Plan maximum|
|Specialty Care Referrals||80% up to 12 office visits, 12 months or $600 per condition per lifetime maximum, whichever occurs first||60% up to 12 office visits, 12 months or $600 per condition per lifetime maximum, whichever occurs first|
|Mental Health & Substance Abuse Treatment (Inpatient)||80% - lifetime maximum $20,000||60% - lifetime maximum $20,000|
|Mental Health & Substance Abuse Treatment (Outpatient)||80% up to $60 per visit for 40 visits per year with a lifetime maximum of $3,000||80% up to $60 per visit for 40 visits per year with a lifetime maximum of $3,000|
|Therapy (Physical, Speech, Occupational)||80% for up to 10 visits||60% for up to 10 visits|
|Chiropractic Care & Osteopathic Manipulations||50% up to $50 per visit for 20 visits||30% up to $50 per visit for 20 visits|
|Hospice Care||80% up to MOOP, then 100% up to 6 months||60% up to MOOP, then 100% up to 6 months|
|Home Health Care||80% up to MOOP, then 100% for 30 days||60% up to MOOP, then 100% for 30 days|
|Durable Medical Equipment & Prosthetics||80% up to MOOP, then 100% up to $5,000||80% up to MOOP, then 100% up to $5,000|
|Dental Restoration (Trauma Only)||80% up to $5,000 per lifetime||80% up to $5,00 per lifetime|
* MOOP = Maximum Out-of-Pocket
** Visits to the ER for non-emergency conditions are not eligible.
Student Healthcare Flow Chart
Needle Sticks & Blood Borne Pathogens Exposure
During work hours, 8:00 a.m. to 4:30 p.m., immediately call the ID Nurse at 217-545-8970, pager #217-492-2446, located at MMC in Room A474. After hours, weekends or holidays call the SIU Answering Service at 545-5880 and have them page the ID physician on call.
The following exposure forms also need to be completed:
Exposure report packet for students
Exposure procedures for students on extramural electives
Mental Health Counseling
Ginny Zahrn is available for both mental health counseling. Dr. Erik Constance, Dr. Careyana Brenham at Family Medicine, and Ms. Zahrn are all available depending on your comfort level to assist you in accessing mental health providers. You may schedule an appointment to see Ms. Zahrn by calling 545-7078.
Springfield students may send prescriptions to the SIU Carbondale Pharmacy to be filled. Include: your name, address, DOB, student ID number (aka SS#), phone number, known drug allergies, and that the prescription is for a Springfield School of Medicine student. Dr. Brenham may also fax or call prescriptions to Carbondale at the time of visit.
Students mail prescription to: Student Health Program Pharmacy, 374 East Grand Avenue, Carbondale IL 62901-6802. Students may call Sue Chaney (618) 453-4417 for refills on established prescriptions and also to inquire about the cost. However, once the script is sent and filled you may not return it. Pharmacy ships via UPS on Monday afternoon weekly to Springfield Office of Student Affairs and distributed confidentially to the student.
Remember that Walmart and Target stores will fill many generic prescriptions for $4.00. Meijer stores will fill some antibiotic prescriptions for free.
SIUMED Infection Control Policies
Medical Insurance Plan Office
Student Health Center
374 East Grand Avenue, 2nd Floor
Carbondale, IL 62901-6802