Each plan year, each GEO member is entitled to a reimbursement from UHS for any prescription copayment costs that exceed $250. According to Article 35(g) of the GEO contract, no one should make more than $250 in co-payments per year. Members have to keep track of their co-payments themselves, however, because UHS does not automatically stop charging co-pays once this limit is reached. To receive this benefit, you must submit an Aetna Navigator print-out that tracks claims, or receipts from UHS or other pharmacy (reprinted receipts are fine).
We are not aware of any caps on this plan, so each time you are charged a copay after paying the initial $250, submit another reimbursement.
Please notify the GEO office when you are interested in submitting a reimbursement so we can assist and also track how many are filed. Keep reading for more details.
1. To verify that you have paid more than $250, review your benefits statement and/or personal claims status by logging on to Aetna Navigator. Start at the UHS web page: http://www.umass.edu/uhs/insurance/ship/ and follow the link to Aetna Student Health and then to Access Navigator. You can also use this claims print-out as proof of spending over $250.
If you are having problems logging in, you can call Aetna: 877-480-4167 or Aetna Pharmacy Management: (800) 238-6279.
2. Fill out a GEO co-pay reimbursement form and a W-9 form (both available at UHS or in the GEO office).
All the above documentation must be submitted to Linda Haines at University Health Services, Financial Services Division – Room 369C. She can also be reached for questions at 413 577 5268.
Please contact the GEO office if you have any questions about the procedure or the forms and documentation required.