Carry This Card With You At All Times Office of Student Health

Carry This Card With You At All Times

Hospital Emergency Room

Emergency Injury – 100% Emergency Illness – 100%

Emergency Room Expenses for non-emergency illness are not

covered

Hospitalization – 80%

Office visits – 80%

Diagnostic Lab, X-ray, Surgery, Anesthesia, Consultation, Inpatient

Physician Care – 80%

$50 Deductible Per Policy Year waived if a coordinating policy

also covers the insured. This Program is underwritten by:

Aetna Life Insurance Company (ALIC)

$50 Annual Prescribed Medicines

Office of Student Health Insurance

Campus Box 2541

Normal, Illinois 61790

(309) 438-2515

Insurance Identification Card

School Name: Illinois State University

Payer Number: 60054 0315

Student Name:

Id Number:

Group #: 711123