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Doctor Visits and Hospital Stays

This section provides information needed when you, your spouse, or your child must visit the doctor or hospital, or are referred to a specialist.

Doctor Visits

In case of an EMERGENCY — CALL 911 or visit the nearest EMERGENCY ROOM!
Map to U-M Hospital Emergency Room

 

emergency room deductible

If it is NOT AN EMERGENCY, your least costly options depend on your status and age. International students, scholars, spouses and children age 10 or older can visit the University Health Services (UHS) and pay $0 deductible for treatment.

Scholars, spouses, and dependents can visit the Packard Health (PH) clinic and pay a $10 deductible for treatment.

Children age 18 and younger can visit the Pediatric Primary Care at East Ann Arbor Health Center (EAAHC) and pay $10 deductible for treatment.


If you and/or your family need to see a specialist, go to any of these clinics (UHS, NCFHS, CFHC, and EAAHC) first and get a REFERRAL TO A SPECIALIST (the clinic directs you to another doctor or hospital). If you get a referral, you will not pay any additional deductible. However, if you see any other doctor or specialist without first getting a referral from UHS, NCFHS, CFHC, or EAAHC, you will have to pay a $50 deductible.

other deductible

* When a physician from UHS, NCFHS, CFHC, or EAAHC refers you to a specialist, you will receive a note from the referring doctor. It is a good idea to make a copy of this referral note and keep it for your records. The insurance company might ask to see it.

Hospital Stays

  • For an inpatient non-emergency hospital admission, where you will be in the hospital for 18 hours or longer, you must notify the insurance company at least three (3) working days prior to admission in order to obtain Pre-Certification for the hospitalization. You, your doctor, or the hospital must call the insurance company at 800.239.9697. The insurance company will ask you why you are planning to go into the hospital and will certify your visit over the phone.
  • For an inpatient emergency admission, you must notify the insurance company by phone within one (1) working day of admission to the hospital. You, your representative, your doctor, or the hospital must call the insurance company at 800.239.9697.
  • Pre-Certification or Notification for hospitalization is required by the insurance company. If you do not follow this procedure, the first $200 of the hospital bill will be your responsibility.

Preferred Provider Network

In all cases, it costs less to go to a hospital or doctor in the PREFERRED PROVIDER NETWORK (you can use any other hospital or doctor worldwide outside the Preferred Provider Network, at possibly slightly higher expense).The University of Michigan Health System is part of this network. To find other Preferred Providers and to find Aetna-network pharmacies, visit the Aetna website or call 1.800.239.9697.

* In many cases, the doctor/hospital will bill the insurance company directly. If so, either you will not receive a bill at all or you will be billed for the portion of the services that the insurance company does not cover, such as the deductible.

 

Last reviewed: 10/12