Introduction

The Medical College is dedicated to providing the finest medical care to its students. The following summary highlights the Student Healtthrough the United Healthcare ­ Choice Network


Descriptions and Explanations

All students must have comprehensive health care coverage. The Medical College has designed a package, which should meet the needs of most students and dependents. The program consists of 2 integrated components - a Student Health Service and a managed care plan through the United Healthcare - Choice Network which utilizes physicians and institutions of the Medical Center and surrounding area. In brief, students who use the coordinated program will have their choice of participating physicians (many faculty members) with some co-payments. In this program, students also have the option to go outside the United Healthcare network but are responsible for all charges.


Student Health Service

All students must participate. The mandatory fee for 2008-2009 is $1,250.00 a year. Dependent coverage is optional, but each dependent over the age of 18 may be enrolled at a cost of $1250.00 a year. Dependents under the age of 18 are not seen in the SHS. With the Medical College's plan for families, dependents under the age of 18 are fully covered for all care if they are seen by participating pediatricians.

The SHS Medical Director is the primary care provider for all full-time, matriculated students. In conjunction with a registered nurse, all non-emergency medical problems and preventive care are managed at the SHS. After hours and on weekends, coverage is provided by on-call physicians for emergencies. The SHS coordinates all activities related to health care in the ambulatory and hospital settings. The SHS Medical Director determines the need and appropriateness of referrals to specialists/subspecialists and should be consulted for referrals.

Services available at SHS:
Services rendered within the confines of the Student Health Center are done at no additional charge beyond the SHS Fee (with the exception of a limited number of vaccines). Anything outside of our four walls will be billed to insurance.

The Medical Director is a family medicine trained physician with broad expertise, and together with his nurse provides care in many areas including:

• Evaluation and Management of Common Conditions in Primary Care, “sick visits”*
• Chronic Disease Management
• Contraceptive Counseling and Management
• Cervical Cancer Screening
• Routine physicals and other preventive services
• Primary Care Mental Health Screening and Treatment
• Sports Medicine Care
• Occupational Health Services ­ i.e. management of body fluid exposures (“needlesticks”)
• pre-Travel consultations
• Immunizations
• Allergy shots (in consultation with an allergist)
• Ancillary services, including phlebotomy and a limited number of point-of-care testing such as urine dipsticks and rapid strep throat tests; completion of elective rotation requests and other forms
• Referrals to other specialists, including mental health services, laboratories and imaging centers as needed

* For sick visits, Student Health Services does not “excuse” students for missed educational and rotation activities (See Attendance Policy in the handbook). We will, however, evaluate and treat you and provide documentation that you were seen at SHS. Your course/rotation staff will determine the need for making up missed work if appropriate. If you have a condition that poses a risk to patients in the clinical setting, we will work with you and the course leadership to determine appropriate restriction of duties.


Health Insurance Plan

The Medical College’s student health insurance plan is specifically tailored to meet the needs of our students. The cost for 2008 -2009 is: $3,953.00 for a student, $9,462.00 for a student and 1 (one) dependent, and $14,381.00 family (student, spouse and children). In-network benefits include no deductibles or co-insurance, unlimited lifetime benefits, a prescription plan, national and international hospital care, out-of-area emergency care and a highly confidential mental health program with a generous visit schedule. Mental health coverage includes some co- payment. Optional dental and vision care coverage is available through separate programs at additional cost.

While all students must participate in the SHS, participation in the Medical College's health insurance plan is optional, but the student must provide evidence of being enrolled in a comparable insurance plan in order to waive participation in the Medical College’s plan. Students with other health insurance policies are responsible for determining the specific benefits, limitations and differences of their policies from the Medical College plan as well as filling out required forms and settling financial issues with their insurance company. These students may also be limited in their choice of specialist referral depending on which of the Weill Cornell faculty participate in their specific insurance plan. Health insurance is a complex matter with stark and subtle differences among policies. Before you waive participation in the Medical College plan, review carefully the eligibility, coverage, payment and restriction features of your parent's or spouse's insurance plan.


Criteria for Waiving Participation in the Weill Student Health Insurance Plan:

In order to waive enrollment in the student health insurance plan, your coverage must be comparable to our plan. Comparable coverage requires that your alternate plan meet following minimum criteria:

• Your plan provides coverage for medically necessary care while you are in New York City, including inpatient hospitalization, AND outpatient benefits ­ such as office visits, outpatient laboratory and radiology procedures (Coverage for emergency care only does not meet this requirement);
• Your plan provides coverage for emergency care while traveling or studying abroad;
• Your plan covers mental health care, inpatient psychiatric care, and treatment for chemical dependence;
• The maximum benefit under your current policy is at least $1,000,000 per year;
• Your coverage will remain in force as long as you are a registered student;
• Your plan will cover you for any pre-existing conditions prior to the start of the WCMC Plan Benefit Year;
• Your plan is provided by a company licensed to do business in the United States, with a U.S. office and phone number
• Your plan’s maximum individual out-of-pocket expense is not unlimited.
• Your plan includes coverage for medically necessary drugs, including antiretrovirals in the event of a blood or body-fluid exposure.

Waivers must be done annually. For more information on health insurance plan waiver, contact the Office of Student Affairs in Olin Hall 110.


Referrals to Speicalists/Sub Specialists

If you are in the Medical College’s plan: you do not need written referrals, however, we recommend that you obtain a referral from Student Health Services as we have long standing relationships with many participating physicians in many specialties at the Medical Center and outside the medical center. If you choose a specialist who is out-of-network, any associated hospital charge will be your financial responsibility.

If you have other health insurance: you do not need the SHS Director's approval or referral, but encourage you to obtain a recommendation from the SHS Director as he may know “student friendly” physicians that participate in your plan. Be sure to be familiar with the restrictions of your plan, what physicians are participants, and what deductibles, co-payments and co-insurance exist. YOU ARE RESPONSIBLE FOR ARRANGING THE APPOINTMENT AND FOR HANDLING BILLING AND CHARGES.


Student Health Essentials

LOCATION
418 E. 71st Street
Suite 21
New York, N.Y. 10021

TEL: 212-746-1450
SECURE FAX: 212-746-1732
CONTACTS
Edgar Fiueroa, M.D., M.P.H., Medical Director
Bernadette Abaya, R.N., Nurse Administrator
Mary Anderson, Coordinator

HOURS: Currently, 8:00 a.m. to 4:00 p.m. Monday through Friday

AFTER-HOURS - Urgent/Emergency Care - Physician-on-Call Service
To reach the doctor on call, dial in full 212-746-1450. If medical care is needed, the physician will direct the student to New York Presbyterian Hospital.

WHAT TO DO IN AN EMERGENCY

1. Call physician on-call service: 212-746-1450
2. Leave your name, number and the nature of your problem.
3. If it is not necessary for you to have immediate medical care, physician will reccomend appropriate measures.
4. If the physician determines that you need immediate attention, physician will instruct you to go to the Emergency Department of NYPH.
5. Bring your insurance cards and I.D.
6. Identify yourself as a Weill Medical College student when being registered.
7. Students seen in the Emergency Department should follow up with Student Health on the next business day.

IT IS ESSENTIAL THAT YOU FOLLOW THIS EXACT PROCEDURE. UNLESS THE PROBLEM IS THOUGHT TO BE LIFE THREATENING, DO NOT INITIATE THE ER VISIT WITHOUT APPROVAL OF THE ON-CALL PHYSICIAN. OTHERWISE YOU WILL BE RESPONSIBLE FOR SUBSTANTIAL ER CHARGES.


Immunizations and Other Health Requirements

1. Measles, Mumps and Rubella: New York State Public Health Law requires you to be immune to Measles, Mumps and Rubella. Our institution requires demonstration of proof of immunity by serologic titer. Any student who is not immune by titer (e.g. negative, inconclusive or equivocal) will require boosters. There is no fee for required vaccines given at SHS. Titers will be drawn at Student Health for all incoming students who have not provided lab reports prior to matriculation, and billed to your insurance within the first two months of the academic year. If you are allergic to any of the vaccines or vaccine components, you will need to provide documentation from your physician. There is no “moral objection” permissible for vaccination for health care workers. If you have had titers drawn previously, provide copies of the lab reports to the Student Health Service in addition to your immunization record. Documentation of being “immune” without actual lab reports is not sufficient proof of immunity, nor is clinical history of disease. Non-compliance may result in the student's inability to attend classes.
2. Hepatitis B Vaccine: The Hepatitis B Vaccine will be offered to all students free of charge at the Student Health Service. We recommend that 1st year medical and graduate students begin the three injection series upon arrival at the Medical College if they have not received the vaccine previously. We will check for proof of immunity by quantitative titer at the same time we check measles, mumps and rubella if there is no prior lab report of immunity. Students who are not found to be immune may need to undergo additional testing to exclude chronic infection with Hepatitis B, and/or repeat of the 3-dose series.
3. Meningococcal Vaccine: New York State Public Health Law requires all college and university students to complete a meningitis information response form. It acknowledges that you have received information about meningococcal meningitis and the availability of a vaccination. You are not required to have the vaccination. However, the vaccine is available at SHS at a fee of $110.00. If you did not receive information on meningococcal meningitis or the respoinformation packet, please contact the SHS.

As per the Centers for Disease Control and Prevention’s Guideline for infection control in health care personnel, and working agreements with New York Presbyterian Hospital, the following additional vaccines and screening are required:


4. Varicella Vaccine: Two doses of vaccine at least 30 days apart or a positive titer indicating immunity. Clinical history of disease is not sufficient proof of immunity for our campus. Titers will be checked at SHS if there is no lab report provided with registration materials.
5. Tetanus diphtheria (Td) or Tetanus diphtheria acellular pertussis (Tdap): completion of the childhood series, and a booster within the last 10 years. If you have received Td greater than 2 years ago, we will recommend a new booster with Tdap to confer additional protection against pertussis.
6. Tuberculin Skin Test (PPD): All students will be required to undergo two tuberculin skin tests on initial arrival to the Medical College, and annual testing subsequently. Additional testing may be needed depending on disease exposure during your course of study. For students who already have a positive skin test, you will be required to submit an x-ray report and information regarding previous treatment. You may be asked to complete a periodic assessment to determine that you are free from symptoms of tuberculosis. Please note that previous immunization with BCG (Bacille Calmette- Guerin) is NOT a contraindication to testing if you have not been found to be PPD positive in the past. Students who are found to develop a new positive skin test will undergo additional testing and counseling at SHS.
7. Periodic Health Assessments: A completed history and physical examination should have been performed prior to your matriculation. If it is incomplete, you may be asked to be evaluated at SHS and/or restricted from classroom activities. Clinical students will undergo a pre-rotation health assessment at the end of their pre-clinical years in preparation for rotations at New York Presbyterian Hospital and its affiliates. This must be completed prior to starting the 3rd year Introductory Clerkship, or you may be removed from clerkship activities.
8. Influenza Vaccination: Is strongly encouraged for students in the health professions, and students in the clinical years will be required to document accepting or declining the vaccine. It is provided free of charge during the fall and early Winter (assuming supplies are adequate).

SHS follows all relevant New York Presbyterian Hospital Policies and Procedures. We will notify you of any additional screenings, vaccinations or policies that may be recommended after the printing of this edition.

Mental Health Service

Coordinator:	Richard Friedman, M.D.
Location:	NYPH - Baker 11 - Room 1154
Hours:	by appointment only
Phone:	212-746-5775

Confidentiality, prompt and responsive care are the hallmarks of the Mental Health Program. You can call Dr. Friedman directly without referral from Student Health. Dr. Friedman will see you and then, if necessary, refer you to continued care. Dr. Friedman can also be contacted for any questions regarding the diagnosis and treatment of substance abuse problems.

Mental Health insurance plans are quite variable in the number of visits allowed and the charges. The Medical College’s plan enables students to have up to 30 "in-network" visits/year with co-payments. IF YOU DO HAVE OTHER HEALTH INSURANCE, BE SURE TO READ THE RULES, RESTRICTIONS AND FEE SCHEDULE BEFORE YOU SELF-REFER.


Confidentiality

The following measures have been initiated to ensure confidentiality of medical records in the Student Health Service.

1. Confidentiality of every student medical record will be adhered to by the Student Health Service staff.
2. Students who request laboratory results by phone must speak to the Nurse Administrator giving their name, date of birth and identifying the specific laboratory test.
3. Laboratory tests are usually performed by New York Presbyterian Hospital Service laboratornumber.
4. Requests for student medical information by any individual or organization outside of the Health Service will be directed to the Student Health physician. Unless so required by law, no medical information will be released without the approval of the Student Health physician, the Office of Legal Affairs and the student.
5. If a needlestick injury occurs, students are encouraged to follow the specific guidelines outlined by the policy in this Handbook. If the student wishes to preserve confidentiality, open discussions with other students, house staff and staff physicians are discouraged.