Using Your Student Health Plan
You can use SHP at any in-network or out-of-network medical or mental health practice that accepts insurance in the United States. SHP contracts with Aetna Student Health’s provider network. To find out if a provider is in Aetna’s network, go to the Aetna Student Health Website and search by provider name, type or location. Seeing an in-network provider is a lower cost option than seeing an out-of-network provider.
SHP is a PPO plan and you do not need a referral to see a provider. Some services however do require prior authorization. Please consult the Certificate of Coverage to learn which services require prior authorization. *For an accommodation for this PDF, please contact email@example.com.
To find a pediatrician, or other provider of healthcare to children in SHP’s network, you can use Aetna's Provider Search tool. Cornell Health’s Students with Children webpage has additional resources and information.
Aetna Member Resources
Download the Aetna HealthSM App for tools and resources to help you manage your benefits and save money. Through the Aetna HealthSM app you can:
Access plan information and claim Explanation of Benefits (EOB) statements
Estimate the cost of common health care services and procedures
Take advantage of discount programs and services including: Aetna's Smoking Cessation Program; the Beginning Right Maternity Program; vision services; health and exercise programs and equipment; chiropractic visits; nutrition services; and more
Finding Participating Providers
When seeking medical or mental health care anywhere in the United States, you will get the best coverage by seeing an Aetna participating (or "in-network") provider / facility.
SHP also provides coverage for non-participating providers, usually with a $400 plan year deductible and then a 30% co-insurance. See our summary of benefits for more information.
When using a participating pharmacy, SHP members generally have a $12 copay for generic drugs, and a $40 to $60 copay for brand and specialty drugs.
Log in to your account through OptumRx.com or the OptumRx app to learn more about your prescription coverage, drug pricing, and to find participating pharmacies.
Prescriptions Requiring Prior Authorization
- Look up the name of your prescription drug in the OptumRX Formulary below.
- If there is a PA (prior authorization), QL (quantity limit), or ST (step therapy) in the Notes column, consult with your prescribing provider about how that might affect your pharmacy prescription.
- If there is an E (excluded) in the Notes column, that means the drug is not covered by OptumRX. Refer to the OptumRX Premium Formulary Exclusions document for preferred alternatives for excluded medications, and consult with your prescribing provider about changing your pharmacy prescription.
*For an accommodation for this PDF, please contact firstname.lastname@example.org.
Questions about your prescription coverage?
SHP offers limited reimbursement for gym membership. To make a claim for gym reimbursement, you must provide verified documentation of at least fifty visits in a six month period. Please see the Wellness Section of our Certificate of Coverage for more information.
When you have the required documentation, you may log into the Aetna member site to make a claim.
Cornell’s Student Health Plan includes access to Aetna’s network of providers in the United States and abroad, as well as access to providers of telemedicine. For more information on how to use SHP at various locations and how to find providers, visit the links below.