Health Coverage Overview for Students at Yale Health

Important note: All care must be obtained at the Yale Health Center at 55 Lock Street unless it is an emergency situation or your child has a referral with prior authorization to see an outside clinician for services.

Yale Health Basic Coverage

All students enrolled at least half-time in a degree-seeking program receive Yale Health Basic Coverage at no charge.

Yale Health Basic Coverage includes services in the following departments at the Yale Health Center:

  • Student Health
  • Athletic Medicine (for varsity athletes)
  • Gynecology
  • Acute Care
  • Mental Health & Counseling
  • Laboratory
  • Inpatient Care
  • Nutrition

Yale Health Hospitalization/Specialty Care Coverage

All students enrolled at least half-time in a degree-seeking program are automatically enrolled in and charged a fee for Yale Health Hospitalization/Specialty Care Coverage.

If your child has alternate insurance and you would like to waive Yale Health Hospitalization/Specialty Care Coverage (see below).

Students enrolled in Yale Health Hospitalization/Specialty Care Coverage receive all the services in Basic Coverage along with the prescription coverage and the following services at the Yale Health Center:

  • Allergy
  • Dermatology
  • Diagnostic Imaging
  • Ear, Nose & Throat
  • Emergency Services
  • Infectious Diseases
  • Endocrinology
  • Gastroenterology
  • Hospital Services
  • Neurology
  • Obstetrics
  • Oncology
  • Ophthalmology
  • Orthopedics
  • Physical Therapy
  • Urology

Services not available on-site at the Yale Health Center are also covered with prior authorization by Yale Health.

Please see the Student Handbook for a complete description of coverage, including limitations, deductibles and co-payments.

NOTE: Pre-entrance immunizations are not covered by Yale Health. It is strongly recommended that you receive all of your required immunizations from your healthcare provider prior to your arrival on campus.

Prescription Coverage

Prescription drugs are also covered under Hospitalization/Specialty Care Coverage.

Students enrolled in Yale Health Hospitalization/Specialty Care Coverage also have prescription coverage.

Prescription drugs are covered if medically necessary and FDA approved subject to a 3-tier copay structure when purchased at the Yale Health Center Pharmacy. For copays and specific drug information, please see the Yale Health Drug List.

Prescription coverage includes free generic oral contraceptives, related devices, and emergency contraception at the Yale Health Center Pharmacy.

If prescriptions are filled at an outside pharmacy, your child must pay the full retail price for the prescription and submit a Pharmacy Claim Form for reimbursement.

They will be responsible for the greater of 20% of the cost or the co-pay.  

Example:
Cost of drug purchased at outside pharmacy: $120
Co-pay (found on the Yale Health Drug List): $10
20% of your cost of $120: $24
They will be responsible for $24 (when purchased at an outside pharmacy).  If they had the prescription filled at the Yale Health Pharmacy they would only need to pay $10.

Coverage When Not on Campus

If your child is away from campus for school breaks, weekend trips, semesters abroad, etc., Yale Health Hospitalization/Specialty Care Coverage only covers them outside of Connecticut for emergency care, acute care and pre-authorized short-term follow-up care. Please see the Terms of Coverage section of the Student Handbook for details. If you have alternate insurance, you should check the specifics of that insurance.

Coverage Dates

Fall Term and full-year coverage for both Basic Coverage and Yale Health Hospitalization/Specialty Care Coverage for incoming students begins on the date dormitories open or the date they are required to be on campus for orientation. The coverage year ends on July 31 and the following year’s coverage begins on August 1 with no lapse in coverage. Even students who graduate are covered through July 31.