Understanding Taking a Leave of Absence from the University and Yale Health Coverage

Important Note:

Taking a Leave of Absence (LOA) from the University directly impacts your Yale Health Hospitalization & Specialty Care Coverage. The timing of your LOA can impact whether you can get a refund for your health coverage received or be billed for health services you used. Note: Tuition and Yale Health coverage fees are billed separately and considered separately in the LOA policies. Contact Member Services or your Student Heath Care Navigator for guidance or questions about your specific situation.

It’s important to understand how these apply to your situation.

Please note: The following policies apply to all students who were enrolled in courses half-time or more in the term their leave of absence was approved*. The only portion of the below policy that differs based on your school is the specific first date of classes. The type of LOA you are approved for (medical, personal, etc.) does not impact the below policies with Yale Health.

*This does not apply to EMBA, EMPH, MSN Nursing Online, and PA Online students. Please reach out to Yale Health Member Services to understand your specific policies.

Terms to understand:

• Insurance Term: the coverage period for Yale Health Hospitalization & Specialty Coverage and Basic Health Services in the Fall (August to January) and/or the Spring (February to July). The specific dates are determined by your status as a new or continuing student for that academic term.
• Academic Term: the academic semester (Fall or Spring) of the University.
• First Day of Classes: the date that classes begin for that academic term; this is determined by your specific school.
• Waiving Coverage: opting out of Yale Health Hospitalization & Specialty Care Coverage with Prescription Coverage and having fees for this insurance coverage removed from your student account. You keep access to Yale Health Basic Student Health Services, including primary care in Student Health, Gynecology, Acute Care, Mental Health & Counseling, and Blood Draw. While you have access to services at Yale Health, you do not have insurance coverage through Yale Health.
• Not Waiving Coverage: remaining enrolled in Yale Health Hospitalization & Specialty Care Coverage with Prescription Coverage and having fees for this insurance coverage billed to your student account. Students enrolled in Yale Health Hospitalization & Specialty Care Coverage receive a comprehensive insurance plan that includes all the services in Basic Student Health Services, prescription coverage, specialist services, urgent care, and emergency care managed at the Yale Health Center.

What happens to my access to Yale Health if I take a leave of absence?*

If the Registrar is notified of your LOA on or before the first day of classes:

• Your Yale Health Hospitalization & Specialty Coverage will end retroactively to the start of the insurance term (Fall or Spring) in which you have taken a LOA, as if you were never covered by Yale Health Hospitalization & Specialty Coverage or Basic Student Health Services.
• You’ll get a full refund for the Yale Health Hospitalization & Specialty Coverage fee if you did not waive coverage; if you waived coverage, you would not get a refund.
• You may be eligible for Student Affiliate Coverage and have 30 days to enroll (see below – How to Enroll in Student Affiliate Coverage).
• If you waived coverage and do not enroll in Student Affiliate Coverage, you will not be eligible for any Yale Health services and coverage moving forward. If you’ve already used health services, those services will be billed directly to you by Yale Health.
• Example: Sam did not waive coverage, and is approved for a leave on the first day of classes (classes began on August 28th):
  • Sam’s Yale Health Hospitalization/Specialty Coverage ends retroactively to the start of the fall insurance term, August 1st.
  • Sam receives a full refund for the Yale Health Hospitalization & Specialty Care Coverage fee.
  • Sam is eligible for Student Affiliate Coverage and has until September 27th (30 days) to enroll.
  • If Sam had received care at Yale Health after August 1st, he would receive a bill from Yale Health for those services, unless they enrolled in Student Affiliate Coverage.
• Example: Macy waived coverage and is approved for a LOA on August 20th (classes began on August 28th):
  • Macy’s access to Basic Student Health Services ends retroactively to the start of the Fall insurance term, August 1st.
  • Macy has until September 19th to enroll in Student Affiliate Coverage.
  • If Macy had received care at Yale Health after August 1st, she would receive a bill from Yale Health for those services, unless they enrolled in Student Affiliate Coverage.

If the Registrar is notified of your LOA after the first day of classes:

• Your Yale Health Hospitalization/Specialty Coverage ends on the day the Registrar is notified of your Leave of Absence.
• If you waived coverage, then your access to Yale Health Basic Health Services ends on this date, and if you’ve already used health services, those services will not be billed directly to you by Yale Health.
• If you did not waive coverage, then your insurance, Yale Health Hospitalization & Specialty Care with Prescription Coverage, ends on this date. If you’ve already used health services, those services will not be billed directly to you by Yale Health. However, any fees for Yale Health Hospitalization & Specialty Coverage won’t be refunded nor prorated.
• You may be eligible for Student Affiliate Coverage and have 30 days to enroll (see below – How to Enroll in Student Affiliate Coverage).
• Example: Taylor did not waive coverage and is granted a LOA after the first day of classes and the Registrar is notified on September 23rd (classes began on August 28th):
  • Taylor’s Yale Health Hospitalization & Specialty Coverage ends on the date the Registrar is notified of the LOA on September 23.
  • Taylor is eligible for Student Affiliate Coverage and has until October 23rd (30 days) to enroll.
  • Taylor does not get a refund for the Yale Health Hospitalization & Specialty Care Coverage fee. If Taylor, enrolls in Student Affiliate Coverage, the fee they already paid will be applied to the cost of Student Affiliate Coverage.

*Please note: The dates provided are for example purposes only and should not be considered definitive.

How to Enroll in Student Affiliate Coverage:

• Enrollment in Student Affiliate Coverage isn’t automatic—you’ll need to complete and submit an enrollment form.
  • Forms are available at the Member Services Department or on the Forms & Guidelines page.
  • Fees you’ve already paid for Yale Hospitalization & Specialty Coverage will be applied to the cost of Student Affiliate Coverage; the full fee will still be charged to your student account; however, you’ll only be charged the difference in the fee.
  • Regardless of what point in the semester you enroll, fees will not be prorated or refunded.

Key Benefits of Student Affiliate Coverage:

• Student Affiliate Coverage allows you to maintain access to the Yale Health services you are currently accessing while you are on a leave of absence from the University.
• The coverage provided through Student Affiliate Coverage is identical to the Yale Health Hospitalization & Specialty Care Coverage. All the same plan rules apply, including out-of-area coverage.*
• Funding for Student Affiliate Coverage may be available through your specific school. Reach out to your Financial Aid office for more information.

*If you are a Yale College student going on a Medical Leave of Absence, you are eligible for the Undergraduate Affiliate Coverage, which provides an additional layer of coverage through Aetna that provides you with access to primary and specialty care outside of the Yale Health services area. This coverage only extends to the continental United States (Alaska & Hawaii are not included).

What If I Need Help?

If you’re unsure about your options or how these policies apply to your situation, contact Member Services or your Student Health Care Navigator. They’re here to help you navigate your coverage and ensure your health care needs are addressed.