Plan Info and Requirements

The chart below shows how the plan pays your benefits for the major types of health care expenses. You can see the difference in your cost when you use preferred providers. A list of all preferred providers can be obtained using the Doc-Find tool. Click on the Doc-Find link to obtain more information on how to use it. The complete health plan brochure can be viewed by logging on to Aetna Student Health. Our health plan has a lot of different benefits available to those who are enrolled, such as travel assistance, health programs, and the Care Hub. Our school ID is IIT.

You may review our Summary of Benefits or Master Policy below.

Master Policy (1.67 MB)

Type of Service or Supply Benefit Level

Policy Year Maximum


Plan Deductible

Preferred Care: $300

Non-Preferred Care: $400

Annual Out-of-Pocket Limit

Preferred Care: $6,850

Non-Preferred Care: $ Not applicable


Preferred Care

Non-Preferred Care

Physician Office Visit Expenses

Plan pays 80%

Plan pays 60%

Inpatient Hospitalization Expenses

Plan pays 80%

Plan pays 60%

Emergency Room Expenses

Plan pays 80%

Plan pays 80%

Prescription Drug Expenses *

Plan pays 100%

Not covered

Rx Co-pays

$12/40/55/110 (please see brochure and below for details on co-pays)

Rx Annual Maximum


*There is a $12/40/55/150 co-pay for prescription drugs, a $12 co-pay for generic, a $40 co-pay for brand-name formulary, a $55 co-pay for brand name non-formulary, or a $150 co-pay for specialty drugs.

There is no coverage for prescription drugs filled at a non-preferred pharmacy.






*Fall Only







*Monthly rates are based on qualifying life events only. Contact the SHWC for more information.

Coverage Period


August 10, 2023 through August 9, 2024


January 6, 2024 through August 9, 2024


May 20, 2024 through August 9, 2024

*Fall Only August 10, 2023 through January 5, 2024

Enrollment and Waiver Deadlines


September 1


January 12