Yale Athletics Training Insurance Information
The Yale athletics department does not have special medical insurance coverage for student-athletes participating in intercollegiate athletics. All Yale degree candidate students receive primary care services at the Yale Health Services. All students are also required to have hospitalization coverage, either through their private insurance, or through Yale Health Plan. Students are given the option of purchasing YHP hospitalization and specialty services coverage. Yale Health Plan has sent you more complete information regarding YHP services.
This document outlines the Yale University policy on medical
insurance. We understand that this is a very important issue for
our student-athletes and their families. Please do not hesitate to
contact our head athletic trainer if you have any questions or
Part One - Medical Insurance
I. The Yale Athletics Department DOES NOT provide medical insurance coverage for athletic injuries.
- All medical expenses incurred (including deductibles, co-payments and other charges) for treatment of athletic related injuries are the responsibility of the student-athlete. This includes all expenses related to x-rays, MRIs, bone scans, lab tests, hospitalization, physical therapy, surgery, emergency room services, emergency transport service and professional fees associated with those services.
- This applies even if the injury was sustained in formal practice or competition while representing Yale.
II. Yale Health Plan Coverage and Options
- The Yale Health Plan (YHP) provides primary care services to all degree candidate Yale students at no additional charge. Primary care services and departments include: athletic medicine, student medicine, internal medicine, mental hygiene, urgent care, inpatient care facility, gynecological and on-site laboratory tests.
- All degree candidates have the option of purchasing additional coverage which includes hospitalization
and specialty services (YHP Care Plan) or maintaining private insurance. Specialty services include allergy, audiology, dermatology, ear, nose and throat, general surgery, off-site lab testing, neurology, obstetrics, ophthalmology, orthopedics, physical therapy, radiology and urology. These services are fully covered by the YHP Care Plan if purchased for the selected fiscal year.
- Example: Eli Yale, student-athlete, sprains an ankle during practice. Eli will be referred by the athletic
trainer to the team physician at the YHP. Eli needs x-rays, and also needs to see an orthopedist.
Scenario 1: Eli has private insurance. There is no charge for
the visit to the team physician (YHP
primary care service). Eli's insurance will be billed for the x-rays and for the visit with the orthopedist
(radiology and orthopedics are YHP specialty services). All deductibles and co-payments are Eli's
Scenario 2: Eli has YHP Care Plan. There is no charge for the
visit to the team physician (YHP
primary care service). YHP Care Plan will cover the radiology and orthopedic visits with no additional
III. Personal Insurance Coverage for Specialty Services
- If you choose to waive the YHP hospitalization/specialty care coverage, you will be responsible for all expenses including deductibles, co-payments, out-of-network charges, etc.
- If you are a member of an HMO or PPO, your insurance may not provide coverage out of their prescribed service area. Determine if you have higher co-payments for services rendered outside of the service area.
- Investigate whether you need a referral form from your primary care physician at home in order to see a specialist (e.g., orthopedist, cardiologist, etc.) This may be required by your insurance company.
- Investigate the policies and procedures maintained by your insurance for expensive services such as MRIs, bone scans, dental injuries, knee braces, etc. These are common sports medicine services.
We are confident that the Yale sports medicine team will provide excellent care for your son/daughter. We do recommend that our student-athletes purchase the YHP Care Plan (hospitalization/specialty care coverage) in order for our sports medicine team to provide the most expedient care to your son/daughter. We understand that this is a family decision and courage you to carefully review your personal medical insurance policy prior to making this important decision regarding medical insurance.
Part Two - Dental Insurance and Outside Services
I. Dental Coverage
- All dental injuries must be reported immediately to the athletic training staff. In addition, student- athletes who participate in football, lacrosse, ice hockey and field hockey are required to wear mouthguards in order to be eligible for dental benefits.
- If an injury to sound natural teeth is sustained or a post-operative appliance is required as a result of an injury sustained in direct participation in Yale athletics, the Yale athletics department will cover charges not covered by the YHP or other insurance company to the maximum of $600 per fiscal year. In other words, Yale athletics will pay $100 deductible + 20% of $2,500 (or $500) during July 1 through June 30.
The athletics department is not responsible for deductibles in excess of $100; any co-insurance other than 20% of $2,500 and any expense over $600 per fiscal year.
These limits apply to all major programs including private insurance and YHP Prescription/Supplemental Benefit Plan. The deductible and co-payment for these services and appliances will not be covered unless you have private dental insurance or the YHP Prescription/Supplemental Benefit Plan.
II. Other Services
- The athletics department will not reimburse or cover any expenses related to physical therapy rendered outside the YHP, chiropractic care, acupuncture, or other alternative treatments, lost corrective lenses or medications to treat injuries, illnesses or other medical conditions.
Part Three - Acknowledgment Form and Emergency Information Card
- We require that all student-athletes and their parent/guardian return the completed acknowledgment form regarding Yale University medical insurance policies prior to participation.
- We also maintain insurance and emergency information in our training room for all student-athletes. This card also must be on file prior to athletic participation.