Understanding & Using Your Insurance
We understand that health insurance can be very confusing, especially if this is the first time you are on your own plan. There are a number of short videos that may be helpful in understanding the basics of health insurance, including key terminology, how to use your plan, and understanding the difference between healthcare in the United States and other countries. These videos are all available here.
We have a full team available to help provide support and guidance, as well. For the most expedited support related to your situation, please contact the following:
- For assistance with the Gallagher student insurance portal, benefits questions, or claims assistance – connect by using the Contact Us form on the Help Center website or by calling 866-931-5275
For all other inquiries, connect with the Student Health Insurance Support Team at shs-insurance@duke.edu or call us at 919-684-1000.
Your Health Insurance Card
Your health insurance card, which is sometimes referred to as your Member ID card, is your proof of insurance. You will need this when you go to see a medical provider or go to the pharmacy.
The Duke Student Medical Insurance plan is an Aetna plan. Aetna provides digital insurance cards. Once you are enrolled in the Aetna plan, you will receive a notification that your card is available for you to access and download. You will not receive a physical card.
You can access this card in a number of ways:
- For students enrolled in the Duke Student Medical Insurance Plan or Dental Insurance Plan, navigate to the Gallagher Student Insurance Portal and select “Get an ID Card” in either the SMIP or Dental section of the webpage.
- You can also register on the Aetna member website, download the Aetna Health app from App Store or Google Play, or text “STUDENT” to 90156 for a link to download the app and register. When accessing the website/app, you will be able to access the provider directory, look at claim payment details, and retrieve an image of your ID card.
You should keep a copy of your insurance card with you. We recommend keeping a copy on your phone. You can do this in a number of ways:
- Download the Aetna Health app so you can pull up your card from the app whenever you need it.
- After downloading the app, you can also add the card to your mobile wallet. Instructions here.
- For students who have a physical card, take a photo of the front and back of your card. This is a great solution for students who may be a dependent on someone else’s plan and do not have access to the app or a physical card for themselves.
The Duke SMIP is an Aetna Whole Health Plan, which leverages more than 10,000 local in-network healthcare providers in the Duke Health, WakeMed & THN-Cone Health network, including our world class Duke University Health System facilities and providers. Supplemented by Aetna’s robust nationwide Preferred Provider Organization (PPO), this plan offers a wide range of flexibility for students to seek services and choose their healthcare provider while helping to reduce out-of-pocket costs for our students. With this structure, you continue to have a wide range of medical providers you can choose to see for your care and who can support your health and well-being needs while at Duke.
As a member of an Aetna Whole Health – Duke Health, WakeMed & THN-Cone Health plan, it’s easy for you to connect with doctors and other health care providers within a network dedicated to you.
Providers within the Aetna Whole Health – Duke Health, WakeMed & THN-Cone Health network collaborate closely with Aetna to improve coordination of member care, with the mutual aim of better care, better health and better cost savings for you.
When you use Aetna Whole Health – Duke Health, WakeMed & THN-Cone Health providers, you’ll benefit from seeing doctors and other care providers within a network that’s dedicated to:
- A team-based model of care, including treatment from primary care doctors, nurses, care managers, assistants and other providers for a well-rounded care plan
- Keeping you healthy and improving your health, not just treating you when you’re sick or injured
- Encouraging you to play an active and informed role in your health and wellness decisions
- Creating programs to measurably improve your care
- Providing you with easier access to doctors and follow-up careOutside of the Aetna Whole Health – Duke Health, WakeMed & THN-Cone Health network coverage area, you will have access to the Aetna Open Access® Managed Choice® broad network of In-network Providers.
When seeking care, we encourage you to check your provider’s network status to confirm if they are in the Duke Health, WakeMed & THN-Cone Health network, the Aetna nation-wide PPO, or out of network. Providers who are enrolled in the Duke Health / Wake Med network as well as those in the Aetna PPO are considered “in-network” and are preferred providers, offering better coverage of your healthcare expenses than you will get with “out-of-network” providers
We encourage you to use in-network providers to maximize the insurance coverage for your healthcare expenses. If you are enrolled in the Duke Student Medical or Dental Insurance Plan, you can locate an in-network provider by visiting the Gallagher Student Health Insurance Portal and clicking “Find a Doctor” in the medical or dental section of the page.
If you would like to determine whether your current medical provider is enrolled with the Aetna Whole Health network, you can also follow these steps:
- Visit the Aetna Provider Search website.
- Continue as a Guest and enter the zip code where you are seeking care.
- Select the (NC) Aetna Whole Health℠ - Duke Health, WakeMed & THN-Cone Health plan option and click Continue.
- Then search by provider name or specialty or you can browse the list of enrolled providers.
If you are enrolled in other private health insurance, visit your health insurance carrier’s website. You may also find information on locating a provider on the back of your health insurance card.
We want to be sure you are aware of how to use your student insurance benefits. You will want to familiarize yourself with key insurance terminology, including deductibles, copays, and coinsurance. We recommend you review this brief video to better understand these terms and using your benefits.
When you need to seek medical care, you will want to provide them with your insurance information. This quick video will walk you through the process of how to use your insurance when you see a medical provider.