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Coverage for dependents

We provide full coverage for your children and other dependents as part of your employer-provided plan. Please check your Summary of Benefits to see what your coverage entails.

Peace of mind with the Students Away at School coverage

When the children on your plan are off to school (ages 17 to 25), they are covered through our Students Away at School coverage. This means that they are protected whether they are studying down the road or across the country. Please check your Summary of Benefits to see what your coverage entails. 

What does the Students Away at School coverage cover?

Dependents away at school have access to a wide range of care under this coverage:

We cover emergency care for dependents without the need for prior authorization. Make sure your child knows to call 911 or go to the nearest emergency room to get help for serious accidents or injuries.

If your student is admitted for an inpatient emergency condition, you or someone you designate must call the HAP Admissions department within 48 hours of the admission. You can reach our Admissions department at (313) 664-8833.

We cover urgent care for problems that aren’t severe enough to need a trip to the emergency room but can’t wait until a regularly scheduled doctor’s appointment. Some examples of urgent care situations include:

  • Burns or cuts
  • Illnesses such as the flu or bronchitis
  • Injuries from falls
  • Strains or sprains

We also cover X-rays and lab tests needed to treat these conditions.

Visit our Contact Us page or call us toll-free at (800) 422-4641 to locate an affiliated urgent care center near your child. If there isn’t an affiliated center nearby, your child should just go to the nearest urgent care facility or the school’s health care center.

We require prior authorization before follow-up treatment after an emergency room or urgent care visit. Our medical director also may need to review the request.

Visit our Contact Us page or call us toll-free at (800) 422-4641 to find out if your child’s follow-up care requires prior authorization.

If we authorize coverage for follow-up care, we’ll cover items such as:

  • Follow-up visits
  • Outpatient imaging and lab tests
  • Short-term physical therapy for rehabilitation
  • Durable medical equipment (if included in your specific health plan)

Your student is also covered for:

  • Routine allergy injections, flue shots and immunizations
  • Prescription medication as covered by your plan
  • Required maintenance visits for chronic conditions (for example, asthma or acne)
  • Office visit to get birth control or continue birth control (check your health plan for prescription drug coverage)

While your student is outside of HAP’s service area, authorization is needed for all services, except emergency or urgent care. To obtain authorization for treatment or services, please contact a HAP Students Away coordinator by calling (248) 557-6271 or by email us at StudentAway@hap.org.

What the Students Away at School coverage doesn’t cover

When your student is away at school, they are only covered for certain services. That’s why it’s important to take care of their other medical needs while they're at home. They must get the following routine services at a doctor or facility in HAP's service area or they won't be covered by your HAP health insurance:

  • Complete physical examinations – including gynecology exams.
  • All elective surgery or hospitalizations.
  • Eye examination (e.g., eyeglasses, contact lenses).
  • OB-GYN services for pregnancy.
  • Some doctor office visits (Doctor visits are covered, with authorization, for illness, follow-up, injuries, etc.).
  • Long-term physical or occupational therapy (short-term physical and occupational therapy may be covered with an approved authorization).
  • Treatment for complex or chronic medical conditions. This includes, but is not limited to, radiation therapy, chemotherapy, stem cell transplants, organ transplants and extensive evaluations for diagnosis purposes. A chronic condition has a long duration or recurs frequently.
  • Testing for tuberculosis.
  • Vaccines not universally recommended but required by your school or for travel.
  • Sports medicine services.
  • Nonemergency dermatology services.

Please note: We don’t cover dependents who live with a parent outside our service area under the Students Away at School Program. Visit our Contact Us page or call us toll-free at (800) 422-4641 (TTY: 711) to determine if your child is eligible for coverage.

Make the most of the Students Away at School coverage

Because we don’t cover routine doctor’s visits while your child is away at school, make sure to schedule these appointments during holidays, summer breaks or other times when your child is home.

Dependents over the age of 18 should carry their HAP ID card at all times. Our HAP App lets members view their HAP ID cards on their Apple or Android smartphones and send the cards to doctors' offices, hospitals and pharmacies via fax or email as needed.

Claims and reimbursements

Health care providers outside the HAP network may not accept your child’s HAP ID card. If this happens, you or your child may need to pay for services from these providers.

Make sure your child requests an itemized bill and receipt (i.e., credit card receipt, canceled check, bank statement, digital receipt) for these services. Itemized bills must include:

  • Patient name
  • Date of service
  • Details of services given, including procedure codes
  • Diagnosis code
  • Dollar amount charged
  • Provider’s name, address, tax ID number, NPI number and phone number

Please download a Direct Member and Enrollee Reimbursement Form and fill it out. Then, send us the itemized bill and receipt (i.e., credit care receipt, canceled check, bank statement, digital receipt), along with your child’s name, address and HAP ID number. We’ll reimburse you for the full covered amount, minus any copays you or your child are responsible for.

Send your claims to:

HAP Claims
Attn: Member Reimbursement
1414 E. Maple Rd.
Troy, MI 48083

Need additional information?

Talk to your employer for plan details, or contact us.