Information on Student Health Insurance program
How do students buy the insurance?
Students registered for 9 or more credits will be billed for the insurance with their tuition bill for the fall semester.
Students who are not registered for 9 or more credits in the fall semester but do register for 9 or more credits in the spring semester will be billed with their tuition bill for the spring semester.
Students registered for less than 9 credits can purchase the insurance, but must purchase it directly from the insurance company, using a form included in the brochure (available at Student Accounts or Health Services); please note that the deadline for purchasing in the fall of 2006 is October 10th, and for the spring of 2007 is February 10th.
How do students use the insurance?
If ill or injured, visit a doctor or a clinic. If the problem is serious, go to a hospital emergency room.
Bring your insurance brochure with you, or at least your ID card.
The provider will call the number on the student’s insurance ID card to verify that the student is insured.
If the provider is in the network, the provider will send the bill for
If the provider is out of network, the provider will bill the student, who can send the bill to the insurance company claims department.
To determine if the student’s health care provider is in the preferred provider network OR to see a list of preferred providers in the student’s geographic area, go to either universityhealthplans.com (and look at health care value management’s list) or consolidatedhealthplan.com (and look at consolidated health plan’s list).
How much of the medical bills do students have to pay?
Co-pays of $10 for a visit to a doctor’s office, $25 to go to a clinic, or $50 to go to a hospital emergency room.
In addition to the co-pay, if students go to a doctor, an outpatient clinic, or a hospital emergency room not in the preferred provider network, they will be billed for at least 20% of the cost of covered services. If they go to a preferred provider they will not be billed the additional 20%.
What is covered?
The minimum benefits required are set by the state.
The insurance plan is focused on treatment when a student has an injury, illness etc., not on wellness or preventative treatment, which would raise the cost of the insurance.
The brochure describes what is covered.
Please note that the only wellness/preventative service covered is the annual Pap smear, and this is because it is mandated by the state.
Are prescription drugs covered?
Prescription drugs are not covered by the insurance, unless the student is admitted to a hospital as an inpatient and needs medications in the hospital.
Students can obtain a prescription card at no cost. This entitles them to a discount at Brooks Pharmacies (note: this is not an insurance benefit) The discount may be as high as 10-15%, but varies.
Adding prescription coverage could increase premiums by $300 per year
What about students who are enrolled but aren’t “verified” as being insured?
To avoid having an outstanding balance, community colleges send the list of confirmed students and their premiums to the insurance company at the same time.
Many of the students who enroll pay for the plan with financial aid. With the time to process financial aid packages, the insurance company may not receive payment until several months into the semester, and the student will not be on their list until so.
Providers generally will call the insurance company to verify that the student is listed as being insured. Some providers may be unwilling to provide treatment to unlisted students. However, students are insured from September 1st in the fall semester, or from January 1st in the spring semester, although they may not be verified by the insurance companies. Bills for medical treatment occurring on or after the start date may be submitted (or resubmitted) to the claims service after the student becomes listed with the insurance company.
What about students who waive the student health insurance?
Students who already have insurance policies with comparable coverage can waive the insurance at the time that they are billed for it; they need to provide the name and policy number and sign the form.
Note: starting in 2007 there will be an increased effort from the state to verify that students who waive the health insurance do, in fact, have comparable coverage. (Bill Devine from University Health Plans is hoping to accomplish this by using the database of waivers submitted.)
Note: a student who waives the insurance in the fall semester will not be eligible to purchase the student insurance until the following fall semester.
Who should I call with questions?
For basic information or routine coverage questions, please email or call Mitch at ext. 2180
For the more complicated coverage questions or billing issues, please call Consolidated Health Plans at 800-633-7867.
Problem still not solved? Then please call University Health Plans at 800-437-6448.
Please note: students can look up their claims history online at consolidatedhealthplan.com
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