Why do I need health insurance? The Medical University of South Carolina requires all students to have health insurance coverage. This requirement is for the protection of the student. While Student Health Services provides economical primary care for students, it cannot meet all potential health care needs. During the time they are enrolled, students are exposed almost daily to TB, HIV, and a host of other infectious diseases. In addition, many students find themselves needing treatment for an illness or injury that requires specialty care, surgery, and/or hospitalization. To reduce health risk, avoid devastating medical charges, and ensure reliable access to health care services, all faculty, staff, and university students are required to have health insurance coverage.
How much does the Student Health Plan cost?
2009 - 2010 The Student Health Plan premiums for the 2009-2010 academic year are $434 for fall semester which covers August 20, 2009 - January 1, 2010 and $635 for spring semester (spring premium includes coverage for summer) which covers from January 2, 2010 - August 19, 2010.
2010-2011 The Student Health Plan premiums for the 2010-2011 academic year are $498 for fall semester which covers August 20, 2010 - January 1, 2011 and $729 for spring semester (spring premium includes coverage for summer) which covers from January 2, 2010 - August 19, 2011.
Are pre-existing conditions covered under the Student Health Insurance Plan? Pre-existing conditions are not covered during the first 12 months following a Covered Person's effective date of coverage under the Policy. This limitation will not apply if
(a) the Covered Person has been covered under the Policyholder's prior Policy for 12 consecutive months immediately preceding the effective date of coverage under the current Policy; or
(b) the Covered Person transferred from an institution of higher learning where he or she was previously covered under a sponsored University plan for 12 consecutive months and
(1) he or she did not have a break in coverage of more than 31 days between the previous sponsored plan and enrolling in this Policy; and
(2) the condition was covered under the previous plan and eligible for benefits under this Policy. Prior coverage under the previous sponsored plan of less than 12 months will be credited toward satisfying the Pre-existing Condition limitation; or
(c) the individual seeking coverage under the Policy has an aggregate of 18 months of Creditable Coverage and becomes eligible and applies for coverage under this Policy within 63 days of termination of prior Creditable Coverage; and the individual's most recent prior Creditable Coverage was under an employer group plan; and the individual accepted and used up COBRA continuation of coverage or similar state coverage if it was offered to him or her; and the individual is not eligible for coverage under any other group health plan, Medicare or Medicaid; and the individual does not have other health insurance.
Prior individual health plans are not considered creditable coverage in South Carolina.
Will the Student Health Insurance Plan cover me if I need urgent medical care during the hours that Student Health is closed? Yes. Be aware that it is less expensive to visit an Urgent Care Facility instead of an Emergency Room. A visit to an ER involves a $100 co-pay in addition to meeting your deductible. There is no co-pay if you visit an Urgent Care Facility.
Will the Student Health Insurance Plan cover me if I go to any doctor? Students covered by the Student Health Insurance Plan must use Student Health Service (SHS) as their primary care facility. To use the insurance outside of Student Health Service one of the following circumstances must apply:
1) A referral by a SHS provider after being initially evaluated at SHS;
2) Medical emergency; or,
3) Student is more than 30 miles from Student Health Services and requires immediate medical attention. This does not apply to routine care.
Deductibles and co-pays apply for any visits outside of Student Health Service.
If a full time student requires emergency medical treatment and has paid all of his/her fees, there is a $500 EXCESS benefit (called A&I coverage) that can be accessed to help cover the costs of the emergency visit only. Please contact the Student Health Services the next business day for information on accessing this benefit. The insurance company determines if the visit is a covered benefit.
If you have an emergency visit and it is determined that you may need follow up care you must schedule an appointment with Student Health Services to determine if that care can be provided at Student Health Services or to determine you need to follow up with a Specialist.
Am I still covered by the Student Health Insurance Plan if I am not enrolled for any classes during the summer? When a student enrolls in the Student Health Insurance Plan for the spring semester and pays the health insurance premium, this premium includes coverage for the summer. If a student is not enrolled in any summer classes the student health insurance coverage remains in effect through the summer without any changes in benefits.
Why is the Spring premium higher than the Fall premium? The fall premium covers the fall semester only, Aug 20th – Jan 1th , a coverage period of 5 months. The spring premium includes the premium for summer so the student does not have any lapse in coverage and covers from Jan 2th – Aug 19th, a period of 7 months, to ensure the student has year round coverage.
Does the Student Health Insurance Plan cover dental? The student, covered spouse and/or dependent(s) are reimbursed 100% up to $100 for the following dental services:
1. Two Annual Comprehensive Oral Evaluation;
2. Two Annual Adult/Child Cleaning; and,
3. One Annual bitewing X-rays (up to 4)
The covered individual may go to any dentist, pay up front, and then mail the receipt to the Student Health Insurance Company. A reimbursement check will be mailed to the student (make sure your address in your Student Insurance Company account is correct). Reimbursement takes 4-6 weeks.
Other dental services are not covered.
What is the Wellness Benefit? The Wellness Benefit is a $300 benefit that the student may use for preventive or wellness services such as immunizations, vision exams, screening laboratory services, etc.
Do I need to complete any enrollment forms to be enrolled in the Student Health Plan? Yes, even though the premium fee is charged to your student account, you must go to the student insurance web site athttp://www.studentinsurance.com/and create an online account so that you can print a temporary insurance card and have access to view your EOBs (Explanation of Benefits) online. If the fee for the Student Insurance Plan is added to your tuition, choose “Mandatory” when creating your online account. Once you have created your account online, you can go to the student insurance web site and choose “My Account” to change your address, print a temporary insurance card, request a new insurance card if yours is lost, or check EOBs (Explanation of Benefits).
Home
