Frequently Asked Questions: Insurance

 


GENERAL HEALTH INSURANCE CONCERNS


 

What should I bring to the University Health Center (UHC) for my visit?

  • Insurance card (We see all students with or without insurance) 

  • Photo ID

  • Payment: Co-payment/visit fee(s) will be collected at the time of visit

What methods of payment are accepted at the UHC?

The UHC accepts cash, credit cards and Terrapin Express. You can also have charges placed on your Bursar Account.

How much will my visit cost?

A typical UHC visit without any procedures, lab, or x-ray services will range from $50 -$125 with exceptions for those who are eligible for hardship, or do not wish to use their insurance.

Please visit the following pages for current pricing:

 

How much does STD/STI (sexually transmitted disease or infection) testing cost?

The laboratory cost for a common STD test panel is $49. All other STD/STI test costs are dependent on the test performed and whether a provider visit is required. Charges are subject to change without notice. Click here for more information regarding testing fees.  

Free HIV/STI testing is provided on certain dates


What information may be sent home concerning my UHC visit?

If your appointment is billed to your insurance, an explanation of benefits (EOB) is typically sent to the policy holder by the insurance company. The EOB will contain the date of visit and list the services provided. Sometimes services are noted with a code, a general description of the appointment, or both. You can call your insurance provider and ask them specifically how the appointment information will be noted on the EOB.

If you prefer NOT to use your insurance for this reason, or any other reason, during a scheduled appointment, charges may be paid with cash, credit card, or Terrapin Express. SOME charges can be placed on your Bursar account. The same information applies to prescription purchases billing insurance.

If you prefer NOT to use your insurance for an appointment or purchase, please notify registration at check-in. When you come in for future appointments, you will be asked if you would like to continue to self-pay or bill to insurance.

Can I pay for my visit even if I have insurance?

If you prefer not to use your insurance for any service, we will honor your request at the time of your visit. Charges can be placed on your Bursar account or paid by cash, credit card, or Terrapin Express.

Why should students have health insurance?

Health care expenses such as those associated with unexpected illness, accidents, or mental health care can destabilize a student’s financial situation and derail his/her progress toward a degree. These potential barriers to attendance and degree completion are reduced when students have health insurance. Conversely, students without health insurance who do not have access to needed specialty care or hospitalization may attempt to continue their academic pursuits but fail to reach their full potential due to their untreated illness. The Affordable Care Act requires most people to have health insurance.

What if I do not have insurance?

We see all students, with or without insurance. The UHC accepts cash, credit cards and Terrapin Express. You can also have charges placed on your Bursar Account.

If you bill my insurance, will I have to pay anything for care I receive at UHC?

You are responsible for all visit co-pays, deductibles, co-insurance and non-covered services. Charges can be placed on your Bursar account or paid by cash, credit card, or Terrapin Express.

I am covered by private health insurance.  Will the University Health Center (UHC) accept my insurance?

The UHC is able to bill many private insurance plans for office visits and covered medical services provided in our facility. We cannot bill Medicare, Kaiser Permanente, and TRICARE Prime, United Optimum Choice or United MDIPA. You should contact your plan (customer service) in advance and ask if they will cover your care at the UHC while you are away at school. You are responsible for any non-covered charges.

Are UHC providers considered “preferred providers” with any insurance plans?

The UHC providers are contracted with the PPO and EPO insurance products of:

  • Aetna 

  • United Healthcare

  • Carefirst/Blue Cross-Blue Shield and

  • Cigna

We can also file State of Maryland Medicaid plans for our registered students only.

If the UHC is not a participating or “preferred provider” (i.e. in-network) with my plan, can I still use my insurance?

Yes, we can file for you, however, we cannot bill government insurance programs, such as Medicare and TRICARE Prime. Again, call the Customer Service phone number listed on your insurance card to see if your service will be covered.

I belong to an HMO. Can I use the Health Center?

Any student can use the University Health Center (UHC). If you belong to an HMO, you should contact your plan’s Customer Service number in advance and ask if they will cover your care at the UHC while you are away at school. If your HMO does not cover costs, you may still be seen and charges will be billed to your bursar account. If your HMO is United Optimum Choice, United MDIPA or Blue Cross/Blue Shield-BLUE CHOICE, you should call the member service number on your insurance ID card and name the University Health Center or one of UHC’s providers as your Primary Care Provider (PCP).

What if my insurance information changes?

It is your responsibility to let us know immediately if your insurance coverage changes. If you do not notify us of any changes, you will be responsible for all charges. Charges will be sent to your Bursar account.

What happens if I need to see a specialist?

If you are referred for treatment or services outside of the UHC, we will identify specialists or facilities within your insurance network whenever possible. You should contact the customer service number on your insurance ID card to ask if pre-authorization or pre-certification is required. The outside provider’s office staff may know the answer. If your insurance is Blue Choice and you have named one of the UHC providers as your PCP, your UHC provider will give you a referral if it is required. Blue Choice Open Access does not require a paper referral. Your insurance plan may cover all, part, or none of the costs associated with outside services. You will be responsible for all costs incurred.

Will you bill my health insurance for Physical Therapy visits?

The UHC will not bill health insurance companies for physical therapy services, except students enrolled in the SHIP policy. Patients can request a Statement for services provided to submit to their insurance company for reimbursement. The UHC can provide a list of local physical therapy facilities.

Can I use my prescription plan at the UHC?

Yes. The UHC Pharmacy participates with many prescription insurance plans. The Pharmacy staff can advise you if your plan is accepted. Methods of payment accepted include cash, check, Terrapin Express, student account, American Express, Visa, Discover, and Mastercard.

International Students

The Health Center can only bill U.S. health insurance companies. International students can request a Statement for services provided to submit to their home country coverage plan for reimbursement.

  • The US health care system is not easy to understand

  • The US does not have a national health care plan

  • People are responsible for the cost of their own care

  • Health care can be very expensive in the US

  • You may not be able to get all the health care services you need without health insurance

  • Health insurance helps to pay for part or all of your medical costs

 

 

 

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STUDENT HEALTH INSURANCE PLAN (SHIP) 


What is the Student Health Insurance Plan (SHIP)?

SHIP is an insurance policy specially designed to cover University of Maryland, College Park students at a reasonable cost. Students can also enroll their spouse and/or dependents (under age 26) for an additional charge. Visit www.firststudent.com for cost and coverage details. All clinical services at the UHC are covered by SHIP at no additional charge. SHIP is a United HealthCare plan that can be used nationally with any hospital or provider who accepts United HealthCare.

Who is eligible to purchase the Student Health Insurance Plan?

To be eligible, students must be registered for at least 6 undergraduate credits or 1 graduate credit at the time of enrollment in the Plan.

Do I have to enroll in the University’s Student Health Insurance Plan (SHIP) in order to use the University Health Center?

No, all registered UM College Park students can be seen at the University Health Center, regardless of the type of insurance they have.

I am already covered by health insurance. What do I need to do to avoid being billed for Student Health Insurance Plan (SHIP)?

Students who are covered by health insurance (i.e. through parent plans, family plans, or employer-sponsored plans) may apply for a waiver of the requirement to enroll in SHIP at the beginning of each academic year by submitting the name of their insurance company and insurance policy number for verification on-line during the waiver period. Waivers can only be completed online at firststudent.com.

  • Students must either waive or enroll in the University sponsored student health insurance plan.

  • Students are required to complete a waiver each academic year.

  • Students who do not show proof of health insurance will be automatically enrolled and the premium will be billed to their student account.

  • Policy number for verification on-line during the waiver period. Waivers can only be completed online at www.firststudent.com

What is covered by the University’s Student Health Insurance Plan?

The policy provides benefits for the “Usual and Customary Charges” for loss due to a covered injury or sickness. Most services at the University Health Center are covered by SHIP except the 3rd and subsequent sessions of massage therapy and some uncommon laboratory tests. Examples of Health Center services which are covered include: acupuncture, flu shots, and immunizations. Pharmacy benefits at the UHC are defined by the policy. Prescriptions are subject to co-pays at the UHC. Any services billed by the UHC are not subject to the policy deductible.

Is there a vision or dental plan?

There is pediatric vision and dental coverage for students up to age 19. All other SHIP insured students have access to a discount dental and vision plan. There is an on-line procedure to access the discount dental and vision plans as well as many other discount programs at www.firststudent.com. The link also includes a brochure that can be downloaded and printed.

Does the Student Health Insurance Plan provide coverage if I travel abroad?

SHIP has Emergency Global Travel Assistance meaning that each insured person has access to emergency medical assistance services when traveling 100 miles or more from campus, his/her permanent home or around the world. Services are available 24 hours a day, 365 days a year, and meet or exceed the United States J-1 visa requirements for international students. For more information on the Global Emergency Services program, contact Customer Service at (800) 505-4160.


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MANDATORY HEALTH INSURANCE


The University of Maryland requires comprehensive health insurance coverage for all undergraduate student registered for 6 or more credits. These students are required to show proof of health insurance coverage by completing an online waiver card. Waivers can only be completed online at www.firststudent.com.

The waiver site is now open for the 2015-2016 academic year. Instructions on completing the on-line waiver will be sent to your e-mail or can be found here.


 

Why is the University of Maryland requiring health insurance?

Unexpected health care expenses such as those associated with unexpected illness, accidents, or mental health care can destabilize a student’s financial situation and derail his/her progress toward a degree. These potential barriers to attendance and degree completion are reduced when students have health insurance. Conversely, students without health insurance who do not have access to needed specialty care or hospitalization may attempt to continue their academic pursuits but fail to reach their full potential due to their untreated illness.

I am already covered by health insurance. What do I need to do to avoid being billed for Student Health Insurance Plan (SHIP)?

Students who are covered by health insurance (i.e. through parent plans, family plans, or employer-sponsored plans) may apply for a waiver of the requirement to enroll in SHIP at the beginning of each academic year by submitting the name of their insurance company and insurance p

  • Students must either waive or enroll in the University sponsored student health insurance plan.
  • Students are required to complete a waiver each academic year.
  • Students who do not show proof of health insurance will be automatically enrolled and the premium will be billed to their student account.
  • Policy number for verification on-line during the waiver period. Waivers can only be completed online at www.firststudent.com.

If I waived  the insurance plan last year, then I am good for the next four years at UM, right?

No! Every UM undergraduate student enrolled in or after Fall 2009 and taking at least 6 credits must complete the waiver process each fall semester.

How do I determine if my health plan is adequate?

Families are responsible for determining if the student has adequate health insurance using the following guidelines:

  • Student has coverage for physician and hospital care in this geographic area
  • Student has mental health coverage
  • Student has prescription drug coverage
  • Annual deductible should not exceed $500
  • Plan covers care 365 days per year
  • Plan has a benefit of at least $100,000 annual coverage per accident or illness per year For females, plan covers pregnancy
  • Plan covers mandatory requirements for J-1 Visa holders
  • Policy provisions are available in English or be from a U.S. owned company that is headquartered and operating in the U.S.
  • Policy does not unreasonably exclude perils inherit into the students program of study
  • Policy covers a minimum 80% coverage of professional and hospitalization fees
  • Plan will continue coverage if student is enrolled less than full-time
  • Coverage is in effect until June 1, 2017

 

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Insurance Terms Glossary

Insurance is complicated. Various terms are used depending on the type of insurance plan. Below are some of the most frequently used terms. This list is not exhaustive and only intended to provide basic, general level knowledge. You are advised to call your health insurance provider for a detailed explanation of the terms in your policy.

 

Authorization: When the health insurance company approves and agrees to pay for the medical services rendered.

Copayment: A pre-payment determined by your insurance company, payable by the individual at the time of a medical visit.

Deductible: A fixed amount of money you have to pay before most, if not all, of the policy's benefits can be enjoyed.

HMO (Health Maintenance Organization): A group of doctors and other medical professionals offer care for a flat monthly rate with no deductibles. ONLY visits to professionals within the HMO network are covered by this policy. All visits, prescriptions, and other care must be cleared by the HMO in order to be covered.

POS (Point-of-Service): A point-of-service (POS) plan is a combination of a health maintenance organization (HMO) and a preferred provider organization (PPO). Typically, POS plans have a network that functions like a HMO – you pick a primary care doctor, who manages and coordinates your care within the network. POS plans also allow you to use a provider who is not in the network. However, if you choose to go out-of-network for your care, you will pay more.

PPO (Preferred Provider Organization): A medical insurance plan in which members receive more coverage if they choose health care providers approved by or affiliated with the plan.

TRICARE: A regionally managed health care program for active-duty and retired members of the uniformed services, their families and survivors.

 

 


 

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