Insurance

Patient Financial Responsibilities (Participating Carriers-In Network) Patient is responsible for knowing what his/her insurance will and will not cover. The financial responsibility of a patient or the responsible party is determined by the health insurance coverage of the patient or responsible party. Once that has been determined, the remaining balance (co-payments, deductibles, and non-covered services will be billed to the responsible party).  

“Self-Pay” Accounts Patients are classified as Self Pay accounts in three situations: (1) patients who do not have any type of health insurance; (2) patients having health insurance coverage via a health insurance company that is non-participating with the Student Health Center; (3) patients having Out of Network accounts with certain plans that will not cover the services at the Student Health Center. Payment is expected when services are rendered.

Payment Agreement The patient or responsible party agrees to pay any portion of charges that are not paid by the patient or responsible party’s insurance company. Patient also acknowledges that they are responsible for the payment of all services rendered, if not paid by the insurance company.  

Out of Network Insurance Accounts Patient is responsible for knowing what his/her insurance will and will not cover. Patients having health insurance with a health insurance company with which the Valdosta State University Student Health Center does not participate, are classified as Out of Network (see website). The insurance company will be billed as a non-assigned claim. Payment may be made by the insurance company to the patient or responsible party. If the Out of Network insurance company does not cover all of the charges for the patient’s services, the patient will owe the remaining balance. 

Please bring your insurance card or a hard copy of your card (front and back) at each visit. We will not accept images of your insurance card on your phone.

There is a new option available to you through the online appointment scheduling system to upload a copy of your insurance card (front & back).

Unfortunately, we are unable to accept HMO plans at this time for any insurance company.

We cannot determine whether a specific insurance policy will cover charges incurred here at the health center. Patients will need to contact their insurance company and ask whether their plan will cover services at the health center and what services are included in that coverage.

Letter to students and parents regarding insurance

Listing of frequently asked questions regarding insurance. (updated on 8/10/12)

 

Listing of "In Network" Carriers Listing of "In Network" Carriers
BC/BS OF GEORGIA & BC/BS FEDERAL PLAN PGH Global
CIGNA UMR
FIRST CHOICE UNITED HEALTHCARE-Limited: Please check your insurance plan for details
COVENTRY OF GA UNITED HEALTHCARE (SHIP) Seeking care through an outside provider requires a referral & a copy of your Insurance Card. Effective August 2012
GREAT WEST HEALTH INSURANCE TRICARE STANDARD (as of 3/11/13)
HUMANA TRICARE PRIME (must have referral prior to appointment)
OPTUM HEALTH & OPTUM INSIGHT UNITED HEALTHCARE (Some plans)     
Listing of "Out of Network" Carriers Listing of "Out of Network" Carriers
AETNA GEHA
CBCA ADMINISTRATION

Reviewed by: Nicole Foster 12/13/16

**We are not in network with KAISER** - Students with Kaiser Insurance will be expected to pay the self-pay rate for all services provided.

Student Health Insurance Plan (SHIP)

University System of Georgia (USG) Mandatory groups for health insurance:

  1. All graduate students receiving a full tuition waiver as part of their graduate assistantship award.
  2. All graduate students receiving fellowships that fully fund their tuition.
  3. All undergraduate, graduate, and ESL international students in F or J visa status.
  4. All undergraduate and graduate students enrolled in programs that require proof of health insurance (Nursing and Exercise Physiology) Exercise Physiology students are only required to have health insurance for term the exercise physiology internship is performed.
  5. International Scholars  

The USG requires all students in the above categories to have reasonable, comparable, creditable coverage to the current system-wide student health insurance plan provided.  The following minimum benefits must be included in your plan to be considered for a waiver and final determination is made at each institution—per each individual institutions standards.

International Students in the F-1 and J-1 student or scholar statuses must have a minimum of the following benefits:

  • Both accident and sickness coverage
  • Minimum benefit $250,000 per policy year
  • A deductible of $500 or less and/or co-pay per individual, per year
  • In-patient and outpatient, mental and nervous disorder benefits
  • Prescription Drug Coverage
  • Pay benefits worldwide
  • Medical evacuation to one’s home country and family reunification of not less than $10,000*
  • Provision for repatriation of remains of not less than $7,500*
  • All Georgia mandated requirements+

*Federal Standards required for International Students

Domestic Students must have a minimum of the following benefits:

  • Both accident and sickness coverage
  • Minimum benefit $500,000 per policy year*
  • Coverage for all pre-existing conditions
  • Reasonable deductible ($3,000 or less) and/or co-pay per individual, per year
  • In-patient and outpatient, mental and nervous disorder benefits
  • Prescription Drug Coverage
  • Pay benefits worldwide
  • All Georgia mandated requirements+

*To meet 2014 Federal ACA requirements your health plan should have no annual benefit limits.

(These requirements are based on the federally mandated requirements of the Affordable Care Act.)

+Georgia mandates coverage for the following benefits to be paid as any other Sickness: maternity expense and routine newborn care, including 48 hours care in a Hospital or birthing facility following a normal vaginal delivery and a minimum 96 hours following a cesarean section. If a mother and newborn are discharged prior to the post-partum inpatient length of stay, coverage includes up to 2 Post-Partum Visits, provided that the first such visit shall occur within 48 hours of discharge; Benefits for Diabetes, Mammography, Pap Smears, Chlamydia Screening; Mastectomy Benefits; Dental Anesthesia Benefits; Prostate-Specific Antigen (PSA) tests; Treatment of Temporomandibular Joint Dysfunction; and any other applicable mandated benefits.

Student Health Insurance Plan (SHIP)

Georgia Board of Regents Insurance Plan

2016/2017 Student Health Insurance Program

The University System of Georgia has a contract with United Health Care as the vendor for student health insurance for the academic year 2016-2017. Student Health Insurance is required for nursing students, international students with an “F” or “J” visa, Exercise Physiology students during the term they are enrolled in their internship, and students with a graduate assistantship.

Summer Term 2017

Important:  If you purchased insurance or received an approved waiver for the spring/summer term (January 1-July 31, 2017, there is no action required for the summer term.  All waivers and enrollments must be completed by the end of open enrollment, June 11, 2017.  After this date the waiver requests and enrollments will be closed and anyone who is required to have student health insurance and has not requested a waiver will be enrolled in the Student Health Insurance Plan through United Health Care.

The following are the brochures for the domestic and international plans which will list coverage and prices:

Domestic

https://www.uhcsr.com/uhcsrBrochures/Public/ClientBrochures/2016-1193-1%20Brochure.pdf

https://www.uhcsr.com/uhcsrBrochures/Public/BenefitSummaryFlyers/2016-1193-1%20Summary%20Brochure.pdf

International

https://www.uhcsr.com/uhcsrBrochures/Public/ClientBrochures/2016-1193-4%20Brochure.pdf

https://www.uhcsr.com/uhcsrBrochures/Public/BenefitSummaryFlyers/2016-1193-4%20Summary%20Brochure.pdf

Mandatory Plan

The following students are required to have student health insurance that meets the minimum standards set by the University System of Georgia. Students in these categories who are not covered by a policy held by a parent, spouse, employer or if the policy does not meet the minimum standards, will be charged for a USG Student Health Insurance Plan (SHIP) policy.

  • All undergraduate, and ESL international students holding F or J visa status.
  • All undergraduate students enrolled in programs that require proof of health insurance.
  • All graduate students receiving a Full Tuition Waiver as part of their graduate assistantship award.
  • All graduate international students holding F or J visas status.
  • All graduate students enrolled in programs that require proof of health insurance.
  • All graduate students receiving fellowships that fully fund their tuition.
  • International Scholars holding J visa status.

Minimum Insurance Standards 

International Students in the F-­‐1 and J-­‐1 student or scholar statuses must have a minimum of the following benefits:

  •  Both accident and sickness coverage
  •  Minimum benefit $250,000 per policy year**
  •  A deductible of $500 or less and/or co-­‐pay per individual, per year*
  •  In-­‐patient and outpatient, mental and nervous disorder benefits
  •  Prescription Drug Coverage
  •  Pay benefits worldwide
  •  Medical evacuation to one’s home country and family reunification of not less than    $50,000*
  •  Provision for repatriation of remains of not less than $25,000*
  •  All Georgia mandated requirements+
  •  International students and scholars, and any accompanying spouse and dependent(s), may be subject to the requirements of the Affordable Care Act.

*Federal Standards required for International Students

Domestic Students must have a minimum of the following benefits:

  • Both accident and sickness coverage
  • Minimum benefit $500,000 per policy year** 
  • Coverage for all pre-­‐existing conditions
  • Reasonable deductible ($3,000 or less) and/or co-­‐pay per individual, per individual, per year
  • In-­‐patient and outpatient, mental and nervous disorder benefits
  • Prescription Drug Coverage
  • Pay benefits worldwide
  • All Georgia mandated requirements+ 

**To meet Federal Affordable Care Act (ACA) requirements your health plan should have no annual benefit limits.  (These requirements are based on the federally mandated requirements of the ACA.)

+Georgia mandates coverage for the following benefits to be paid as any other Sickness:  Mammography, Pap Smears, Prostate-Specific Antigen (PSA) tests, Chlamydia Screening; Mastectomy , Bone Mass Measurement, Colorectal Cancer Screening, Dental Anesthesia, Diabetes, Surveillance Tests for Ovarian Cancer, Telemedicine, Drug Treatment of Children’s Cancer, Bone Marrow Transplants, Postpartum Care, and Mental Illness..

Waivers

Students in the mandatory groups will have the option to waive the student insurance if they have a plan that meets University System of Georgia requirements. They can apply for a waiver on-line by visiting the United Health Care website www.studentcenter.uhcsr.com/valdosta  Approximately half way down the page is a link (Waiver Form).  Click on this link and answer the questions and provide information regarding your current health insurance coverage.  Students that apply for a waiver may be randomly selected to provide documentation of their health insurance coverage.  Randomly selected students that cannot provide documentation of coverage will have their health insurance fee added back to their account.

International students at Comprehensive universities within the University System of Georgia cannot waive out of the United Health Care coverage using the PGH Global plan.  The exception to this is the PGH Global plan is available only for J Exchange Visitors who are NOT degree-seeking students and/or J Exchange Visitors who are not in student status.

Please note that waivers are approved term by term so you must re-apply each term to confirm your information has not changed.

Voluntary Plan

All undergraduate students not eligible for the Mandatory Plan enrolled in six (6) or more credits per term and enrolled in a degree seeking program; or all Graduate students enrolled in a minimum of (3) graduate level credit hours and enrolled in a degree-seeking program are eligible to enroll in the Voluntary Plan.   Eligible dependents of enrolled students may participate in the plan.  All Voluntary Plan students should contact United Health Care Student Resources directly to enroll.  www.uhcsr.com/usg (select Valdosta State University) or (866) 403-8267.  The premium for Voluntary Student will be paid directly to United Health Care Student Resources.