Patient Financial Responsibilities (Participating Carriers-In Network) 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 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 AccountsPatients 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.
Unfortunately, we are unable to accept HMO plans at this time for any insurance company.
Listing of frequently asked questions regarding insurance. (updated on 8/10/12)
|Listing of "In Network" Carriers||Listing of "In Network" Carriers|
|FIRST CHOICE||UNITED HEALTHCARE|
|HUMANA||BC/BS OF GEORGIA & BC/BS FEDERAL PLAN|
|OPTIUM HEALTH & OPTUM INSIGHT||GREAT WEST HEALTH INSURANCE|
|COVENTRY OF GA||UNITED HEALTHCARE (SHIP) Seeking care through an outsider provider requires a referral & a copy of your Insurance Card. Effective August 2012|
|TRICARE STANDARD (as of 3/11/13)||TRICARE PRIME (must have referral prior to appointment)|
|Listing of "Out of Network" Carriers||Listing of "Out of Network" Carriers|
|CBCA ADMINISTRATION||SECURE HEALTH|
|GEHA||Reviewed by: Nicole Foster 12/12/14|
Student Health Insurance Plan (SHIP)
University System of Georgia (USG) Mandatory groups for health insurance:
- All graduate students receiving a full tuition waiver as part of their graduate assistantship award.
- All graduate students receiving fellowships that fully fund their tuition.
- All undergraduate, graduate, and ESL international students in F or J visa status.
- 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.
- 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.
Georgia Board of Regents Insurance Plan
2014/2015 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 2014-2015. 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.
Student Health Informational Flyer
Spring/Summer Term 2015.
Important: All waivers and enrollments must be completed by the end of open enrollment, February 15, 2015. 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.
All nursing students, graduate assistants, and international students with an “F” or “J” visa are required to enroll in the Mandatory Plan or request a waiver on-line through United Health Care. The health insurance premium will be added to your fee schedule. The rates for AY 14/15 are no longer based on age groups and are listed on the Student Health Informational Flyer above.
Any student that does not meet the requirements for the Mandatory Plan and wishes to purchase health insurance through United Health Care can enroll on-line on the United Health Care website; https://www.uhcsr.com/valdosta At the top right hand corner of the website, there is a red box with “Enroll On-line Now” Click the Enroll Now tab inside the red box and follow the prompts. The Voluntary Plan rates are the same as the Mandatory Plan and are listed in the Student Health Informational Flyer above. Students not required to have health insurance and wishing to purchase health insurance under the Voluntary Plan will pay United Health Care directly and it will not be billed through your student account.
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.
Please note that waivers are approved term by term so you must re-apply each term to confirm your information has not changed.
If you are required to have Student Health Insurance, you must enroll on-line by going to the United Health Care website www.studentcenter.uhcsr.com/valdosta Approximately half way down the page, click on the Enrollment Form link and complete the information. After completing the Enrollment Form information, go to the top left hand corner of the website and click on the Create an Account link if you did not do this in the fall semester. Once you create an account, you will be able to print out your temporary id card to use until you receive your permanent card form United Health Care.
*NEW FOR SPRING/SUMMER 15 (INTERNATIONAL STUDENTS)*
Beginning Spring/Summer 15 term, the USG Student Health Insurance Program (SHIP offers an additional health insurance option for some international students and scholars enrolled at VSU.
F1 and J1 undergraduate and F1 and J1 graduate students are eligible for the new PGH Global Georgia International Student Care Plan (Global Plan). The PGH plan provides the international student a significant reduction in their premium cost. U.S. citizens are not eligible for this insurance as an insured or as a dependent.
Information about the Global Plan, including coverage and premium costs can be found at the following website:
Eligible international students can enroll in the Global Plan at the following website:
International students enrolling in the Global Plan will pay PGH directly during the enrollment application. Following enrollment and submission of payment to PGH, the student must submit a waiver to United Health Care (directions are above under the Mandatory Plan -Waivers). After submission of the waiver to United Health Care, the Student Health Insurance fee will be removed from the student’s account.
International student athletes who purchase the Global Plan are eligible for having the athletic rider however they must not request a waiver with United Health Care if Athletics is purchasing their athletic rider.
Spring/Summer Open Enrollment for the Global Plan is January 31, 2015 and the deadline for requesting waivers is February 15, 2015 (See waiver instructions above.) An important thing for international students to understand is if they do not purchase the Global Plan by January 31, 2015, they must either purchase the insurance from United Health Care or purchase insurance that meets USG requirements. If purchasing insurance that meets USG requirements, the student would need to request a waiver through United Health Care by February 15, 2015 in order for the charge to be removed from their account.