The information on this website is intended to provide guidance to the benefits of the insurance and how to utilize its services. It in no way constitutes a guarantee of payment for claims submitted to the insurance company.
How to find network providers for the new plan year 15-16 effective 8/1/15 for new students to the plan and 9/1/15 for returning students to the plan.
Information below is for the 14-15 plan year effective until 8/31/15.
Benefits are underwritten by UnitedHealthCare and are based on policy TBA and the benefits payable are as defined in and subject to all provisions of the Policy. The master policy on file at the university contains all the provisions, limitations, exclusions, and qualifications of the plans, which may not be included on the web pages. The master policy is the contract and will govern and control the payment of benefits.
Most outpatient physicians Office visits and lab work are covered at 100% after your Co-Payment. Some exceptions to the CO-Payment are all outpatient/inpatient surgeries, MRI's and Catscan's which would apply towards the deductible and co-insurance before payable at the specific network coinsurance level.
After the plan deductible is met, eligible inpatient and outpatient specialty care is paid for by the Student Health Insurance Plan on a percentage basis. The percentage that the Student Health Insurance Plan pays depends on where service is rendered.
Outside the Network
Know your provider's affiliation! Visits outside the networks are covered at 50% of reasonable and customary charges only.
Health Care Management and Pre-Notifications
Required Pre-Admission Notification
Utilization Management Department should be notified of all Hospital Confinements prior to admission by calling UnitedHealthcare 1-877-295-0720
- Pre-Notifications should be done at least five working days prior to any elective admission to a hospital.
- Insured Persons must also call within 48 hours (two working days) of any emergency admission.
When calling, it will be necessary to provide the program with your name, the patient's name, the name of the Physician and hospital, the reason for the hospitalization and any other information needed to complete the review.