Today is Wednesday, Jul. 18, 2018

Department of

UC Student Health Insurance

Policy Benefits and Claims Processing

The University’s Student Health Insurance Plan covers major medical expenses, and is underwritten by United Healthcare Student Resources.  The plan includes in-network and out-of-network coverage, and is gold tier standard.  The Student Health Insurance plan is compliant with the Affordable Care Act, and has a huge nationwide network of providers available.  Additionally, those insured by the Student Health Insurance plan have additional benefits when seeking services through the University Health Services (UHS).

Please Note:

A referral is required before seeking non-emergent care or treatment outside University Health Services (UHS) to ensure the highest level of coverage is received through Student Health Insurance.  

This does not apply if the insured is more than 50 miles from UHS, receiving out of network coverage, or for ob/gyn or maternity care.  

Please call 513-556-2564 for assistance in obtaining a referral.

 

Policy Certificate of Coverage

For detailed coverage benefits please review your certificate of coverage  (PDF) for the 2017 – 2018 policy year.

Please note that this certificate is valid through August 9, 2018.


University Health Services

  • No charge for primary care (only for those covered under the Student Health Insurance Plan)
         Primary care extends beyond preventive services to include women’s
         health, lab work (medically necessary), and x-rays.
  • No limit on primary care visits to UHS
  • Mental Health Visits are < $20 per session
  • Prescriptions are $15 for generic, and $30 for brand name, $60 for brand name when generic is available.

Student Health Insurance Exclusions and Limitations

The exclusions and limitations sections describes items which are excluded from coverage and not considered to be Covered Medical Expenses.  Please see the certificate of coverage for a complete list.

  1. Acupuncture
  2. Cosmetic Procedures
  3. Custodial Care
  4. Any dental treatment not specifically provided for in the Policy
  5. Elective surgery or treatment
  6. Elective abortion
  7. Foot Care (see certificate for full details)
  8. Health Spa
  9. Hearing aids or exams to prescribe or fit them
  10. Hypnosis
  11. Injury sustained while participating in ant intercollegiate sport, contest, or competition
  12. Marital counseling
  13. Voluntary participation in a riot or civil disorder
  14. Reproductive / Infertility services
  15. Weight management, weight reduction, nutrition programs, treatment for obesity.This exclusion does not apply to benefits specifically provided in benefits for preventative care services or weight management/dietician.

Global Emergency Services

Starting the effective date of your policy you are eligible for United Healthcare Global Emergency Services.  For international students you are eligible to receive these services worldwide, except in your home country.  For domestic students you are eligible for these services when you are 100 miles or more away from the University and 100 miles or more away from your permanent home address, while participating in a Study Abroad program.

All services must be arranged and provided through United Healthcare Global services to be considered for payment.  If the condition is an emergency , you should go immediately to the nearest physician or hospital without delay, and then contact the 24-hour Emergency Response Center.  

Some of the services provided under the United Healthcare Global Emergency Services include:

  • Transfer of Insurance Information to Medical Providers
  • Monitoring of treatment
  • Transfer of Medical Records
  • Medication, Vaccine
  • Worldwide Medical and Dental Referrals
  • Dispatch of Doctors/Specialists
  • Evacuation
  • Medical Emergency
  • Security and Political
  • Natural Disaster
  • Facilitation of Hospital Admittance, up to $5000.00
  • Emergency Travel Arrangements
  • Legal Referral
  • Translation Services
  • Replacement of lost or stolen travel documents

    Please visit www.uhcsr.com/UHCGlobal for the United Healthcare Global Emergency brochure which includes full details of all services and limitations and exclusions.

 

Claims Processing

Claims are processed through Health Smart.  You can create an account at HealthSmart.com to view your explanation of benefits.  If you have a question about a claim, you can call Health Smart at 1-800-331-1096. 

If you have a bill that has not been processed through your insurance you can complete the below form and submit to the address on the form for processing.

Major Medical Claim Form

If your claim is for a needle stick, please submit the below form for the Blood Borne Pathogen Exposure Insurance.  For more information on Blood Borne Pathogen Exposure Insurance, please go to Dental, Vision, and Other Supplemental Policies.

Blood Borne Pathogen Exposure Claim Form

Health Information

UC Student Health Insurance

Lindner Center, Suite 334
studins@ucmail.uc.edu

Phone (513) 556-6868
Fax (513) 556-6655

Office hours: 8:30 a.m. - 4:30 p.m.