Eligibility and Rates

Eligibility

All students enrolled in a qualifying program who registered for six or more credit hours including co-op students on work quarter, are assessed a fee for single student coverage under the university’s student health insurance plan. Students are given the option to waive this coverage, if they have coverage that meets the requirements.

Student must attend classes for at least the first 31 days after the date for which the coverage is purchased.

Graduate students who enroll in fewer than six credit hours in order to maintain their candidacy for degree may request to purchase coverage but will not be charged automatically. Students must be matriculated and taking at least one credit hour towards their degree.  Such students must request coverage from the student health insurance office and must satisfy all application requirements each semester. 

Students who wish to enroll in family coverage must do so at the beginning of their enrollment for the fiscal year, unless a qualifying event occurs.  Students must maintain eligibility for the entire year and will be charged the premium at the beginning of the semester for the enrollment period.

Students enrolled in the following programs do not qualify to receive the student health insurance and will not be charged the premium:

• Distance Learning, Senior Audit, Professional Development, Dual Enrollment, Greater Cincinnati Consortium of Colleges & Universities.

For Dependent coverage, then eligible students who do enroll may also insure their Dependents.  Eligible dependents include:

• The insured’s legal spouse
• The insured’s domestic partner:

• Insured’s sole spousal equivalent
• Lives together in the same residence
• Is responsible with the Insured for each other’s welfare

• Dependent children up to age 26
• Disabled children beyond age 26 if the child is:

• Incapable of self-sustaining employment by reason of intellectual disability or physical handicap
• Chiefly dependent upon the Insured for support and maintenance

• Children for whom the parent is required by court or administrative order to provide coverage

Premium Rates for 2018-2019

Single Student Coverage: $1232 per semester for Fall and Spring Semesters ONLY (Spring coverage extends through summer). $597 Summer semester- only applicable if NOT charged in the spring

Charges are added to the student bursar account, and are due at the beginning of the semester.  Students do have the option to sign up for a payment plan.  For more information on the student payment plan, please go to http://www.uc.edu/bursar/paying_your_bill/payment_plans.html .

Family Plan Coverage:
Below rates are for annual coverage only and charged once in the Fall semester.  You must complete the enrollment form and email to studins@ucmail.uc.edu for family coverage.

Student + Child Under 18	$4,494
Student + Child or Spouse age 18 or older	$4,928
Student + Children Under 18	$6,524
Student + Spouse + Child 18 or older	$7,392
Student + Spouse / Child 18  or older + Child Under 18	$6,958
Student + Children age 18 or older	$7,392
Student + Spouse /Children 18 or older + Children Under 18	$8,988
Student + Spouse + Children 18 or older	$9,856

                   
  
When being seen at University Health Services, for primary care, you can expect no co-pays or deductibles.  When seeing a doctor outside of the University Health Services, your deductible is always due first.  After you have met your deductible, your co-insurance will kick in, and you are responsible for the co-insurance amount, up to a maximum amount.  For some services, in addition to your co-insurance you will also have a co-pay, that would generally be due at the time of service.

Please see below for more information regarding rates.

Deductible

• No deductible for primary care services received at UHS.
• $500 deductible for in-network, non-UHS services.
• $800 deductible for out of network, non-UHS services.

Co-Insurance

• 20% for in-network, non-UHS services.
  • $500 deductible must be met first.
  • UHS referral is required prior to treatment, otherwise the co-insurance is 40%.
  • No referral is required if the insured is more than 50 miles from campus, or receiving ob-gyn, or maternity care.
• 40% for out of network, non-UHS services.
  • $800 deductible must be met first.

ER (“medical emergency”)

• Not available at UHS
• $150 co-pay + 20% co-insurance for both in and out of network providers.
  • The insured may call UHS prior to going to the ER to receive a referral number to have the co-pay reduced from $150 to $50.

Mental Health

• 20% co-insurance at UHS
• 20% co-insurance for In-Network providers
• $500 deductible must be met first
• UHS referral is required prior to treatment, otherwise the co-insurance is 40%.
• 40% co-insurance for Out of Network providers
  • $800 deductible must be met first

Physician’s Office Visit/ Physiotherapy

• Not available at UHS
• $35 co-pay + 20% co-insurance for In-Network providers
  • $500 deductible must be met first
• 40% co-insurance for Out of Network Providers
  • $800 deductible must be met first

Preventive Care

• No charge at UHS
• No charge for In-Network Providers
• Not covered under Out of Network Providers 

Urgent Care

• Not available at UHS
• 20% co-insurance for In-Network Providers
  • $500 deductible must be met first
  • UHS referral is required prior to treatment, otherwise the co-insurance is 40%.
• 40% co-insurance  for Out of Network Providers
  • $800 deductible must be met first

Prescription

• $15 for generic, $30 for brand name, if filled at UHS Pharmacy
  • $60 for brand name if generic is available
• 20% co-insurance for In-Network Providers
  • $500 deductible must be met first
• 20% co-insurnace for Out of Network Providers
  • $800 deductible must be met first

Out-of-Pocket Maximum

• $5000 for In-Network Providers
• $12,700 for Out of Network Providers