IMPORTANT INFORMATION
HEALTH INSURANCE
Understanding Student Health Insurance
T
he university requires all students on campus be covered by health insurance. To ensure this, one of the fees assessed to eligible students is enrollment in the Student Health Insurance Plan. The university recommends all students remain enrolled under the Student Health Insurance Plan during their years at the university. This plan is compliant with the Affordable Care Act and designed to meet the needs of full and part-time students. A brief outline is listed below: 1. Students can go to any doctor, any hospital, anywhere in the world. Most benefits are 80/20, paid at 80% of Usual and Customary charges. If the student chooses to go to a UnitedHealthcare Options PPO network provider, they can receive discounts in addition to 80%. 2. There are low deductibles per insured person per plan year for outpatient, inpatient, and emergency room visits. For current benefits please go to our website: si.illinois.edu and click on ‘Forms’.
Below are questions students should consider before opting out of the insurance: Q. Can I keep the Student Health Insurance plan if my hours fall below full time hours? A. With our plan, part time eligible students can have coverage no matter how many hours they are taking. Q. Is the Urbana-Champaign area included within your health insurance carrier benefit coverage area? A. The Student Health Insurance Plan can be used anywhere in the world. Q. Does your insurance plan require referrals and pre-authorizations? A. There ARE prior authorization requirements, however only on Rx benefits and vary by prescription. Students can review the PDL (Prescription Drug List) on the Student Health Insurance website to determine whether or not their Rx will be subject to this requirement. Reinstatement: If a student has previously waived the Student Health Insurance Plan, they do have the option to reinstate into the plan assuming they are registered in a manner in which the fee may be assessed. There are typically two types of reinstatements and with either, approval is not guaranteed. Please contact the Student Health Insurance office for more information.
3. Prescription drugs are covered when dispensed at most pharmacies or at McKinley Health Center. Copays or coinsurance may vary based on the medication obtained. 4. If the student believes that their private medical plan is comparable to the Student Health Insurance Plan, they may file to opt out of the University Plan. This can only be done during the Enrollment/Change Period. Check the Student Health Insurance website for dates and waiver application requirements. Waivers cover the semester during which they were submitted and are in effect continually through the end of that academic year.
Extension of coverage: Students who are not registered during a semester may elect to extend their coverage, provided they were registered and enrolled in the plan the previous semester and are returning the following semester. This can only be done during the Enrollment/Change Period. If a student has to leave school for a semester, coverage is available for those students who meet the extension requirements.
STUDENT HEALTH INSURANCE OFFICE McKinley Health Center Room 29 1109 S. Lincoln Ave. Urbana, IL 61801-3620 (217) 333-0165 EMAIL: insure@illinois.edu WEB: si.illinois.edu
18 Illini Family Resource Guide union.illinois.edu/pfpo
