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When you are in need of medical attention, the very first
place you should go is to your university Student Health Center.
In most instances, the treatment you receive there is free
or very low cost, does not require filing a claim, and will
take care of your problem.
The Student Health Center should always be your first stop.
In many plans, any off-campus treatment must first be referred
by the Student Health Center to be covered, so go there first.
If the Student Health Center is closed or otherwise unavailable
or if your university does not have a Health Center, you will
want to look to see if your plan requires use of a PPO (look
in your Student Health Insurance Brochure).
If your school has no PPO plan, you may use any licensed
provider. If your plan DOES require use of a PPO provider,
go to a Provider that is on the PPO plan of your school (see
reference to PPO plans that follows) If you receive medical
treatment off-campus, refer to the following information on
the claim filing process.
Filing a Claim
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| MOST COMMON FAQ's |
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The following questions are common inquiries
that we will need to respond to you with specific information
from our claim files.
Since our phone lines can often be busy during peak hours,
feel free to send an email to us detailing your question exactly,
and we will attempt to reply very shortly. For all written
claim inquiries, always provide us with your name, the name
of the school you attend, a return email address, and a complete
detailed question. For all claim questions, email:
Claims Information.
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- Is my particular injury/illness
covered?
(give complete details of the injury or illness
including when the accident happened or when you first noticed
the symptoms of the illness)
- What has been paid on my claim?
- Have you recieved the bills for
__________ Provider?
- What are the benefits/details of
my plan?
(give the school you attend, policy #, and ID#)
- Why did you not pay all of my claim?
(list Providers not paid in full)
- Have you received my claim form?
- How do I appeal a denied claim?
- I do not understand your correspondence,
please explain.
(Give date of correspondence)
- I do not understand your Explanation
of Benefits.
- Have you received my premium payment?
- When does my coverage start/end?
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| OTHER COMMON FAQ's |
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| My ID Card has the wrong address, how do
I get a replacement? |
| The address on the ID Card is used mainly
so the Post Office can deliver it to you. It is not necessary
for your Card to have your current address to get medical attention,
therefore we do not replace ID Cards for an address change. |
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| My name has changed. |
| Drop us an email at the address above with
your new correct name. |
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| How do I add my newborn child to my policy? |
| A newborn child needs to be added to the
coverage within 30 days of his/her birth. Send us an email with
the newborn’s name, date of birth, and the primary insured’s
name. We cannot add a newborn if the primary insured does not
have "family" coverage. |
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| What doctors and Hospitals can I use? |
| Unless your plan requires you use a PPO
provider, you can use any licensed physician or hospital. (See
reference to PPO plans above) |
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| Do you have a copy of my brochure/policy
on the Website? |
| Yes, you can download a brochure by clicking
on the following link: Claim
Forms and Brochures. You may also obtain a brochure describing
the plan in full at your local Student Health Center. Or, you
can send us an email request and we will be happy to email,
mail or fax you a copy. Be sure to include your email address,
mailing address or fax number. |
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| Can I enroll in my insurance plan online
at your website? |
| Not currently. |
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| Can my wife/parents/friends/roommate/relative
call you and get information on my claim? |
| Because of Federal Privacy laws, we are
not allowed to give private medical information to anyone other
than the insured student. To be in compliance with this law,
we will need the insured student to give us prior written and
signed authorization specifically stating who we may provide
medical information to other than himself. (this may be faxed
to our customer service department at 210-822-4113) |
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| Will I get a refund or reimbursement when
I cancel my coverage? |
| Each student is covered under a master
policy issued to the universities which provides for a refund
ONLY if the insured student enters military service. The coverage
you purchase stays in force for the full time period chosen,
no refunds. |
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| When will I receive my ID Card? |
| Some university accounts provide for an
ID Card which is part of the application or Brochure. The student
simply tears it off, completes it and keeps it. On other accounts,
we may issue ID Cards. During fall and spring enrollment periods
we have hundreds of colleges enrolling, and data input may take
a little longer than usual. You should receive a card in about
two weeks. However, should you need medical attention before
then, simply present your Student Insurance brochure to the
Provider, who may call us for coverage verification. Or, if
you send an email with a fax number, we will be happy to fax
a card to you. |
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| When does my coverage go into effect? |
| If you mail or fax your application to
us, your coverage will be effective on the day after postmark
if mailed, or the day after you fax it to us. |
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