Proof of Insurance Requirement for USC - Columbia and School of Medicine

The fall 2017 waiver period closed September 15, 2017

USC Proof of Insurance Policy

All incoming freshmen who are enrolled in six or more credit hours and pay the student health fee, graduate students taking 9 or more hours, graduate assistants, and international students are required by the university to show proof of insurance and must either:

Purchase the University-sponsored Student Health Insurance Plan through CHP
Or
Waive out by providing documentation of enrollment in a health insurance plan
that meets the requirements detailed below.

Why is USC requiring these (incoming freshmen, graduate students taking 9 or more hours, graduate assistants and international students) students to provide proof that they have health insurance coverage?

Although the majority of college students are healthy, unexpected illness, accidents and mental health care needs can result in unanticipated health care costs and the need for specialized treatment. Not getting health care because of cost concerns can jeopardize a student’s ability to stay in school and graduate, and unexpected health care costs can derail a student’s financial stability.

Research shows that students who have adequate health insurance coverage are healthier and are more likely to complete their academic goals. Having a campus community with sufficient health insurance coverage means an overall healthier community.

What does proof of health insurance mean?

This means that students must have adequate health insurance as a condition of enrollment at the University of South Carolina and must submit their health insurance information via a secure web-site (studentinsurance.com).
Once this information is entered into the system and it is accepted, you have officially “waived out” indicating that you have adequate health insurance coverage and you do not wish to purchase the University-sponsored Student Health Insurance Plan.

If students do not waive out by the deadline or do not have adequate health insurance coverage, students will be enrolled in the University-sponsored Student Health Insurance Plan and the premium fee will remain on their tuition bill.

Please refer to studentinsurance.com to compare your current health insurance coverage to the University-sponsored Student Health Insurance Plan.

Who is required to show proof of health insurance?

All incoming freshmen, graduate students taking 9 or more hours, graduate assistants and international students who take six or more credit hours and pay the student health fee are required to show proof of health insurance coverage.

How is health insurance different from the student health fee?

The health fee is a mandatory part of tuition that pre-pays a number of student health services and initiatives to increase the overall wellness of the campus community. Payment of the student health fee also covers the cost of numerous health services, including:

  • Primary Care and Women’s Health office visits. (Specialty services such as Sports Medicine, Physical Therapy and Psychiatry may be subject to additional fees)
  • Up to 10 individual visits at the counseling center per academic year
  • Unlimited group counseling
  • Support groups and workshops
  • Annual flu shot
  • Certain preventive screenings, such as blood pressure and body fat percentage measurement
  • Nutritional consults
  • Sexual assault and interpersonal violence prevention and advocacy services
  • Health coaching on topics such as stress management, healthy eating, fitness assessments, and sexual health

Health insurance benefits cover costs associated with procedures such as suturing of wounds, intravenous (IV) therapy, vaccines, x-rays and laboratory tests that are not covered by the health fee. The Student Health Insurance Plan is specifically designed to cover additional costs that are typical to the needs of students. In addition, the health insurance gives students access to services not available on campus such as hospitalization or surgery, dental care and services needed while away from campus.

What does it mean to waive out?

Waiving out means that a student shows they are already covered by a health insurance plan that meets minimum requirements and does not need the student health insurance coverage. The premium fee will be removed from the student’s tuition bill.

How do I waive out of the Student Health Insurance Plan?

To start the waiver process please visit the secure web-site studentinsurance.com to enter your health insurance information. You will receive emails indicating the status of your waiver throughout the verification process. The waiver period closed September 15, 2017.

What health insurance coverage is required to waive out of the Student Health Insurance Plan?
Coverage must allow the insured student to receive services in South Carolina and have coverage for the following services:

  • Out-of-pocket limit per policy year not to exceed $6,350/individual and $12,700/family.
  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorders (including behavioral health treatment)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services (to include dental and vision)
  • Chronic disease management
  • Unlimited maximum benefit per policy year per covered person
  • No pre-existing condition limitation

Note – the covered benefits listed above are required for all plans according to the Affordable Care Act.

Medicare, Medicaid and Tricare plans are accepted as proof of adequate health insurance coverage.

How will I know if my personal health insurance qualifies and I have successfully waived out?

Students will receive an email typically within 48 hours of entering their health insurance information on the secure web-site from Consolidated Health Plans, the Student Health Insurance provider, confirming that their waiver has been accepted. Please remember to check your spam email account.

When can I complete my waiver for the Student Health Insurance Plan?

The studentinsurance.com website opens for the spring and summer in November 2017.

When will the Student Health Insurance Plan fee be waived?

The Student Health Insurance Plan fee will automatically be removed from a student’s tuition bill after the waiver has been accepted.

What is the deadline to waive out of the Student Health Insurance Plan?

The deadline for the spring and summer is February 15, 2018. Please keep in mind if you purchase another policy, coverage must be effective on or before January 2, 2018 (spring term) and extend through the entire year (and/or semester), including breaks and holidays.

If my waiver application is denied, how will I be notified?

You will receive email notification if your waiver application has been denied, usually within 48 hours of submitting the information. Please remember to check your spam email account. If you have questions about why the health insurance waiver was denied please contact Consolidated Health Plans, at 877-657-5030. You may also contact SHS’s Health Insurance Assistance office by email sahiao@mailbox.sc.edu or at 803-777-3175, option 3.

What if I miss the deadline and get charged for the Student Health Insurance Plan?

You can submit an appeal if your waiver is denied. These appeals must be submitted to Student Health Services’ Health Insurance Assistance Office either by email or by phone. Each appeal will be carefully reviewed. If you have questions about the proof of insurance requirement, contact the Health Insurance Assistance Office at 803-777-3175, option 3 or sahiao@mailbox.sc.edu.  

Will health insurance waivers be checked and verified each semester?

Yes. Waivers are checked and verified each semester, but you only need to complete the waiver process once each academic year.

What if I waive out of the Student Health Insurance Plan and later lose my health insurance coverage?

If you experience a qualifying event, you are allowed to purchase the Student Health Insurance Plan within 31 days of the qualifying event. A qualifying event means that your situation has changed and resulted in a loss of health insurance coverage. Examples include job loss or turning age 26, when parental coverage is no longer available.

Who can I contact if I have questions about my waiver?

Contact Consolidated Health Plans, the Student Health Insurance Plan provider, by calling 877-657-5030.

What are the dates of coverage for the Student Health Insurance Plan?
August 1, 2017 – July 31, 2018. For the spring and summer semestrs, coverage begins January 2, 2018 through July 31, 2018.

What is the cost? How will I be charged?

The annual premium is $2,020 ($168.33 per month). This cost will be billed to you in two installments: $852 for August 1, 2017 to January 1, 2018 and $1168 for January 2, 2018 to July 31, 2018.

What are the benefits of the Student Health Insurance plan for services received on-campus through Student Health Services?

  • Easy enrollment
  • Unlimited maximum benefit
  • No annual deductibles
  • Generic prescriptions $10 co-pay (outside pharmacies have a $20 co-payment)
  • No exclusions for pre-existing conditions
  • Preventative Care 100% coverage (as defined by the Affordable Care Act).
  • Most services at the health center are covered at 100% with a co-pay of $20.00 per visit (only applicable if an office fee is charged).
  • Lab work 100% coverage including screening for sexual transmitted infection
  • X-rays 100% coverage
  • Vision Care at Student Health Services 100% coverage with a $20.00 co-payment (opening Spring of 2018)
  • Co-Insurance 100%
  • Mental health 100% coverage (with a $20 co-payment if applicable)

What are the benefits of the Student Health Insurance plan for services received off-campus? 

  • No pre-existing condition exclusions
  • Coverage while at USC and at home
  • Lower deductibles, copays & co-insurance
  • Worldwide coverage
  • Easy enrollment
  • Medical Travel Assistance Service benefits
  • Most generic prescriptions $10 at the on-campus pharmacy in the Center for Health and Well-Being with no deductible and $20 at outside pharmacies with a $100 deductible
  • Most services at the health center are covered at 100 percent
  • Vision coverage up to $300 annually
  • Dental coverage – two cleanings and one set of x-rays annually, plus resin fillings covered
  • 100 percent coverage for preventive services, as defined by the Affordable Care Act
  • Sexually Transmitted Infection screenings
  • Adult immunizations
  • Routine gynecological services/well-woman exams
  • Preventive screenings
  • Annual exams
  • Exceptional mental health coverage
  • 100 percent coverage of lab work and X-rays at the Center for Health and Well-Being.

    A full description of plan benefits and covered services is available at studentinsurance.com.

Can financial aid cover the cost of the Student Health Insurance Plan?

If proof of health insurance is required as a condition of enrollment for your status (incoming freshmen, graduate students taking 9 or more hours, graduate assistants and international students), you can request additional loan money for the amount of the premium, if you are eligible for financial aid. Contact the Office of Financial Aid and Scholarships at 803-777-8134 for more information.

Can I enroll my spouse, domestic partner and/or children in the plan?

Yes. Go to studentinsurance.com  or contact Consolidated Health Plans, the Student Health Insurance Plan provider, by calling 877-657-5030 for more information about dependent coverage and enrollment.

Can I charge the cost of the insurance plan for my dependents to my University account?

No. The Bursar’s Office will only bill for the student’s coverage. Contact Consolidated Health Plans at 877-657-5030 to set up a payment plan for your dependents.

Why should I consider the Student Health Insurance Plan versus my current health insurance plan?

This affordable plan has been negotiated by USC to be an excellent match for the most common needs of college students and is considered a Gold Plan in the Health Insurance Marketplace.  A comparable plan purchased elsewhere could cost more than $350 per month, while the Student Health Insurance Plan is just $168 per month. Please compare your coverage with the Student Health Insurance Plan.

Additional reasons to consider the Student Health Insurance Plan include its exceptional coverage for services offered through Student Health Services. This includes no deductibles, excellent mental health coverage, 100% coverage of lab work and X-rays and a $10 co-payment for generic prescriptions. This plan also includes travel benefits, vision and dental coverage.

What should I consider when comparing the Student Health Insurance Plan to other health insurance plans?

Common considerations include the cost of co-pays, deductibles and annual out-of-pocket maximum. Another major consideration is the availability of local in-network providers. If your health insurance plan only has in-network providers from your home state and none in South Carolina, your out-of-pocket health care costs may be much higher while at USC.

How can I tell if a provider is in-network with the Student Health Insurance Plan?

Consolidated Health Plans, offers a comprehensive network of providers in South Carolina and throughout the U.S. To find specific providers, visit studentinsurance.com or contact Consolidated Health Plans, the Student Health Insurance Plan provider, by calling 877-657-5030.

Does the Student Health Insurance Plan cover dental care?

Yes. The plan offers a dental benefit that includes two cleanings per year, one annual oral evaluation, and annual bite-wing X-rays. You choose your own provider. To learn more about the dental benefit, please visit studentinsurance.com or contact Consolidated Health Plans, the Student Health Insurance Plan provider, by calling 877-657-5030.

Does the Student Health Insurance Plan cover vision care?

Yes. The plan offers a vision benefit that includes coverage of 100 percent Reasonable and Customary after $20 copay per visit. Student Health Services will offer a convenient on-campus Vision Center starting in January 2018. To learn more about the vision benefit, please visit studentinsurance.com or contact Consolidated Health Plans, the Student Health Insurance Plan provider, by calling 877-657-5030.

Does the student health insurance plan cover mental health services?

Yes. Mental health is part of the essential health benefits. Most mental health services are covered in a similar manner to other heath conditions. For specific coverage information, visit studentinsurance.com or contact Consolidated Health Plans, the Student Health Insurance provider, at 877-657-5030.

What are the pharmacy benefits?

The pharmacy benefits at the Student Health Services include a waived deductible with 80% of Preferred Allowance for Covered Medical Expenses and a $10 co-pay for prescriptions. Off-campus pharmacy benefits are 80% of Reasonable and Customary costs, with co-pays ranging from $20 to $100 after a $100 deductible is met. For more information, visit studentinsurance.com or contact Consolidated Health Plans, the Student Health Insurance provider, at 877-657-5030.

Prescription contraceptive products, commonly called birth control, are included within the pharmacy benefits.

Is Student Health Services the only place I can go with the Student Health Insurance Plan?

No. However, when you have the Student Health Insurance Plan, it is more cost-effective to go to Student Health Services since most of their services are covered. If you need to be referred to a physician or specialist outside of Student Health Services, our staff will assist you in making the referral. Work with your Primary Care Physician and your care team staff.

How do referrals work with the Student Health Insurance Plan?

If you are enrolled in the Student Health Insurance Plan, a referral to a specialty provider is necessary except in the following instances:

  • Treatment of an emergency medical condition
  • When the Center for Health and Well-Being is closed
  • When the service is rendered at another facility during official University holiday breaks or vacation periods
  • When medical care is received by a covered person who is more than 30 miles from campus
  • Maternity services
  • Psychotherapy services
  • When medical care is received by a covered person who is no longer able to use Student Health Services (due to a change in student status)

How do I file a claim with the Student Health Insurance Plan?

You do not need to file a claim for any services provided at Student Health Services.  For services elsewhere a claim must be filed with the Consolidated Health Plans within 50 days. To submit the claim form, go to studentinsurance.com, log into your account and select ‘student options.’ The claim form can be submitted online. Please present your insurance card to the community provider and ask that they file your claim. As with most health insurance plans you must call 877-657-5030 for pre-notification of all hospital confinements, some imaging scans and surgery prior to admission.

You should retain a copy of all claims information submitted for your records. Payment will be made to the providers (hospital, doctor and others) unless a paid receipt accompanies the bill at the time the claim is submitted.

What is my deductible per year and maximum benefits per year?

There is no deductible for services received at Student Health Services. The deductible for off-campus services is $750 for in-network and $1500 for out-of-network providers. The aggregate maximum benefit is unlimited.

What happens when I graduate?

The Student Health Insurance Plan coverage period is August 1 to July 31. You will remain covered until the coverage period ends.

Can I continue coverage after I graduate or leave the University?

No. There is currently no long-term option for continuation of the Student Health Insurance Plan after graduation or after leaving the University. Coverage will end on the termination date of the coverage period you are enrolled. Please refer to the extension of Benefits in the policy located in your insurance account at www.studentinsurance.com for the continuation of treatment for an emergency medical condition. For more information, call Consolidated Health Plans at 877-657-5030.

The University-sponsored Student Health Insurance Plan through CHP meets all additional insurance requirements for international students and dependents. In addition to the coverage requirements listed for graduate students, international students must have insurance that meets the following requirements:

A combined benefit of $100,000 for medical evacuation and repatriation of remains.

For J-1 exchange visitors and their J-2 dependents, the U.S. Department of State regulations require that the health insurance plan must also meet one or more of the following criteria:

  • Part of a group benefits program offered to enrolled students by a designated sponsor, or
  • A health maintenance organization (HMO) that is federally-qualified as determined by the Health Care Financing Administration (HFCA) of the U.S. Department of Health and Human Services, or
  • A Competitive Medical Plan (CMP) as determined by the Health Care Financing Administration (HFCA) of the U.S. Department of Health and Human Services, or
  • Underwritten by an insurance company that has an AM Best Company rating of "A-" or above, an Insurance Solvency International, LTD. (ISI) rating of "A-" or above, a Standard and Poor's Claims Paying Ability rating of "A-" or above, or a Weiss Research, Inc. rating of "B+" or above.

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