Frequently Asked Questions


I'm young and healthy. Why do I need health insurance?
You may think now isn't the time to care about health insurance. After all, you may have tuition, books, and rent to worry about. But since an unplanned illness or accident may happen any time, now's the perfect time to consider health insurance. Your school-sponsored plan meets the requirements of the Affordable Care Act. Most of the plans offered by UnitedHealthcare StudentResources are Gold or Platinum-level plans, but at lower-than-average premiums. According to comparison data from the 2013 Employer Health Benefits Survey by the Kaiser Family Foundation, there's a good chance your student plan is more affordable than being added as a dependent on your parent's plan or purchasing individual insurance through a Health Insurance Marketplace (also called an Exchange).
What's available for me if I don't qualify for my school's student insurance program?
If you don't meet the qualifications set by your school for the plan, contact UnitedHealthOneSM at 800-980-7395 for other health insurance options.
Aren't there government assistance programs to help me pay my health care bills?
Yes, there are assistance programs available to uninsured individuals, but most have strict income guidelines that you must meet before becoming eligible for help. Some programs will only provide help for certain services.


Where can I review policy details before I enroll?
Policy brochures for schools can be found by simply clicking the "Find My School's Plan" link on this website. Type in the name of your school (or the policy number) and click Search. That will pull up a link to your school's page where you'll find links for plan information. Simply choose the policy you're interested in (if more than one appears) and click the appropriate link. The documents are stored as Adobe Acrobat .pdf files for easy reading and/or printing.
If I don't enroll in the student insurance plan during the open enrollment period, can I enroll later?
Typically, you can only enroll in the plan during the designated open enrollment period. The exception to this is if you have a Qualifying Life Event (QLE). To determine acceptable QLEs, contact the person at your school who oversees the student health insurance, or call the Customer Service number found on the plan brochure.
If I have the student health insurance, but drop out of school, am I still covered? If not, will I get a refund?
Insured students who withdraw from school after the first 31 days of the policy period remain enrolled in the plan for the full period for which the premium was paid. In most states, refunds are only made in the case of an insured student entering the U.S. Armed Forces, or if eligibility requirements are not met.
Does my coverage expire upon graduation?
Your coverage continues to the end of the coverage period for which you have paid the required premium. So if you graduate early, your coverage continues to the expiration date of the paid-for policy period.
Can I enroll my family members in the student insurance plan?
You may be able to enroll dependents. Refer to the plan brochure on this website to determine if this is an option at your school. If it is, the enrollment form will show you how dependents may be added as well as the costs associated for adding dependents.
What's my coverage period or effective date?
Upon submission of your online enrollment, you'll receive an email with the subject line of "Insurance Enrollment Completed". The effective dates of coverage are included in that email. If you didn't receive that email, or misplaced it, simply login to your My Account page. From there, click on the link "Current Coverage Information" in the View My Information box. The link will display all necessary coverage information. Please note that for most policies coverage is effective the date enrollment and premium is received by the company or its representative or the effective date of the coverage period purchased, whichever is later.
How do I renew my insurance?
Due to changing policy and benefit schedules, a new enrollment must be completed each policy year. During a specific policy year you can extend coverage either through your school or online within your My Account.
What will I receive to prove I have coverage?
Within 48 hours of UHCSR receiving your enrollment information, you'll receive an email with a link to download your electronic insurance ID card. You can then access your card from your computer, or with our free UHCSR app, from your mobile device. If you need to access covered services prior to that, have your health care provider call our Customer Service number (found in your plan brochure) to verify coverage. Please note that an ID Card is not a guarantee of coverage. All claims must be evaluated for benefits.
What if I lost my insurance card?
Thanks to our electronic insurance ID card, losing your ID card can be a thing of the past. It's always available via your My Account page or the mobile app. If you prefer a hard copy of your card, you can request one through My Account.
Is a refund available if I enroll in a Medicaid or other plan after I have enrolled in the student plan?
No, coverage under the policy may not be cancelled. In most states, refunds are only made in the case of an insured student entering the U.S. Armed Forces, or if eligibility requirements are not met.
Why do you need my Social Security Number (SSN)?
The Affordable Care Act requires UHCSR to file a 1095-B for each insured. This form lets the IRS know you have acceptable health insurance coverage so you won't be penalized. We need your SSN in order to file this on your behalf.


If I am ill or have an accident, what should I do?
If this is an emergency, call 911 or go to the nearest emergency room. If that's not the case, and your school has a Student Health Center (SHC), you should go to the SHC. That's your most cost-effective solution. To seek care from another preferred provider, your school may require you to get a referral from the SHC first. Check your plan brochure to see if that applies to you. Of course, if your school does not have a SHC and it's not an emergency, your best option is to search for a preferred provider in the area. We make this easy with either the search options within your My Account or on your school's page on this website, or with our UHCSR mobile app.
What should I do if the SHC is closed or I'm away from school?
Our plans include a national network of health care providers. You can use the provider search features on your school's page on this website or our UHCSR mobile app to locate preferred providers in your area. Almost all of our plans also include Global Emergency Services when you're traveling out of the country. Please refer to your plan brochure for details.
What if I need to be admitted to a hospital?
Some of our plans do have a pre-admission notification requirement. Please refer to your plan brochure to see if this applies to you. Of course, in an emergency, this doesn't apply.
How do I know if something's covered?
Please refer to the Schedule of Benefits in your plan brochure to see what services are covered by your plan. You should also review the Exclusions and Definitions sections for additional information. If you still have questions, call the Customer Service number found in your brochure, on your ID Card, or within the UHCSR mobile app.


How can I find a preferred provider?
A provider can be found by using the links on your school's page on this website (in the section entitled "Search for a Provider") or from within your My Account. You can also search for a provider with our free UHCSR mobile app.
What's the advantage of seeing a preferred provider?
UnitedHealthcare StudentResources has negotiated special rates with our preferred providers, thus saving you money. You don't have to see a preferred provider, but going out of the network will cost you more.
Are preferred providers just located in the area around my college campus?
Most of our plans come with a national network of health care providers. So whether you're at school, at home, or even enjoying spring break, odds are you'll find preferred providers in the area.
Which pharmacy can I use to fill my prescription?
You can search for a network pharmacy on your school's page on this website or from within your My Account.
When scheduling an appointment, should I tell the provider's office that I have insurance from UnitedHealthcare
Yes, when you schedule an appointment, let the office know who your coverage is with, as well as your policy number and group name (found on your ID card). With the UHCSR mobile app, you can also email or fax a copy of your ID card to the provider.


Do I have to submit a claim form?
Not with most policies, but please refer to the the Claims Procedures in the policy for specific information regarding your plan. If your policy does require a claim form, you'll find one on the Helpful Resources & Forms page on this website.
If I am in an accident or I have an injury, is there a special form to complete?
Yes, log into your My Account page and click on "Accident Details Forms" in the navigation menu. Complete the online form and submit it.
I want to make sure I provide all necessary information so my claim can be processed as quickly as possible. What do I
     need to do?
Log into your My Account page and make sure UHCSR has all your correct information. That would include answering the questions about "Other Insurance." Even if the student plan is your only plan, you'll need to use the "Add Other Insurance" link and certify you don't have another plan. Also, go into the "My Personal Information" screen and Email Preferences" and verify we have your correct email, mailing address, date of birth, etc. All of this information is critical in case we need to contact you in order to process your claim quickly.
If I'm covered under my parent's insurance as well as the student health insurance plan, which company should I submit
     a claim to first?
This varies depending on how your school's plan is structured. In general, you should submit claims first to your parent's plan, and submit any outstanding balances to the student health insurance plan. Be sure to submit the claim along with the Explanation of Benefits from your parent's plan to UnitedHealthcare Student Resources; P.O. Box 809025; Dallas, Texas 75380-9025.
How can I check the status of a claim?
Log into your My Account page and select "View My Claims" in the navigation menu. From there you can see both completed claims and claims in progress. You can also use the mobile app to view the status of claims processed within the past 60 days.
Where do I send claims?
Log into your My Account page and you'll see a section headed Policy Information. Under that is a link called "View Claims Address". Clicking that will display the correct address for processing claims (including a fax number if you prefer to submit your claim that way).
What if I need someone else to call in about my claims?
Only the insured member can access secure health care information contained within the My Account. If you need someone else to call in on your behalf, you can simply login to My Account and select the Personal Representative Form (PRA), then complete it for the caller prior to them calling our Customer Service. A PRA form is also available on our website. Please allow 48 hours if we're receiving the PRA form via mail, fax, or email.


If I have a question regarding my insurance plan benefits, who should I ask?
If you have questions about your benefits or other aspects of your plan, please feel free to call our Customer Service department. You'll find the number in your plan brochure, on your ID Card, or log into your My Account page and you'll see the appropriate toll-free phone number as well as an email link.
How do I update my personal information such as a mailing address, phone number, etc.?
You can easily update your personal information by logging into your My Account page and clicking on the "Edit" link in the My Personal Information box on the right. However, if your eligibility is submitted from your school, you'll also need to make sure you've updated your information in their database as well.
What services are provided online?
We understand you live in a digital world, so we've made several handy self-help features available both online and via our free UHCSR mobile app. With the mobile app, you can view, fax, or email your electronic ID card, check the status of recent claims, search for a preferred provider, and set up your My Account page.

Via your My Account page, you can do all that and more. For instance, you can review your plan coverage (including effective and expiration dates), update your personal information, view Personal Representative forms, submit an Accident Details Form, see your coverage history, and get information about any value added benefits available on your plan. In your My Account Message Center, you can see any documents we've sent to you.

Why do providers tell me my coverage is terminated when I know it's active?
Check with the provider and find out how they're verifying your coverage. Providers need to contact UnitedHealthcare StudentResources to verify eligibility by calling the provider number listed on your ID card.
How come my claim was denied for no coverage when I know I have coverage?
It's possible the claim was sent to the wrong address. Providers need to send your claims to UnitedHealthcare StudentResources; P.O. Box 809025; Dallas, Texas 75380-9025. If they file electronically, the electronic payer ID is through Emdeon and it's 74227.


Does my plan include dental or vision coverage?
As required by the Affordable Care Act, all our plans include pediatric dental and vision coverage for insureds up to age 19. At some schools, a voluntary dental and/or vision plan is available for purchase. To see if your school offers this, check the school's page on Voluntary enrollment for these products is available on an annual basis only.
Am I covered for health care while studying or traveling abroad?
Most of our school plans include Global Emergency Services from UnitedHealthcare Global (previously named FrontierMedex) that includes medical assistance services, medical evacuation and repatriation services, as well as travel assistance service. Please refer to your plan brochure to determine whether it includes this coverage.


What health insurance options are available to today's college students?
Since the passage of the Affordable Care Act, college students have several health insurance options:
  • If available and you are eligible, you can purchase the school-sponsored student health insurance plan.
  • If you're under the age of 26, you may be covered as a dependent on your parent's health insurance plan (if dependent coverage is available).
  • You can purchase an individual health plan through a Marketplace.
  • If you're under the age of 30 (or qualify for a hardship exemption), you can purchase a catastrophic health plan through a Marketplace.
  • If you're employed you may be able to purchase your employee health plan.
  • Depending on your state, you may qualify for Medicaid.
Does the UHCSR student health insurance plan satisfy the "Individual Mandate" requirement of Minimum Essential
Yes, the student injury and sickness health insurance plans from UHCSR meet the requirements for Minimum Essential Coverage.
What is the penalty for not having Minimum Essential Coverage?
For 2014, the penalty is $95 per person or 1% of individual's income, whichever is greater. The penalty for 2015 is $325 person or 2% of income. The penalty increases every year, with it going to $695 per person or 2.5% of income in 2016. This penalty is paid on your federal income tax return.
Is anyone exempt from the Individual Mandate and subsequent penalty?
You may qualify for an exemption from the penalty if:
  • You're uninsured for less than three months of the year.
  • The lowest-priced coverage you can get would cost you more than 8% of your household income.
  • You don't have to file a tax return because your income is too low.
  • You're a member of a federally-recognized tribe or eligible for services through an Indian Health Services provider.
  • You're a member of a recognized health care sharing ministry.
  • You're a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare.
  • You're incarcerated and not being held pending disposition of charges.
  • You're not lawfully in the United States.
  • You qualify for a hardship exemption.
What is a Health Insurance Marketplace?
As part of the health care reform law, Health Insurance Marketplaces, also called Health Insurance Exchanges, were established to make it easy to sign up for health insurance plans that meet the requirements under the law. Individual states were to set up their own Marketplace, but for those that didn't do that, residents can purchase from the federal Marketplace. To purchase a plan from a state Marketplace, you must meet any residency requirements set by that state.

For more information on Health Insurance Market-places, go to or call them at 800-318-2596.

Who manages the Marketplaces?
That depends. Some states established their own state-based Marketplace, while others are using the federal Marketplace. The federal Marketplace is managed by the Centers for Medicare & Medicaid Service (CMS).

Regardless of who manages the Marketplace in your state, your can go to or call 800-318-2596 to be directed to the Marketplace applicable to you.

When is open enrollment for plans offered through the Marketplaces, and when would they become effective?
Go to to see when the next Marketplace open enrollment period begins. Plans purchased through a Marketplace run on a calendar year, not your academic year like the school-sponsored student health insurance plan.

You may be able to purchase coverage through a Marketplace outside of the open enrollment period, but only if you've had a Qualifying Life Event (QLE). These include things like losing insurance from another source, experiencing a change in your family size (marriage, divorce, a new child), moving to a new state, or changes in your income.

What kinds of health insurance options are available through the Marketplaces?
There are five categories of plans offered through Marketplaces. Plans in each category pay different amounts of the total costs of an average person's care. This takes into account the plan's monthly premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums. The actual percentage you'll pay in total or per service will depend on what you use during the year. The five categories are:
  • Platinum: Your health plan pays 90% on average. You pay about 10%.
  • Gold: Your health plan pays 80% on average. You pay about 20%.
  • Silver: Your health plan pays 70% on average. You pay about 30%.
  • Bronze: Your health plan pays 60% on average. You pay about 40%.
  • Catastrophic: These plans pay less than 60% of the total average cost of care. These are only available to those under 30 years of age, or those with a hardship exemption.

Depending on your household size and income, you may qualify for a premium tax credit that lowers the monthly premium on a Marketplace plan. Sometimes referred to as a subsidy, these are only available on Marketplace plans (except for catastrophic plans).

Once you've enrolled in a Marketplace plan, you cannot change that plan unless you've experienced a Qualifying Life Event (QLE). These include things like losing insurance from another source, experiencing a change in your family size (marriage, divorce, a new child), moving to a new state, or changes in your income.

What is the "Catastrophic Plan" offered through the Marketplaces?
Catastrophic plans are only available to those up to 30 years of age or those who have qualified for a hardship exemption.

This type of plan tends to have lower premiums, but there is a trade-off. While it covers three primary care visits per year at no cost and some preventive services are free, everything else requires you meet your deductible before the plan helps cover costs. The deductible can be pretty high on these plans.

You cannot get a premium tax credit with a catastrophic plan. You must pay the standard price.

Who is eligible for a premium tax credit, or subsidy, through the Marketplaces?
According to the IRS, you may be eligible for a premium tax credit if you meet all of the following:
  • You purchase health insurance through a Marketplace.
  • You are not eligible for coverage through an employer or a government plan.
  • You fall within certain income limits.
  • You cannot be claimed as a dependent by another person.
  • You don't file a Married Filing Separately tax return (unless you meet the criteria related to victims of domestic abuse and spousal abandonment).
  • To determine your eligibility for a premium tax credit, go to or call 800-318-2596.
Who is eligible for Medicaid under PPACA?
This varies by state. To determine whether you qualify in your state, visit and select your state.
How can I calculate the premium tax credit I'll get?
The Henry J. Kaiser Family Foundation has created a Subsidy Calculator, available on their website:

You may also go to, select your state, and complete the application process to determine whether you qualify and what impact it will have on premiums.

How are premium tax credits managed and reconciled?
If you're eligible for a premium tax credit, you have two choices:
  • You can have some or all the estimated credit paid in advance to the insurance company, thus lowering your monthly premiums.
  • You can wait and get the full credit when you file your tax return.

If you experience any changes in income or family size, report them to the Marketplace when they happen. This will help ensure you're getting the proper amount of financial assistance, and help avoid a surprise at the end of the year when you file your taxes. If the estimated amount of credit was too high, you'll have to pay the difference back to the IRS.

If my college/university offers a school-sponsored student health insurance plan, can I still opt to purchase a plan
     through a Marketplace?
Yes, even if a school-sponsored plan is available, you can purchase a plan through a Marketplace. However, before doing that, be sure to do a thorough comparison of the plans. Odds are the school-sponsored plan is a better option. Here are some things to consider:
  • If your school has a Student Health Center, is it treated like a preferred provider? That's typically the case with UHCSR student injury and sickness health insurance plans.
  • If it's a Marketplace plan, will it cover medical care beyond emergency services (e.g., doctor's office visits, diagnostic testing, x-rays, prescription drugs, mental health, etc.) in the geographic region of your campus?
  • Are there in-network providers available across the nation (so you're covered at school, at home, and even when you're travelling)?
  • Does it offer Global Emergency Services when you're abroad?
  • Does the plan have pre-certification or pre-authorization requirements, or does it require a referral from your Primary Care Physician?
  • To complete your comparison, make sure you compare more than just the monthly premium. Look at the deductibles, copays, and total out-of-pocket cost, too.
Can a school require students to carry health insurance?
Yes, colleges and universities can require students to have health insurance as a condition of attendance. Typically, this requirement can be met by enrolling in the school-sponsored student health insurance plan, or completing a waiver form showing proof of comparable coverage.
If I go to an out-of-state school, can I purchase a plan on that state's Marketplace instead of my home state?
No, you can only purchase plans from the Marketplace that services your state of residence. Each state has its own residency requirements that must be met in order to purchase from their Marketplace.
Can international students purchase a plan through a Marketplace? If so, are they eligible for a premium tax credit, or
International students who are legally in the United States may purchase a plan through a Marketplace, but they aren't eligible for a premium tax credit.
Are plans purchased outside of the Marketplaces eligible for a premium tax credit, or subsidy?
No, plans purchased outside of a Marketplace, including a student health insurance plan, are not eligible for any federal premium tax credit.
What is "Community Rating"? How does this apply to Marketplaces and student health insurance plans?
As defined by, Community Rating is a rule that prevents health insurers from varying premiums within a geographic area based on age, gender, health status, or other factors. With the health care reform law, insurers must consider the claims experience of all individual health plan enrollees in a particular state, combining them into a single risk pool. This means any risk factors are spread across the whole group, versus a single person. However, PPACA does allow for some reasons to vary the premium amount; for instance, there can be as much as a 3:1 ratio in premium ranges of the highest to lowest risk. That means a healthy young adult's premium can be no lower than a third of that for someone with serious health issues.

The Department of Health and Human Services (HHS) recognized the unique nature of the school student health insurance market (mostly young healthy adults who will only be on the plan for a few years). PPACA allows school-sponsored student health insurance plans an exemption from the single risk pool or community rating. That means premium costs for student health insurance plans are typically lower.

Why is the school-sponsored student health insurance plan a good alternative to a Marketplace plan?
There may be several reasons why the school-sponsored plan is a better option. It starts with the fact that student plans don't have to follow Community Rating, and instead benefit from the fact that schools typically have younger, healthier adults and the plan is only needed for a few years. This typically means the premiums will be lower than a comparable plan on the Marketplace. On top of that, school-sponsored student health insurance plans from UHCSR typically offer the following:
  • If the school has a Student Health Center, it may be treated as a preferred provider with a plan from UHCSR.
  • Our student plans have a national network of preferred providers backed by UnitedHealthcare. That means whether you're at school, at home, or enjoying spring break, we've got you covered.
  • Most UHCSR student plans include global emergency services from UnitedHealthcare Global; great for when you're traveling or studying abroad.
  • Our plans typically offer lower deductibles, copayments, out-of-pocket maximums, and premiums than the lower cost options (Bronze, Silver, and Catastrophic) offered through the Marketplaces.
  • Your school-sponsored plan from UHCSR meets the Individual Mandate requirement of Minimum Essential Coverage.
  • With the school-sponsored student health insurance plan, the plan period is based on the school's academic year, not the calendar year like Marketplace plans. This means you can have coverage from the first day of school in the fall instead of waiting until a January 1 effective date.
  • Whether you're attending an in-state or an out-of-state school, you can purchase the school-sponsored plan. With the Marketplace, you can only purchase plans on your state's Marketplace. For students attending an out-of-state school, those on a Marketplace plan may only be able to get non-emergency care within their Preferred Provider Network, which is often regional.
  • Depending on the school, you may be able to use financial aid to purchase the school-sponsored student health insurance plan.


What is a deductible?
A deductible is the amount you owe for services your health insurance plan covers before the plan begins to pay. For example, if your deductible is $100, your plan won't pay anything until you've met your $100 deductible for covered health care services subject to that deductible. The deductible may not apply to all services.
What does "copayment" and "coinsurance" mean?
A copayment is a specific out-of-pocket dollar amount you pay to a provider at the time of service. Coinsurance is a percentage of covered expenses you pay. For instance, a plan could be set up so the insurer pays 80% of a bill, and you pay the other 20%.
What does "usual and customary charges" mean?
Those words (also sometimes called "usual, customary and reasonable") refer to the charges and costs typical or standard for your region. Let's say the usual, customary, and reasonable fee (based on an accurate study of doctors' charges) for an anesthesiologist is $500. If he charges you $600, your insurance will pay its percentage of the $500. You'll pay anything above that percentage of the $500, plus your deductible.
What does "preferred allowance" mean?
Preferred allowance is the amount a Preferred Provider will accept as payment in full for covered medical expenses.
What is a Preferred Provider Organization (PPO)?
A Preferred Provider Organization is an entity where providers are under contract to an insurance company or health plan to provide care at a discounted or negotiated rate. Typically, you can see any doctor in the PPO network without requiring special approval, and you usually don't need to choose a primary care physician. Most PPOs also allow you to seek care outside of the PPO network; however, the benefits are usually reduced and the insured has a greater out-of-pocket expense.
What does in-network and out-of-network mean?
An in-network provider, referred to as a preferred provider with UHCSR, is a health care provider who has contracted with UHCSR to provide services to insureds for specific negotiated rates. An out-of-network provider is one not contracted with UHCSR. Typically, the deductible and coinsurance are both higher if you go to an out-of-network provider. You'll save money by opting to be seen by a preferred provider.
What are "exclusions and limitations"?
Exclusions and limitations are various conditions, situations, and services not covered by the health insurance plan.
What is premium?
Premium is the agreed upon fee(s) paid for coverage of medical benefits for a defined benefit period. Premiums can be paid by employers, unions, employees, or shared by both the insured individual and the plan sponsor.
What is a waiver?
If a school mandates insurance coverage, a student may request a waiver, allowing him or her to decline the school-sponsored plan as long as certain conditions are met. Each school sets the conditions that must be met. Conditions usually include the student being enrolled in other comparable insurance coverage, such as their parent's or an employer plan, etc.
What is an open enrollment?
Open enrollment is the scheduled time period each year or semester when you can sign up for the Student Health Plan.
What is a Qualifying Life Event (QLE)?
A qualifying life event is an event that triggers an open enrollment window for an individual or family to purchase the Student Health Plan outside of the scheduled open enrollment period. Examples of QLE's are marriage, divorce, birth or adoption of a child, changing job status, or loss of other coverage.