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 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.