Insurance Waiver Periods:
- Waiver Requests for the Spring/Summer 2021 Terms open December 9, 2020 and closes February 1, 2021
- Waiver Requests for the Summer 2021 Term open April 19, 2021 and closes June 4, 2021
More information about waivers can be found at Information by Student Situation.
An Overview of the Health Insurance Policy
As an F-1 or J-1 student, or J-2 dependent you are required by the Texas A&M University System (TAMUS) TAMUS policy #26.99.01 to have health insurance coverage for the entire period of your enrollment. Additionally all J visa holders are required by Department of State regulation 22 CFR 62.14 to have health insurance coverage for their entire program period. Obligations under Affordable Care Act (ACA) may also apply if you are working within the United States.
Health care in the United States can be very expensive. Paying for each and every service and treatment is unaffordable for most people. TAMUS, in order to protect the health, finances, and immigration status of each international student, requires that all students have health insurance coverage.
In order help international students navigate the complex and unfamiliar American health insurance system TAMUS offers the System Student Health Insurance Plan (SSHIP). This plan is automatically billed to international student tuition and fees. Benefits-eligible Graduate Student Employees (GSE) are eligible to enroll in the Grad Plan offered by TAMUS. The benefits of the plans are identical. The difference is whether the student pays through their tuition and fee bill or through payroll deductions. Students are eligible to apply for a waiver from the SSHIP charge if they can document proof of alternative equivalent coverage. Enrollment in Grad Plan qualifies a student for a SSHIP waiver if deadlines are met.
This web page is your first resource for information and questions about your responsibilities, and how health insurance coverage works.
What Do I Need to Do?
You should read the entry in "Information by Student Situation" corresponding to your status for full details, but, in general:
- If you want to keep SSHIP you only need to pay your tuition and fees.
- If you want to enroll in the Grad Plan you can do so in Workday. Your HR liaison can assist you. If you do not know who that is you can find your HR liason by navigating to employees.tamu.edu/findliaisons/. If your hire date is September 1 or earlier for the Fall coverage period or within January for the Spring /Summer coverage period and you enroll in Grad Plan within 7 days of the hire date the SSHIP charge will be removed from your bill.
- In all other cases if you do not want to pay for SSHIP you must apply for a waiver to have the charge removed.
- You must apply for a waiver even if you have coverage through a spouse who works at Texas A&M or have another health insurance plan from Texas A&M.
What if I do not keep insurance for my entire program/visa duration?
If you are a J-1 student not keeping health insurance coverage for your entire program period is considered a serious violation of your visa status. Such a violation is likely to lead to a loss of your visa status and end your time at Texas A&M. F students may face administrative consequences for failing to maintain continuous coverage.
Premiums, Co-insurance, Co-payments, Deductibles, and Out-of-Pocket Expenses and Maximums:
Your healthcare expenses will fall into 2 categories. Premiums and Out-of-Pocket Expenses.
A Premium is the price you pay to be enrolled in an insurance plan. For SSHIP this is collected through tuition and fees bills, while for Grad Plan it is collected through a payroll deduction.
Out-of-Pocket Expenses are what you pay to receive individual services. These include Co-insurance, Co-payments, and Deductibles.
Co-insurance is the percentage of the cost that you must pay. For SSHIP your co-insurance is generally 20% for Network Providers. This means for each dollar that the treatment costs you pay 20 cents and the insurance pays 80 cents.
Co-payments are a set fee that you pay for certain services. For example, in SSHIP you have a $10 co-payment for generic prescription drugs and a $35 co-payment for a doctor's appointment.
A Deductible is the minimum amount of money you must spend on healthcare before insurance will pay its share of the co-insurance. For some services the deductible may be waived, meaning that you do not have to pay the deductible before insurance will begin paying co-insurance. In SSHIP and Grad Plan doctor office visits waive the deductible after the co-payment. This means in most cases you will pay only $35 for the visit. The Out-of-Pocket Maximum is the maximum amount of money you will have to pay for health care under most circumstances.
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