Health Insurance Basics – A&M Student Health Insurance Primer


Who Is Covered? 

Every Texas A&M F-1 and J-1 student will have SSHIP health insurance coverage unless they have received a waiver that verifies their alternative equivalent coverage. Students who are Graduate Student Employees may enroll in Grad Plan.  Under either Texas A&M plan the student is able to add dependents to their plan at an additional cost. J-2 dependents must have health insurance coverage. Students with equivalent alternative coverage will need to consult their insurer for details.  

 

What Is Covered? 

Different health insurance coverage will cover and exclude different kinds of healthcare services.  If you have SSHIP or Grad Plan you can find comprehensive information below:

The Plan Highlights document explain the general benefits of the policy. 
 

Under SSHIP and Grad Plan most dental work is not covered. Dental coverage is provided only for students and dependents who are 18 years old or younger.  Students may enroll in dental insurance with the following link: https://tamusahpdental.myahpcare.com/enrollment. Insurance from other rources may already include dental insurance.  If you have health insurance from another source you will need to contact your insurer to find out more about your coverage.  

 

Where Can I Get Care? 

Once your coverage begins you have many options for when, where, and how to receive healthcare services.  Often the cheapest option will be to go to Student Health Services:

 

Student Health Services is only available to students, not their dependents even if those dependents are enrolled in SSHIP or Grad Plan. For all other services finding a Network Provider will generally be the most cost effective option. You can find Network providers at - Network Provider.  You may still go to Out-of-Network Providers but many costs are likely to be higher with an Out-of-Network Provider.  

 

How Much Does Using My Insurance Cost? 

In general you will pay a small co-payment for routine doctor appointments and care.  For example, the SSHIP and Grad Plan co-payment for a doctor's visit is $35.  You may also be responsible for paying Co-insurance. This a percentage of the cost of any healthcare service. This percentage ranges from 40% to 0%. Most services under SSHIP and Grad Plan have a 20% Co-insurance rate if you use a Network Provider. This means that you pay 20% and the insurance pays 80%. Using Out-of-Network Providers will likely be more expensive than Network Providers. 

 

Many healthcare services for students can be obtained for free or at reduced cost from Texas A&M Student Health Services. 

Academic Blue Advantages of Membership 

SSHIP and Grad Plan offer a wide range of benefits designed to maintain your health, improve wellness, and provide support for your health. These include programs to manage stress and behavioral health issues, free or low-cost alternatives to emergency room visits, telemedicine services, and mental health professional access and referral. Below you'll find programs available with a brief description.  

You can learn more about all of them at https://tamu.myahpcare.com/benefits

 

Blue Access for Members (BAM) 
You can access information about your plan through the website at https://www.bcbstx.com/member.On this site you can see the status of your claims, print a temporary ID card, and sign up for alerts about claim activity. You will need the information below to log in. 

  • The Group Number is 117557 and 

  • Your Member ID is your Student Specific UIN. You are required to place the letters “ZGP” prior to your UIN (example: ZGP120034567) 

You will receive an ID card after you sign up for SSHIP/Grad Plan. To receive the card you have a U.S. mailing address entered into your Howdy account. If you need health care before it arrives and need to print a temporary ID card or if you never received your ID card, you can request another at https://www.bcbstx.com/member .

BCBSTX App - This app provides all the services available on the Blue Access for Members website 

Blue Card PPO - Tips for using your coverage when away from your local area 

 

Maintaining Health & Fitness 

Blue Care Connection - programs and tools for health assessment, fitness, lifestyle management, health education and prenatal & post-partum education.  

myStrength - Online program that provides tools for managing stress. Includes community resources and private exercises 

Blue365 - Discount program for health services and retailers such as vision care and weight loss programs  

Tobacco Cessation: Program that covers counseling and medication to quit smoking or other tobacco use. 

Covered Contraceptives: Details the contraceptive devices and medication covered. 


24/7 Help

Nurseline - 24 hour phoneline; registered nurses available to answer health questions  

Student Assistance Program - 24/7 access to mental health services; these services include crisis intervention when you are feeling overwhelmed. 
 

Finding A Health Provider 

Choosing Your Level of Care - Provides students information on what kind of health provider to seek. If you have a fever should you go to urgent care or the emergency room? If you have questions about medications should you go to the doctor's office or go to the student health center? 

Virtual Visit by MDLIVE - Online virtual access to a doctor when Student Health Services are closed. For non-emergency cases. Counselors and therapists are available in addition to medical doctors. 

Network Provider Search - Use this tool to find a Network Provider that fits your needs

Behavioral Health Referral - Find a Network provider that is equipped to help you with your mental health needs. 
 

COLLEGE STATION CAMPUS HEALTH SERVICES 

Student Health Services - College Station  

First resource for health care services  

A.P. Beutel Health Center, 

311 Houston Street, Building 520 

College Station, TX 

(979) 458-8310 

Open weekdays 8am - 5pm 

https://shs.tamu.edu/ 

 

Counseling & Psychological Services - College Station 

Mental health and Counseling services on campus 

Student Services Building, 4th Floor 

 471 Houston St. | 1263 TAMU 

 College Station, TX 77843-1263 

 979.845.4427 

Open Weekdays 8am - 5pm 

https://caps.tamu.edu/ 


 

GALVESTON CAMPUS HEALTH SERVICES 

Student Health Services - Galveston  

First resource for health services as a student 

UTMB Family Medicine Clinic 

Primary Care Pavilion 

400 Harborside Drive 

Galveston, TX 

(409) 772-2166 

Hours: 9am to 4pm Monday-Friday, except holidays 

http://www.tamug.edu/counsel/Resources/HealthServices.html 


Counseling - Galveston 

Mental health and Counseling services on campus 

Building 3030 

Seibel Student Services Center, Suite 104 

3030 Texas Clipper Rd 

Galveston, TX 

(409) 740-4741 

Hours: 8am - 6pm Monday-Friday, except on holidays 

http://www.tamug.edu/counsel/ 

Do I need insurance? Why? 

  • Yes, you need to have health insurance coverage for your entire time at Texas A&M. All F-1 and J-1 students and J-2 dependents are required by A&M to have health insurance coverage. J-1 and J-2 visa holders are required by Department of State regulations to have health insurance coverage. Health Insurance coverage is also a practical necessity in the U.S. where healthcare costs can be extraordinarily expensive. Paying for all services personally is not feasible for most people. 

 

Do I have to purchase the System Student Health Insurance Plan (SSHIP)? 

  • While all international students are charged for SSHIP automatically the charge can be waived through a waiver process.  

 

I have 2 SSHIP charges, why?  

  • If you are a first time student you have likely been charged for the SSHIP for both the Fall Coverage period and the August coverage period from 08/01 - 08/31. If you have been double charged for a single coverage period contact ISS at iss@tamu.edu Please include your name and UIN in your email. 
 

I will be studying or otherwise outside of the U.S. for a significant amount of time. Do I have to pay for insurance for the time I am out of the country? 

  • Yes, according to TAMU Regulation #26.99.01 a person who leaves the U.S. and maintains their immigration status with the intent to return must be covered under SSHIP, Grad Plan, or have received a waiver. 

 

Do those with Graduate Assistantships  have to enroll in Grad Plan? 
  • No, you may choose not to enroll. However, you will still be charged for SSHIP and will still need to go through the waiver process to have that charge removed or refunded.  

 

How do I get a waiver? 

  • You can apply for the waiver here:
    • ​Students who are physically present and enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
    • Students who are physically present and enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver
  • Please be aware of the deadlines for applying for the waiver. Late applications will not be considered and you will be responsible for any fees. 
 

What documents do I need to get a waiver? 

  • To prove that you have Equivalent Alternative Coverage you need to submit photocopies of the front and back of your insurance card and a copy of your policy including the  schedule of benefits and limitations and exclusions. 

 

How and where do I submit them? 

  • You can submit the documents and find further instructions below. 

    • ​Students who are enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
    • Students who are enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver
  • ISS does not handle the waiver applications. We cannot help you with information regarding the status of your request. Please allow up to 10 business days for AHP to process your application.  


What is the deadline to get a waiver? 

  • The dates for upcoming coverage periods can be found here. 
    • ​Students who are physically present and enrolled at Texas A&M University Main Campus in College Station can view the coverage periods at https://tamu.myahpcare.com/waiver
    • ​Students who are physically present and enrolled at Texas A&M University Main Campus in College Station can view the coverage periods at https://tamug.myahpcare.com/waiver

 

I am enrolled in Grad Plan and I was charged for SSHIP. 

  • If you are enrolled and covered in Grad Plan from September 1st for the Fall coverage period or within the month of January for the Spring/Summer coverage period the SSHIP fee should be removed. If it is not removed contact ISS@tamu.edu you may wish to pay the fee to avoid any late charges and receive a refund at the end of the semester. 

  • If you enrolled and started coverage either after September 1st for the Fall coverage period or within January for the Spring/Summer Coverage period then you will be charged for SSHIP for the entire coverage period. At the end of the coverage period AHP will review your account for periods of double coverage and refund you for the time you were paying for both SSHIP and Grad Plan.  

    • For example, if your Grad Plan coverage starts on October 5th, then you will pay for both SSHIP and Grad Plan through the end of the Fall coverage period. Then after the end of the coverage period you will receive a refund for the SSHIP charge based on the amount of time you had both SSHIP and Grad Plan 

 

Why was my waiver application not approved? 

  • ISS does not process the waiver applications and does not know why any individual application was rejected. To find out more information about why your application was rejected you should contact AHP at support@ahpcare.com or 877-624-7911.  As a general matter AHP must see that any documents you submit as proof of Equivalent Alternative Coverage meet federal minimums and Texas A&M University System requirements. A part of the required coverage that many plans do not meet is Academic Emergency Services, so be sure to check if your plan covers it. If not, you will need to purchase it separately.  

 

What is Academic Emergency Services (AES) and how do I purchase it? 

  • Academic Emergency Services covers the medical costs to transport the person back home to receive care, or, in the event of their death, to transport their remains back their home country. If necessary you can purchase this coverage separately.  


Are my dependents eligible for insurance? Are they required to have insurance? 

  • Dependents are eligible for enrollment in both SSHIP and Grad Plan for an additional cost. Please note that J-2 dependents are required to enroll in SSHIP, Grad Plan, or Equivalent Alternative Coverage for the duration of the program period.  F-2 dependents do not have requirement from Texas A&M University System or the federal government but keeping continuous coverage is highly recommended for all dependents. You can enroll dependents for SSHIP here  


If an employer provides insurance coverage, can I use it? 

  • Yes, as long as the employer coverage meets all of the requirements set by federal law and TAMUS regulations, including AES coverage you may apply for a waiver from SSHIP fees.

    • Students who are physically present and enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
    • Students who are physically present and enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver
  • Please be aware of the deadlines for the period that you are seeking a waiver. If you obtain insurance after the deadline you are not eligible for a waiver. 


Can I keep my insurance when I graduate? 

  • Yes, Continuations of Coverage through SSHIP can be completed through AHP at 
  • Former students who have graduated or are otherwise ineligible for coverage and who have been continuously insured under the policy for three (3) months, are eligible to continue their existing coverage for a period up to three (3) months under the school’s policy. 

  • Continuations for Grad Plan use the GSE Continuation Enrollment form. Continuations for SSHIP use the Non-GSE Continuation Enrollment Form. Forms must be submitted with the applicable premium to AHP within 30 days after the expiration date of the student coverage. Contact AHP at (877) 624-7911 for details. 
    College Station Enrollment  
    Galveston Enrollment 
     

Can I enroll myself or dependents outside the open enrollment period? 

  • Students who lose coverage under another health care plan are eligible to enroll for coverage under the policy within 30 days of the termination of the coverage. Students will need to send a “Qualifying Events” form available at the following sites, based on campus:
  • You will also be required to submit proof to AHP. Proof may be a copy of the Certificate of Creditable Coverage, or a letter of ineligibility (lost coverage), from their previous health insurer, or other legal documentation.  A qualifying event includes but is not limited to: 
    • Loss of Coverage from a previous health insurer 
    • Birth or adoption of a child 
    • Loss of a spouse, whether by death, divorce, annulment or legal separation
    • The premium will be prorated based on what it would have been at the beginning of the semester. However, the effective date will be the later of the following: the date the student enrolls for coverage, or the day after the prior coverage ends. 


​Do I have to pay for the whole spring/summer coverage period? 

  • The Spring/summer coverage period is from January 1 through August 31. There are no early terminations for the policy. 


​I am a F or J student, my spouse is a TAMU employee and I am enrolled in their plan. Do I still need to apply for a waiver?  

 

Is dental covered? How do I get coverage? 

Is vision covered? 

Vision is not covered for adults, but it is covered for dependent children under 19. 

 

How do I get healthcare services? 

All students are eligible to receive services from Student Health Services. This includes many routine services such as doctor's appointments, a pharmacy, and preventative medicine. For more information, please visit the Student Health Services websites listed below, based on campus.  

  • College Station Student Health Services at http://shs.tamu.edu/services/
  • Galveston Student Health Services at http://www.tamug.edu/counsel/Resources/HealthServices.html
  • For other services and dependents SSHIP and Grad Plan users can use the Network Provider tool to find a provider. SSHIP and Grad Plan are both Blue Choice Preferred Provider Organization Network Plan.
  • You may also use Out-of-Network Providers, but be aware that services may cost you more.
  • If you have a plan other than SSHIP or Grad Plan you will need to contact your insurance provider for details. 

How can I find out more about my benefits? 

 

All these health insurance terms are confusing, where can I find some definitions? 

  • You can find definitions and key concepts explained on this website under "Introduction"  

 

How do I get an insurance card? 

  • The BlueCross BlueShield cards are sent through the mail to the local mailing address on your Howdy Account in 10 to 14 days from the beginning of the coverage period. However, if you did not have a U.S. local mailing address in Howdy at the time BCBS mailed the cards, they may have been sent to a default address, and returned to BCBS. You can request your ID card through logging in to Blue Access for Members at http://www.bcbstx.com/member and using the BAM Login information. 

  • The Group Number is 117557 and 

  • Your Member ID is your Student Specific UIN. You may be required to place the letters “ZGP” prior to your UIN. (example: 120034567) 

 

If I have to pay out-of-pocket for a covered expense how do I get a reimbursement? 

 

I will be studying in Qatar for a semester or more, do I still need to pay the student insurance fee?  

  • Yes, as long as you are an enrolled student and maintain your immigration status you must pay the student insurance fee. QLM, the insurance offered while in Qatar, does not qualify for a waiver. 

 

What are low cost options for dental care? 

  • Blinn College has a Dental Hygiene Program that periodically provides dental screenings. Contact 979-209-7283 for details and appointment availability. The location is 301 Post Office Street, Bryan, TX 77801. 

I received a letter requesting a SSN/ITIN from Blue Cross Blue Shield of Texas, what should I do? 

  • The letter you received is a request for SSN or ITIN so that BlueCross BlueShield (BCBS) can send the correct Affordable Care Act documentation if required. If you are not employed, you may disregard the letter. If you have been authorized employment, you will need to send BCBS your information so that you will receive the correct documentation for any tax requirements: Login at  Blue Access for Members (http://www.bcbstx.com/member) with your Member ID (Student Specific UIN#) and Group Number 117557. 

  • Click on the “Contact Us” link. This will direct you to a secure mail email format. 

  • The Student needs to fill out the information requested 

    • At the To: dropdown, choose the (Membership Maintenance (Change of Address), 

    • Continue filling out the form with any changes of address or SSN/ITIN information, 

    • Click Submit 

Why did I receive dental insurance card if I did not buy the dental insurance plan? 

  • If you received a dental insurance ID card and did not enroll in dental coverage, it may be due to your age. Pediatric routine dental care may be included under the age of 19. 

What should I do if I lose Grad Plan and I am still a student?
  • If you lose Grad Plan for any reason in the middle of the semester then you should apply to be added to the SSHIP plan under a Qualifying Event enrollment. You can find more information on how to enroll at the following link. https://tamu.myahpcare.com/enrollment
  • If you lose Grad Plan for any reason at the end of the semester AND you are not enrolled in classes in the following semester (example: A GSE that works only during the Spring semester and is terminated in the summer and who is NOT enrolled in classes in the summer) then you should enroll in the SSHIP plan. You can find more information on how to enroll at the following link. https://tamu.myahpcare.com/enrollment
  • If you lose Grad Plan for any reason at the end of the semester AND you are enrolled in classes in the following semester then you do not need to do anything. You will be charged by the University for SSHIP coverage when you enroll for classes. This is true for the transition between Spring and Summer as well.

 

You can find definitions for many health care terms at Glossary of Common Medical and Health Care Terms.


Additional Terms and Clarifications 
 

4 Ever Life -The company that provides AES. 

ACA -The Affordable Care Act; Federal law that requires most people in the U.S. to have health insurance that meets certain requirements. (link to ACA requirements); Also known as PPACA 

Academic Blue - Another name for SSHIP/Grad Plan 

Academic Health Plans (AHP) -  The company that handles enrollment, waiver processing, and information on SSHIP and Grad Plan 
AES - Academic Emergency Services; Insurance coverage that provides medical evacuation and repatriation coverage, among other services. It can be bought in addition to other health insurance to meet TAMU requirements.  

Alternate Equivalent Coverage - health insurance coverage that is sufficient to grant a waiver from SSHIP 

A.P. Beutel Health Center – College Station Student Health Center 

Benefits - The services, treatments, and medical devices that health insurance will pay for. Benefits often require that the Insured pay co-insurance, a co-payment, and/or a deductible before the insurance will pay. 

Blue Access for Members - Online web portal where those with SSHIP or Grad Plan can find information about their health insurance. 

Blue Card – Program that provides you access to healthcare services and BCBSTX payment of benefits when outside the covered area. I.e. if you are traveling outside of Texas this program ensures that BCBSTX pays for your care as if you were in Texas. 

Blue Cross Blue Shield of Texas (BCBSTX) - The company that provides SSHIP and Grad Plan. 

Coverage Period – The period of time that the insurance is in effect. This is usually for a period of several months. For example the SSHIP  has coverage periods of 09/01/19 - 12/31/19 for Fall and 01/01/20 - 08/31/20 for Spring/Summer 

Deductible - Amount that the Insured must pay Out-of-Pocket before benefits will be paid. When a deductible is "waived" it means that one does not need to pay it before benefits will be paid. 

Dental Insurance – Insurance that covers most dental care. If enrolling in SSHIP or Grad Plan dental insurance must be purchased separately. This can be done at (link) 

Dependent – A person, such as a spouse or child, that gets health insurance through another person. A student might enroll their spouse or children as dependents in SSHIP, Grad Plan, or other health insurance. Adding a dependent increases the premium and may affect the policy's deductible 

Exclusions & Limitations – The medical expenses, treatments, services, devices, etc. that the plan will not pay for. These will be listed in your policy materials. Also called: Excluded Services 

Fall Mandatory First Time On-Campus Arrival - The period of time that first-time students are required to be on campus before the beginning of the first coverage period. This period will require health insurance just like any other. SSHIP will automatically be billed to students but students can obtain a waiver through the standard waiver process.  

  • Students who are physically present and enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
  • Students who are physically present and enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver

Grad Plan – The plan offered to students with a graduate assistantship. Enrollment in this plan will remove the fee for SSHIP if coverage starts on or before September 1st in the Fall coverage period or January 31st in the Spring/Summer coverage period. If enrollment occurs after these date the student will receive a refund for months of double coverage in the following semester. 

  • Students who are physically present and enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
  • Students who are physically present and enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver

Graduate Student Employee – Any person who is both enrolled as a graduate student and working as a benefits eligible employee at Texas A&M. 
Group Number -  A number that identifies the employer or group plan that you are a member of. 

HIPAA – Health Information Portability and Accountability Act; federal which protects your private health information from being shared. 

Inpatient – You are an inpatient if you are staying at a hospital for treatment. 

Member ID – A number that identifies you and your membership to a health insurance plan 

Network Provider – A hospital, doctor, or other provider that an insurance company has a contract with. The intent of such contracts is to reduce costs. Receiving care at a Network Provider will be cheaper in most cases. Also called In-Network Provider 
Open Enrollment Period – The period of time that a student or dependent can be enrolled in an insurance plan. 

Out-of-Network Provider – Any hospital, doctor, or other provider that an insurance company does not have a contract with. Care at Out-of-Network Providers will likely be more expensive. 

Outpatient – You are an outpatient if you receive care but are not admitted to the hospital, or if you receive services in an emergency, or any other circumstance where you are not considered an Inpatient. 

Out-of-pocket – Cost of a service, treatment, medical devices, etc. that the insured is responsible for paying. This can include co-insurance, co-payments, and deductibles. 

Qualifying Event – Qualifying events are the circumstances when you can enroll in health insurance or add a dependent outside of the open enrollment period. This potentially includes; getting married, the birth or adoption of a child, or the loss of insurance from another source. 

Referral- A referral is formal way to recommend the services of a health provider. Some Providers only accept patients with a referral from another provider. Sometimes your Health Insurance Plan my require you get a referral to see certain providers. 
Student Health Services - A collection of health services offered on-campus to Texas A&M students. Services obtained here are often free or cheaper for students. Services include prescription drugs, preventative medicine, physical therapy, doctor appointments, and Emergency Services among others. Note that Dependents of students are not eligible for services at Student Health Services. 

System Student Health Insurance Plan (SSHIP) - The health insurance that all students are automatically enrolled in. This is done to ensure that students do not violate their visa status or TAMU system regulations by having gaps in health insurance coverage. The cost of the plan is charged to the student's tuition. Students who wish to not pay for SSHIP must show proof of equivalent coverage via the waiver process. 

  • Students who are physically present and enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
  • Students who are physically present and enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver

Telemedicine – Telemedicine is when you receive medical services from a doctor or other health professional through telecommunication technology like video conferencing, Virtual Visits, or online chats. 

Virtual Visits – Service offered by SSHIP and Grad plan to have non-emergency medical appointments and mental health counseling using telemedicine.  

Waiver – Document you need to avoid an SSHIP fee or have it refunded. You can find more information on the process here: 

  • Students who are physically present and enrolled at Texas A&M University Main Campus in College Station, Texas will apply for a waiver though the College Station Waiver website at https://tamu.myahpcare.com/waiver
  • Students who are physically present and enrolled at Texas A&M University at Galveston will apply for a waiver though the Galveston Waiver website at https://tamug.myahpcare.com/waiver

Worldwide Insurance Services Inc. - The company that administers AES 

Insurance plans submitted for a health insurance waiver application will only be approved if: 

They meet ONE (1) of the following criteria: 

  1. The plan is a sponsored plan of a US or foreign government, or embassy. 
  2. The plan is an employer provided group health plan. 
  3. The plan is provided by intercollegiate athletics and coverage for all medical insurance is provided through a policy as part of the current sports accident medical policy approved by System Risk Management.  

AND all of the following: 

  1. The policy provides the Essential Minimum Benefits required by the ACA with no annual limits. (See below for a list of required benefits).
  2. The policy annual deductible is no more than $500 (except for employer plans). 
  3. The policy must cover the entire coverage period 
  4. The policy contains no exclusions for pre-existing conditions 
  5. The policy covers 100% of preventative care as defined by the ACA.
  6. The policy covers repatriation expenses of at least $25,000* 
  7. The policy covers medical evacuation expenses of at least $50,000* 

*If a submitted policy does not cover these expenses then such coverage may be bought separately, if such coverage is the only deficiency in the plan. In such a case once a student buys such coverage they will be granted a waiver. 

Essential Minimum Benefits 

  1. Ambulatory patient services  
  2. Emergency services  
  3. Hospitalization (such as surgery)  
  4. Pregnancy, maternity, and newborn care (care for a mother and baby before and after the baby is born)  
  5. Mental health and substance use disorder services, including behavioral health treatment, counseling and psychotherapy  
  6. Prescription drugs  
  7. Rehabilitative and habilitative services and devices  
  8. Laboratory services 
  9. Preventive and wellness services and chronic disease management
  10. Pediatric Vision and Dental Care