Welcome to the Health Care 101 Center! We understand the busy schedule of both parents and kids, no matter what the age. With that in mind, here’s a no-frills, easy-access guide to health insurance benefits.
Insurance 101 is not meant to address your policy specifically (each one of these has its own list of exclusions and limitations). However, this is a generic overview of health insurance types and terminology. If you have a specific question about your policy please give us a call at 1-800-505-4160.
Trying to determine if you should purchase the health insurance plan? Download our tools below for a few tips
Welcome to the Find a Doctor, Hospital, or Lab Center! Whether you’re looking for a doctor, hospital, laboratory, or even medical equipment and supplies, we have the information you need, all located right here.
Preferred Providers are the physicians, hospitals, and other health care providers who have contracted to provide specific medical care at negotiated prices. You should always confirm the Preferred Provider is part of the network, as this can change without notice by calling the Company at 800-505-4160 and/or by asking the provider.
The Preferred Provider for your plan is UnitedHealthcare Choice Plus PPO. If care is received from a Preferred Provider, any Covered Medical Expenses will be paid at the Preferred Provider level of benefits. Reduced or lower benefits will be provided when an Out-of-Network provider is used. By using a Preferred Provider you can also save yourself some out of pocket expenses. Use this link to search for participating physicians, hospitals, facilities, medical equipment, or supplies in your local area.
We recognize the increased need for appropriate mental health treatment for college students. We’ve partnered with United Behavioral Health (UBH) to ensure that you have access to UBH’s network of mental health care providers and facilities. UBH partners with more than 80,000 clinicians and more than 3,500 care facilities nationwide. Clinical excellence, innovation, and a relentless commitment to the most scientifically advanced health care solutions distinguish UBH as the national leader in behavioral health. To find a local Behavioral Health provider in your area, please click the link below:
To file an appeal, please include the following information:
 A letter requesting an appeal to your claim(s), including your:
Name,
Address,
Phone number,
UnitedHealthcare Student ID number,
Date of service for your injury/sickness,
Claim number(s) (located on the top of your Explanation of Benefits), and
Email address.
A copy of your Explanation of Benefits for the claim(s) in question.
Medical Records including all test results from all providers visited for the specific injury/sickness that you are appealing.
Once we receive the documentation, your appeal will be reviewed and a written response will be mailed to you. The response will include what the findings were, if the appeal was approved or denied, and the reason for the final decision.
If you have a question about your claim denial, you may call our Customer Service Department at telephone number 1-800-505-4160 for further explanation to informally resolve your appeal. If you are not satisfied with our explanation of why the claim was denied, you or your authorized representative may request an internal review of the claim denial. (For more information about an authorized representative, please click on “forms†on the left.)
If you would like to submit a paper claim for reimbursement for a prescription that you paid for out of pocket, please print a copy of the Generic Reimbursement Claim Form located below.
After filling out the necessary information, please read the acknowledgement carefully (located at the bottom of page) and sign and date in the space provided.
To submit a Generic Reimbursement Claim Form, please be sure your receipts are complete. In order for your request to be processed, all receipts must contain the information listed below:
Date prescription filled
Name and address of pharmacy
Doctor name or ID number
NDC number (drug number)
Name of drug and strength
Quantity and days’ supply
Prescription number (Rx number)
DAW (Dispense As Written)
Amount paid
This information can usually be found on the receipt which is stapled on the outside of the packaging or in some cases located inside. Your pharmacist can provide the necessary information as well.
If you are a student and would like to check on the status of a claim that you or a provider submitted to UnitedHealthcare, you will need to set up a My Account if you have not already done so.
Please visit our My Account center to log in to an existing account or to create a new one.
It’s easy! Just download the claim form below. Fill out the first page with your personal information, dates of injury or sickness, the cause of the injury or date of first symptoms for a sickness, sign your name with today’s date, and attach all receipts. Please fill out the entire first page and be sure not to leave anything blank.
Your doctor will need to fill out the second page of the form.
Mail Claim Forms to:
FIRSTSTUDENT
P.O. Box 809025
Dallas, TX 75380-9025
Your Doctor can also submit a claim electronically using Emedeon (formerly WebMD). This gives a faster turn-around time than submitting a claim by mail. Check with your doctor to see if they are a participant. If they are, show them your ID Card. The Emedeon information is printed on the back of every ID Card.
If you have any problems filling-out these forms or would like to talk to a customer service representative, you can call us toll free at: 1-800-505-4160 or CONTACT US
Welcome to the NurseLine / Student Assistance Center! Your comprehensive NurseLine / Student Assistance benefit supports you and your eligible dependents with a wide range of issues—all at no cost to you. Our experts can offer trusted advice 24/7 and assist with balancing school and personal responsibilities. We look forward to serving you!
Health questions and issues can come up anytime. With NurseLine you and your family have unlimited access to a Registered Nurse day or night. You can rest easy knowing there’s somewhere to turn for trusted advice when you need it most.
A Registered Nurse can help guide you to the right care at the right time, self-care measures to ease symptoms and treat non-urgent conditions, and dependable information about diseases and medications. NurseLine can help you take charge of your health.
Offer self-care information for non-urgent health issues.
Direct you to the appropriate care for immediate attention.
Explain health conditions and treatments.
Answer questions about symptoms or medications.
Recommend how to treat a fever in the middle of the night.
Tell you if your symptoms mean you have the flu.
Advise how to ease common problems like a sore shoulder.
Inform you of side effects of your medications.
NurseLine is the perfect resource for when you can’t reach your doctor and need immediate answers to your health questions.
Call anytime 24/7 1-866-799-2670.
Student Assistance Program
College life is exciting but it can also be stressful if you are balancing class with personal responsibilities. In addition, you may be facing more serious issues like family matters, depression, or substance abuse that you can’t handle by yourself. Don’t let problems keep you from enjoying college and preparing for the future. Get the help you need today!
Health Advocate will provide you with the right tools to help you through some of life’s toughest challenges. Students can call Health Advocate’s toll-free number for confidential, short-term professional assistance, focusing on coping skills for a full range of emotional, family, and other personal issues.
Health Advocate is an added bonus when you enroll in a UnitedHealthcare student medical plan. Your Health Advocate benefit, provided by College of Saint Elizabeth, includes three important features: Healthcare Help, MedChoice Support, and Medical Bill Saver. This all-in-1 benefit is designed to help you and your enrolled dependents personally navigate the healthcare maze, make better decisions about your medical care, and lower your medical bills.
What is Health Care Help?
You have unlimited access to a Personal Health Advocate (PHA), typically a registered nurse, supported by medical directors and billing and claims specialists. The PHA can help you resolve a full range of clinical and insurance-related issues quickly and dependably, saving you time, money, and worry.
How Does it Work? If you have a healthcare or insurance-related issue, call our toll-free number. You’ll be assigned a PHA who can help you with issues from finding qualified providers and services, to clarifying health coverage, addressing claims and billing concerns, to offering cost estimates for common medical procedures.
Reasons to Call
Find the right doctors, hospitals,
Schedule tests, appointments,
Secure second opinions,
Untangle Claims, billing errors,
Navigate your insurance plan,
Explain conditions, treatments, and
Help you make informed decisions.
MedChoice Support
What is MedChoice Support? MedChoice Support is an interactive online tool that helps you weigh the pros and cons of procedures, treatments, and medications, including the risks and potential outcomes to help you make the right decisions about your care.
How can it Help?
Step-by-step guidance for healthcare decisions, using evidence-based information, on topics from surgery to alternative treatments,
Personal assessments gauge feelings and decisions, and
Downloadable summary to share with your healthcare team.
What is Medical Bill Saver?
The Medical Bill Saver feature provides skilled negotiators who will work with your providers to lower your out-of-pocket costs on your medical or dental bills over $400 not covered by your insurance. We can attempt to negotiate bills to help reduce the balances that apply to deductibles and coinsurance.
How can it Help?
Negotiation can result in 25-50% savings.
Easy-to-read personal Saving Result Statement, summarizing outcome and payment terms.
Provider sign-off on payment terms and conditions.
All three features are available to students and their dependents who are enrolled in the UnitedHealthcare student medical plan. If you have a question about who is covered for service, simply call us.
To view or print the PDF files, you’ll need a free utility called Adobe Reader. If you already have Adobe Reader and still have trouble opening these forms you might need to download the most recent version of Adobe Reader.
If you would like a parent or another specific person to assist you with filing your claim(s) and to be able to discuss details of your claim(s) with our claim department, you will need to complete and sign this form. The Yearly Authorization Form gives us permission to discuss any and all medical conditions with your Personal Representative throughout the school year. This form is filled out once and is good for every injury/sickness for the entire school year.
If you would like a parent or another specific person to assist you with filing your claim and to be able to discuss details of your claim with our claim department, you will need to complete and sign this form. The Specific Case Authorization Form gives us permission to discuss only one specific medical condition with your Personal Representative, as you would specify on the form.
Enrollment Form – N/A for College of Saint Elizabeth
This is the form that you will use to sign up for the School Injury and Sickness plan. It will show you the rates, coverage periods, and any optional coverages available to you.
This form can help you get reimbursed for all covered medical benefits which you have already paid out of pocket. Please keep in mind when you are requesting reimbursement:
Clip, do not staple, all bills to the completed form.
Make sure all bills or itemized receipts indicate a diagnosis code, procedure code, date of service, cost, and the provider’s tax ID number.
Mail claim to: UnitedHealthcare StudentResources P. O. Box 809025 Dallas, TX 75380
Please download this form if you’ve received a request from us for more information regarding a claim submitted by your doctor or if you would like to speed up the claim process. By providing the injury/sickness information we are able to process your claim accurately and efficiently.
Mail to:
UnitedHealthcare StudentResources
PO Box 809025
Dallas, TX 75380-9025
This form is used for reimbursement of prescription drugs. If you did not present your ID card when you purchased your prescription out of pocket, you will need to submit this form for a refund. Along with this form for prescriptions filled at a network pharmacy, please attach the paid prescription receipt and the paid cash receipt to:
This form describes how we will obtain your written authorization prior to use or disclosure of your health information. We are required by law and committed to protecting the privacy of your health information. This form explains how we may use information about you and when we can disclose that information to others. You also have rights regarding your health information that are described in this notice.
Anytime you travel more than 100 miles from your home or to another country and experience a medical emergency, you can make a single phone call to the Operations Center for help! You call will be answered by a medically-certified crisis managers who can put in motion a vast number of emergency resources to solve any problem, 24/7.
This program provides discounts on a wide variety of health care services from a nationwide network of health care professionals and facilities. This booklet describes the products and services available to you at discounted rates. There is no additional charge to you for the discount program.
Welcome to the Student & Dependent Enrollment Center! Here you will find all the necessary tools to enroll in your school sponsored policy.
We suggest you review the brochure for your rates, effective dates and optional coverages before starting the enrollment process. The plan’s benefits can be found in the brochure within the Schedule of Benefits section with the exclusions towards the back.
All full-time Undergraduate Students taking 12 or more credit hours
All full-time Graduate Students taking 9 or more credit hours
All Students in the Dietetic Internship Program
All Students in the EOF Program
All Full Time International students, regardless of the number of credit hours, are automatically enrolled in this insurance plan at registration
Are automatically enrolled in this insurance Plan at registration, unless proof of comparable coverage is furnished.
You can also enroll yourself now by clicking “Enroll Now†below to avoid receiving future reminders and begin using your plan.
Hard Waiver Student Enrollment Instructions
Enrollment Deadlines:
ANNUAL Enrollment Deadline:Â 10/1/16
SPRING/SUMMER Enrollment Deadline:Â 2/13/17 (for new incoming students)
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(NOTE: Enter your 10 digit STUDENT ID#, using the letter P as your first number, in the Student ID# Box to gain access. (example: P000055555)
If you have missed the hard waiver enrollment deadline, but have not previously waived out of the insurance, you will be automatically enrolled in the insurance by your school, after the waiver deadline.
If you have previously waived out of the insurance but have since lost coverage due to a Qualifying Life Event please contact us.
Please note: If you do not enroll for the year during the fall open enrollment period, you will not be able to enroll later during the 2016-2017 school year without experiencing a “Qualifying Life Eventâ€. This means that the loss of coverage is no fault of your own or the policyholders (i.e. you get married or become too old to be on a family plan). You will be eligible to enroll within thirty days of this “Qualifying Life Eventâ€. After thirty days, you will no longer be eligible.
Dependent Enrollment
Eligible students who do enroll may also insure their dependents. Â Please see the Enrollment Instructions below.
Deadlines:
Annual Enrollment Deadline:10/1/16
Spring/Summer Enrollment Deadline:2/13/17Â (For new incoming students only)
Enroll by Mail
Dependent ONLY – Enrollment Form
To enroll by mail-download an enrollment form and submit by mail using a check or money order. The mailing address is listed on the back of the Enrollment Forms.
The effective date of your dependent’s coverage will be start date of the coverage period you enrolled in
If you did not enroll your dependent during the annual open enrollment period but your dependent has since lost coverage due to a Qualifying Life Event please contact us.
Open Enrollment Periods
If you are a student in the Fall semester and eligible to purchase coverage and you choose not to enroll for coverage before the Annual Enrollment Deadline of *October 1, 2016, you will not be eligible to enroll again until the start of next Fall unless you experience a “Qualifying Life Event†during the year.
*For new students in the Spring semester, your open enrollment deadline is February 13, 2017.Â
Qualifying Life Event
Students who did not enroll themselves during the open enrollment period may be able to enroll in the policy if they experience a Qualifying Life Event.
Qualifying Life Events include:
Acquiring a new family member
Marriage/Civil Union
Divorce
Loss or change of Job
Expiration of Benefits
If you meet the requirements for a Qualifying Life Event, you will need to provide the following:
Proof of qualifying life event/proof of involuntary loss of coverage
Enrollment Form
Payment
All documents and payment must be received within 30 days of the qualifying life event. After 30 days, the student or will no longer be eligible to enroll in the plan, until fall of the following school year.
Please Contact Us for cost and enrollment information as a Qualifying Life Event.
If you have any questions about the enrollment process, please call 800-505-4160 or CONTACT US
