Welcome to the Policy Information Center! You will find everything you will need to know about your policy in your plan certificate such as eligibility, effective and termination dates, plan benefits, any exclusions or limitations, and instructions on how to file a claim.
2022 – 2023 School Year
Welcome to the Customer Service Center! We are excited to assist you with any and all questions you may have regarding your policy.
On the left hand side we have provided you with a number of links and downloads for immediate access to any questions you may have regarding your school’s student insurance plan.
If you don’t see what you are looking for, or would like to speak to a live representative, it will be our pleasure to assist you.Â
For questions regarding:
Please call 1-888-251-6253 to speak to a live customer service representative, toll free, 7 am – 7 pm CST.
Email Us
For questions and issues about the following:
Please Contact 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.
Personal Representative Appointment Form (PRA)/Yearly Authorization Form
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.
Specific Case Authorization Form
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.
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:
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
Or fax to:Â
469-229-5625
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:
OptumRx Claims Department
P.O. Box 29044
Hot Springs, AR 71903
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.
UnitedHealth Allies Discount Services
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.
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.
A Licensed Professional Counselor will…Â
Call anytime 24/7 1-866-799-2670.
REMEMBER: Call 911 or go to the ER in an emergency.
Welcome to the Waive Your School’s Insurance Center!
This page is for those students who wish to opt-out (waive) out of the coverage under their school’s student insurance plan. The school’s student insurance plan can only be waived if the student has coverage under a government sponsored plan or Employee sponsored Plan.
The first step to waive out of your school’s student insurance coverage is to verify that you are an eligible student.
 2022-2023 Waiver Information
Hard Waiver Student Eligibility
All international F-1 and J-1 students are required to enroll in this insurance Plan at registration unless proof of a government sponsored plan or Employee sponsored is furnished. Eligible students who do enroll may also insure their eligible Dependents. Â US Citizens are not eligible for coverage as a student or dependent.
For those students who do not submit an approved waiver form before the deadline, you will be required to purchase the Student Health Insurance Plan. Please refer to the “Enroll Now†tab for further instructions.   If you do not meet one of these requirements a hold will be placed on your student account and you will be unable to enroll in classes.
Once enrolled there are no refunds or cancellations.
Please Note:Â If you waive the insurance you will not be eligible to enroll until the following semester unless you experience a Qualifying Life Event.
Hard Waiver Student Waiver Instructions
Waiver Deadlines:
Please note to submit your waiver you will be asked to login using your Webster Student ID number.Â
After you verify that you are a hard waiver student and have other insurance you will need the following to waive:
Once you have completed the waiver form, an email will automatically be sent to the email address you provided notifying you of the waiver request decision. If you receive a:
Please Note:Â If you waive the insurance, you will not be eligible to enroll until the following semester, unless you experience a Qualifying Life Event.
If you did not enroll during your open enrollment period and have since lost coverage under your original plan, you may qualify for a Qualifying Life Event upon providing proof of involuntary loss of coverage and payment within 30 days of losing coverage.　(example: marriage, divorce, loss of job, etc) The enrollment form, check or money order, and the letter of creditable coverage must be received within 30 days of losing coverage. After 30 days the student 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 1-888-251-6253 or CONTACT US
We are always happy to help in any way.
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Welcome to the Customer Service Center! We are excited to assist you with any and all questions you may have regarding your policy.
On the left hand side we have provided you with a number of links and downloads for immediate access to any questions you may have regarding your school’s student insurance plan.
If you don’t see what you are looking for, or would like to speak to a live representative, it will be our pleasure to assist you.Â
For questions regarding:
Please call 1-888-251-6253 to speak to a live customer service representative, toll free, 7 am – 7 pm CST.
Email Us
For questions and issues about the following:
Please Contact Us
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:
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.
Please mail completed form and receipt(s) to:
OptumRx Claims Department
P.O. Box 29044
Hot Springs, AR 71903
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 1-888-251-6253.
Trying to determine if you should purchase the health insurance plan? Download our tools below for a few tips
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.
Mail Claim Forms to:
UnitedHealthcare StudentResources
PO Box 809025
Dallas, TX 75380-9025
Submit a Claim Electronically
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:Â 1-888-251-6253 or CONTACT US
