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File a Prescription Claim

File a Prescription Claim

 

Welcome to the File a Prescription Claim Center! We understand the hassles that come along with filing your claims, which is why we want to make this process as quick and painless for you as possible. Below you will find all the information you will need to file a prescription claim.

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 Reimbursement Claim Form located below.

After filling out the necessary information, please read the acknowledgement carefully (located at the bottom of page1) and sign and date in the space provided.

To submit a 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 if not.

Please mail completed form and receipt(s) to:

OptumRx Claims Department

P.O. Box 29044

Hot Springs, AR 71903

 

Waive Your School’s Health Insurance

Waive Your School’s Insurance

 

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, and have the fee removed from their student account. The school’s student insurance plan can only be waived if the student has coverage under another acceptable insurance plan.

Submitting a waiver, is as easy as 123! The first step to waive out of your school’s student insurance coverage is to verify that you are a “hard waiver” student.

2013 – 2014 School Year

A hard waiver student for your school is:

If you are a……
registered full-time student taking 12 credit hours you are automatically enrolled in the Full-Time Student Insurance Plan (2013-200952-91) at registration and do not have the option to waive.
If you are a……
registered part-time student taking less than 12 credit hours you are automatically enrolled in the Part-Time Student Insurance Plan (2013-200952-92) at registration and do not have the option to waive.
If you are a……
registered full-time Intercollegiate Sports participants, except hockey or in-line hockey you are automatically enrolled in the Intercollegiate Sports Insurance Plan (2013-200952-98) at registration and do not have the option to waive.

 

If you have any questions about the waiver process, please call 800-505-4160 or

We are always happy to help in anyway.

 

Travel Assistance, Evacuation & Repatriation

As a UnitedHealthCare member you are eligible for global emergency and medical assistance services provided by UnitedHealthCare Global. This program immediately connects you to doctors, hospitals, pharmacies, and other services if you experience a medical emergency while traveling 100 miles or more from your permanent residence, campus location, or in another country.

UnitedHealthCare Global Brochure  Â

UnitedHealthCare Global Flyer

One simple phone call to the number on your UnitedHealthCare Global identification card will connect you to:

  • A global network of pre-qualified medical providers.
  • Experienced crisis management professionals.
  • A state-of-the-art Emergency Response Center with worldwide response capabilities.
  • Air and ground ambulance service providers.

UnitedHealthcare Global, in conjunction with First Student, provides you with a multitude of key services such as:

  • Worldwide Medical and Dental Referrals
  • Facilitation of Hospital Admittance Payments
  • Dispatch of Doctors/Specialists
  • Transfer of Medical Records
  • Continuous Updates to Family and Home Physician
  • Hotel Arrangements for Convalescence
  • Emergency Medical Evacuation
  • Transportation to Join a Hospitalized Participant
  • Return of Dependent Children
  • Repatriation of Mortal Remains
  • Replacement of Lost or Stolen Travel Documents
  • Transfer of Funds
  • Legal Referrals
  • Message Transmittals
  • And MORE

To access services please call:
(800) 527-0218 Toll-free within the United States
(410) 453-6330 Collect outside the United States
Services are also accessible via e-mail at operations@UHCGlobal.com.

When calling the UnitedHealthcare Global Operations Center, please be prepared to provide:

  • 1. Callers name, telephone and (if possible) fax number, and relationship to the patient;
  • 2. Patients name, age, sex, and UnitedHealthCare Global ID Number as listed on your Medical ID Card;
  • 3. Description of the patients condition; 4. Name, location, and telephone number of hospital, if applicable;
  • 4. Name, location, and telephone number of hospital, if applicable;
  • 5. Name and telephone number of the attending physician; and
  • 6. Information of where the physician can be immediately reached

For more information on UnitedHealthcare Global and the services they supply please check your policy brochure and MyAccount.

 

PLEASE NOTE:Â UnitedHealthcare Global is not travel or medical insurance but a service provider for emergency medical assistance services. All medical costs incurred should be submitted to your health plan and are subject to the policy limits of your health coverage. All assistance services must be arranged and provided by UnitedHealthcare Global.

Sports-Athletic Insurance

Sports / Athletic Insurance

 

Welcome to the Sports Athletic Insurance Center! Here, we will help you with any questions you have about your school’s Intercollegiate Sports Coverage and provide you with the information you need to file your claim. We’re always here to help make the claim process easier & faster for you!

2014 – 2015 School Year

As soon as the injury occurs, contact the Athletic Director, Athletic Trainer or a designated person in the Athletic Department. They need to document the injury and notify us with the injury details. This is one step towards a speedy turn-around time on your claim.

Log in web-portal, please click here: https://webportal.bobmccloskey.com

If you would like to review your Intercollegiate Sports benefits, please download a copy of your policy.

  • Download Intercollegiate Sports Brochure Coming Soon!
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Don’t know what doctor or hospital to visit? Your plan does not require the use of a Preferred Provider (the Physicians, Hospitals and other health care providers who have contracted to provide specific medical care at negotiated prices), but using one may reduce your out-of-pocket expenses. To find a Participating Preferred Provider, please click here

Don’t know what to do to submit a claim? Download the “How to Submit a Sports Claim” form! This gives you detailed information on what you should do to submit a claim or to get reimbursed for a claim that you paid out of pocket. There is also a list of forms describing what each form can help you with and what you should do before and after you visit a provider.

  • Download How to Submit a Sports Claim Coming Soon!

What does my provider need to know? Your provider will need to know where to send your claim, the phone number to call for benefits and to verify coverage, how they can submit your claim and what they should include. The Claim Submission Information Form will answer these questions. Please make sure to take this form with you when visiting your provider, as it supplies your provider with accurate instructions on how to submit the claim on your behalf. You can also take a temporary ID Card to show your provider at your visit. If you do not have one, you can get one from your Athletic Department

  • Download Claim Submission Information Form Coming Soon!

If you would like someone from your Athletic Department or a parent 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 a PRA (Personal Representative Appointment) 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.

  • Download Specific Case Authorization Form Coming Soon!

If you would like someone from your Athletic Department or a parent 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 a PRA (Personal Representative Appointment) 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 for the entire school year.

  • Download Yearly Authorization Form Coming Soon!

 

 

 

2013 – 2014 School Year

As soon as the injury occurs, contact the Athletic Director, Athletic Trainer or a designated person in the Athletic Department. They need to document the injury and notify us with the injury details. This is one step towards a speedy turn-around time on your claim.

If you would like to review your Intercollegiate Sports benefits, please download a copy of your policy.

Back to Top

Don’t know what doctor or hospital to visit? Your plan does not require the use of a Preferred Provider (the Physicians, Hospitals and other health care providers who have contracted to provide specific medical care at negotiated prices), but using one may reduce your out-of-pocket expenses. To find a Participating Preferred Provider, please click here

Don’t know what to do to submit a claim? Download the “How to Submit a Sports Claim” form! This gives you detailed information on what you should do to submit a claim or to get reimbursed for a claim that you paid out of pocket. There is also a list of forms describing what each form can help you with and what you should do before and after you visit a provider.

What does my provider need to know? Your provider will need to know where to send your claim, the phone number to call for benefits and to verify coverage, how they can submit your claim and what they should include. The Claim Submission Information Form will answer these questions. Please make sure to take this form with you when visiting your provider, as it supplies your provider with accurate instructions on how to submit the claim on your behalf. You can also take a temporary ID Card to show your provider at your visit. If you do not have one, you can get one from your Athletic Department

If you would like someone from your Athletic Department or a parent 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 a PRA (Personal Representative Appointment) 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.

If you would like someone from your Athletic Department or a parent 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 a PRA (Personal Representative Appointment) 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 for the entire school year.

School Link

Links

 

Welcome to the School Links Center. For your convenience, we have compiled a couple of links that we think you will find helpful throughout the school year.

  • Community College of Allegheny County’s website is a great resource for obtaining information to manage your college career. To access your school’s home page and learn more about what your school has to offer, please click here.
  • To learn more about your Student Health Center and the services provided, please click here.

Prescription Drug Information

Prescription Drug Information

2014-2015 School Year

Welcome to the Prescription Drug Information Center! As a UnitedHealthcare member, you have access to a comprehensive and quality pharmacy benefit, provided through the UnitedHealthcare Pharmacy Benefit Program. UnitedHealthcare uses OptumRx. (www.optumrx.com) for certain pharmacy benefit services including your mail order benefit.

Welcome Brochure

Make informed decisions – When selecting a medication, you and your doctor should consult the UnitedHealthcare Prescription Drug List (PDL). The PDL includes most brand and generic medications approved by the FDA. Medications may be placed on different “tiers” based on their overall value, with Tier 1 being the most affordable tier option. Click below to download and review the current Prescription Drug List:

 

 

 

 

To determine if a medication is covered by your pharmacy benefit, its tier level and available lower cost alternatives, log in to “My Account“.

After you log into MyAccount, you can access:

  • Â Payment, pricing and coverage information about most prescription medications
  • Â Information about lower cost medication alternatives
  • A list of participating retail pharmacies by ZIP code
  • Â Your prescription history

 

Choose a pharmacy that is in the network – To get the most from your pharmacy benefit, you should use a participating retail pharmacy. There are over 60,000 retail pharmacies in our network, including both chain and independent stores located across the United States.

Use the Pharmacy Locator to find a participating retail pharmacy.

Participating Pharmacy Chains:

Participating Pharmacy Chains

If you had to pay out of pocket for a prescription and need to receive a reimbursement please download the prescription claim form:

 

 

Filling prescriptions at pharmacies outside our network will increase your cost.

To get prescription drug information please call 1-855-828-7716.

Access theOptumRx Member FAQ for more information. Mail order benefits included only when applicable in your policy brochure.

Need an ID Card

Access your ID now by visiting MyAccount. From your MyAccount, you can print and download your ID card.

Permanent ID Card

In keeping with our Go Green initiative, permanent ID cards will be available by request only. Should you wish to obtain a permanent ID card, you can request one to be shipped to you by accessing your MyAccount. Permanent ID cards will be shipped 24 – 48 hours of your request.

Access Your ID card on your Mobile device

Use MyAccount Mobile to access your ID card from your mobile device.

*Note: Students must have a set up my account to be able to access mobile site.

It would be our pleasure to assist you with any ID Card need you may have. Please feel free to visit our Customer Service center with any other questions regarding your ID card.

Enroll Now-Health Insurance

ENROLL NOW HEALTH INSURANCE

Welcome to the Student / Dependent Enrollment Center! We are here to help make enrolling as easy and as painless as possible.

We suggest you review your brochure and rates 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.

 

View your Uncategorized Brochure

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  • 2015 – 2016 SCHOOL YEAR
  • HARD WAIVER INTERNATIONAL STUDENT & DEPENDENT ENROLLMENT INSTRUCTIONS
  • VOLUNTARY DOMESTIC STUDENT & DEPENDENT ENROLLMENT INSTRUCTIONS

 

PLEASE NOTE: If you do not enroll for the year during the annual open enrollment period, you will not be able to enroll later during the 2015-2016 school year without experiencing a “Qualifying Life Event”. 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 Event.” After thirty days, you will no longer be eligible.

HARD WAIVER INTERNATIONAL STUDENT ENROLLMENT INSTRUCTIONS
If you are a…
As an international student you are automatically enrolled in this insurance Plan at registration, unless proof of comparable coverage is furnished.

 

ENROLL NOWÂ IN COVERAGE ON-LINE
(Hard waiver international students only)

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  • Annual Enrollment Deadline: 9/9/15
  • Spring/Summer Enrollment Deadline: (New incoming students): 1/21/16
  • Summer 1 (New Incoming Students Only): 5/26/16
  • Summer 2 (New Incoming Students Only: 7/9/16

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.

If you have previously waived out of the insurance but your non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan, please:

CONTACT US

 

DEPENDENTS OF HARD WAIVER INTERNATIONAL STUDENTS ENROLLMENT INSTRUCTIONS
Hard Waiver Students who do enroll may also insure their eligible dependents

  • Annual Enrollment Deadline: 9/9/15
  • Spring/Summer Enrollment Deadline: (New incoming students): 1/21/16
  • Summer 1 (New Incoming Students Only): 5/26/16
  • Summer 2 (New Incoming Students Only: 7/9/16

 

  • DOWNLOAD DEPENDENT ONLY ENROLLMENT FORM

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If your dependents non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan or if you have any questions about the enrollment process, please:

CONTACT US

 

 

VOLUNTARY DOMESTIC STUDENTS AND THEIR DEPENDENTS ENROLLMENT INSTRUCTIONS

If you are a…
an undergraduate taking 3 or more credit hours, a graduate taking 1 or more credit hours or enrolled in a departmental 601, 610 or 611 course, a non-graduate assistant/graduate fellow student, a Hershey Medical student, a graduate assistant or graduate fellow, visiting scholar, student enrolled in the intensive English communication program or student who participates in the Co-op work experience program as part of your required academic program. you are eligible to enroll online or with an enrollment form. Voluntary Students who do enroll may also insure their eligible dependents. Please see instructions below to enroll.

  • Annual Enrollment Deadline: 8/14/15
  • Spring/Summer Enrollment Deadline: (Dependents of new incoming students): 1/14/16
  • Summer 1 (Dependents of new Incoming Students Only): 5/14/16
  • Summer 2 (Dependents of new Incoming Students Only: 6/28/16

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  • ENROLL ONLINE
    Have your credit card ready! (If you are already enrolled and only need to enroll your dependents, you will not be able to use this method. You must enroll your dependents with an enrollment form.

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  • ENROLL BY MAIL
    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 coverage will be the period start date for the coverage period you enrolled.

If you or your Dependents non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan or If you have any questions about the enrollment process, please:

CONTACT US

We are always happy to help in anyway.

 

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