Since Metropolitan State does not have a student health center, where do I go for medical care?

The student should go online to the following links to find a provider near you.

The University of Minnesota, Boynton Health Clinic accepts students who have purchased insurance through the United Healthcare insurance policy. For location information and clinic services, visit www.bhs.umn.edu

To find a Network provider/clinic near you go to: https://www.geoaccess.com/uhc/po/Default.asp

Is there any service the insurance will NOT pay for?

The insurance will not pay for anything preventative* including: vaccines, dental (unless an injury to natural teeth), and eye exams. *The reason the above are not covered is because the insurance plan is Accident and Illness only. Preventative care is very expensive and the insurance would cost more if it were included in the policy.

Can I purchase coverage for my spouse and/or children?

You are able to purchase insurance for your children or spouse. Keep in mind that this is the same injury and illness plan that you have (no preventative). Cost Information may be found on the application.

Is there a reason the insurance company does not give us exact prices in the brochure instead of allowable charges or usual and customary (U&C)?

There is really no way to put Allowable charges or U&C amounts in the brochure. These brochures are printed for all of MnSCU. There are so many different CPT codes (numbers used for coding a procedure), and zip codes (zip codes are needed because the U&C charges are different throughout Minnesota) it cannot be done.

How can I find out ahead of time if an expensive procedure will be covered?

Get the CPT code from the doctor along with the tax ID# of the doctor or the zip code and call the insurance company 1-888-251-6243, they will give you a pre-treatment estimate.

Why do I receive a bill right after my visit with the provider and they have not sent it to my insurance?

For the most part providers usually send patients a bill showing what the charges were for the procedure. On this bill it should say something about billing this to insurance; if there is nothing like that you should contact the billing department of the clinic. Keep the bill for your records.

Why am I getting a bill from the insurance company?

The insurance never sends you a bill. What you are receiving is an EOB (explanation of benefits). This tells you what the provider billed for a service, how much the service was, any discount that is applied, how much the insurance company paid, and what your remaining balance is.

Should I send in a payment when I receive my EOB?

Usually the provider will re-bill you for the remaining balance after the insurance has paid. If you have not received another bill within a month of receiving your EOB you should call the provider and ask if a bill has been sent or will be soon.

Please keep in mind that sometimes when you are seen at a clinic or hospital there may be more than one bill even though you are only seen once. The separate bills could be from x-rays (Radiology), lab work, physicians fee, supplies/equipment, anesthesia, etc. With these bills you will also receive a corresponding EOB from the insurance company.

What is a pre-existing condition?

Pre-existing condition: any condition which originates, is diagnosed, treated, or recommended for treatment within the 6 months immediately prior to signing up for the insurance. What this means in non-insurance terms is that if you have any kind of injury or illness that has been going on six months before you signed up for the insurance, even if you have never seen a doctor for this reason, it may be considered a pre-existing condition.

So, if a student has a pre-existing condition then the insurance should pay up to $500 (International Plan ONLY), for covered services as specified in the insurance plan, for the first six months of coverage. After the six months has passed, pre-existing limitations are dropped and the insurance should pay on the condition, from that day forward, as any other illness. The insurance will not go back and pay on any previous charges for these conditions.

How do I get reimbursed for prescriptions?

There is currently a maximum of $500 per injury/illness for DOMESTIC student plan - international plan = $200,000.  Both plans are subject to a $50 deductible (per covered injury/illness) + 20% of the total bill that is the student's responsibility. A student is eligible to receive reimbursements for medications. First the student must go to a provider within the network and get their prescription filled and paid for, then, submit a copy of the receipt and a copy of the prescription to:

Student Insurance
P.O. Box 809025
Dallas, TX 75380-9025
OR  by fax at (469) 229-6507

Reimbursement time is approximately 3 weeks from time of receipt.

Is there an on-line process to check my claim status?

Yes. Please visit: https://www.uhcsr.com/SelfServiceSupport/Students/CollegeStudents.aspx to create an account. Select "create an account".  Once the account is created you should be able to view your claims and information.

If I am an International student and expect to graduate after Fall semester do I have to purchase the full annual coverage?

If you are graduating after fall you would still need to purchase the annual coverage, however refunds are available if you meet one of the following requirements: 1)  Visa change form F-1 to J-1, 2) Graduating and no longer want to keep the insurance coverage after graduation, or 3) Transfer to another non-MnSCU school.

REMINDER: Insurance is required for International students throughout the term of their attendance at Metropolitan State University.