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Mandatory Plan (Hard Waiver Plan) - Summary

 

TIMELY UPDATES

Special Information about Summer-only 2022 Enrollment and Waiver Period

The enrollment and waiver period for Summer-only 2022 is April 25, 2022 – June 22, 2022.

Summer-only 2022 Effective Dates:  May 1, 2022 – July 31, 2022

 

 

 

SUMMARY    

   

The Mandatory Student Health Insurance Plan (Hard Waiver Plan) is with the University System of Georgia Board of Regents student health program administered by UnitedHealthcare Student Resources. It is an accident and sickness insurance policy that provides coverage worldwide. It includes diagnosis and treatment of illness, injury, or medical conditions, along with preventive care benefits. Benefits include physician, hospital, surgical, pharmacy, behavioral health services (i.e., mental health / substance abuse), as well as legally-mandated benefits.

Coverage under this plan cannot be prorated or ended early.

 

 

REQUIRED STUDENT GROUPS      

   

The following groups of UGA students are required to have health insurance coverage.  These students will be automatically charged for the Mandatory Plan on their UGA student account:

  • Undergraduate and Graduate International students holding "F" or "J" visa status.
  • Students whose program requires health insurance (Doctor of Pharmacy program and Doctor of Veterinary Medicine program).

  • Graduate students receiving Qualified Graduate Assistantships: Graduate students receiving a full tuition waiver* as part of their graduate assistantship award. This includes general graduate assistantships, teaching assistantships, laboratory assistantships, and research assistantships, regardless of the source of funds; as well as graduate school assistantships and Graduate Recruitment Opportunity (GRO) assistantships.

  • Graduate students receiving Qualified Fellowships: Graduate students supported by fellowships administered by UGA** that provide funding for the student in an amount equal to or greater than the prevailing in-state tuition rate for graduate students. Such fellowships include, but are not limited to, UGA Presidential Graduate fellowships, National Research Service Awards, National Science Foundation fellowships, and other state and federally funded fellowships.

  • Graduate students receiving Qualified Training Grants: Graduate students supported on state or federally funded training grants administered by UGA** that provide funding for the student in an amount equal to or greater than the prevailing in-state tuition rate for graduate students.

* The terminology "full tuition waiver" means the graduate assistantship provides reduced tuition of only $25.

** The terminology "administered by UGA" in the Fellowship Recipients and Departmental Training Grants sections means that external funds are channeled through UGA accounting systems.  If the Fellowship or Departmental Training Grant recipient receives a payroll or stipend check from any source other than UGA Accounts Payable, then that student is NOT eligible for the UGA contribution.

Students who fall into one of the mandated categories can opt out of the mandatory student health insurance plan if they have other acceptable health insurance coverage.  If a mandated student does not have an approved waiver request at the close of the waiver period, the student will be automatically enrolled in the mandatory plan.

     

 

PLAN INFORMATION      

   

Be sure to read your policy brochure to find information about benefits and the use of the University Health Center and any referral requirements to other doctors.Visit the United Healthcare site to view the policy brochure, prescription drug list, or search for participating providers.

 

Select "Explore Policy" in the appropriate Medical Domestic or International Hard Waiver section to view the policy brochure.

 

If a student has not paid the UGA Health Center fee, the student should be aware that the plan does not cover services/charges normally covered by the UGA Health Center fee. A non-fees paid student must still utilize the Health Center for care per the plan requirements (see the brochure regarding referral requirements and exceptions),  but the student will be responsible for paying the charges normally covered by the Health Center fee.

Referrals required for care outside of Health Center

Students must utilize the University Health Center for care or to obtain a referral when needed. 

The student must use the services of the Health Center first where outpatient treatment will be administered or referral issued.  Expenses incurred for medical treatment rendered outside of the Student Health Center for which no prior approval or referral is obtained are excluded from coverage.  A referral issued by the Student Health Center must accompany the claim when submitted.  Only one referral is required for each injury or sickness per policy year.


Referral Exceptions

A Student Health Center referral for outside care is not necessary only under any of the following conditions:

  1. Medical Emergency.  The student must return to the Student Health Center for necessary follow-up care.
  2. When the Student Health Center is closed.
  3. When service is rendered at another facility during break or vacation periods.
  4. Medical care received when the student is more than 30 miles from campus.
  5. Medical care obtained when a student is no longer able to use the Student Health Center due to a change in student status.
  6. Maternity, obstetrical and gynecological care.
  7. Dermatological services. Dermatological services means services ordinarily and customarily rendered by a physician specializing in the practice of dermatology.
  8. Mental illness treatment and substance use disorder treatment.

Dependents, post-doctoral research fellows, post-doctoral research fellow adjuncts, and visiting scholars are not eligible to use the Student Health Center; and therefore, are exempt from the above limitations and requirements.

 

QUESTIONS      

   

 Questions about student health insurance can be directed to gshiplan@uga.edu or 706-542-2222.

 

Questions concerning plan benefits or claims can be directed to United Healthcare Student Resources customer service at 866-403-8267.