Mandatory Plan (Hard Waiver Plan) - Summary
TIMELY UPDATES
The enrollment and waiver period for Spring/Summer 2025 is
December 9, 2024 – February 14, 2025.
Spring/Summer 2025 Effective Dates:
January 1, 2025 – July 31, 2025
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
as well as 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 Doctor of Veterinary Medicine program, and Applied Behavior
Analysis program).
- Graduate students receiving Qualified Graduate Assistantships: This plan is mandated for 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 The Presidential Fellows award.
- Graduate students receiving Qualified Fellowships: This plan is mandated for 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, National Research Service Awards, National Science Foundation
fellowships, and other state and federally funded fellowships.
- Graduate students receiving Qualified Training Grants: This plan is mandated for 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 ScholarshipUniverse, 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:
- Medical Emergency- The student must return to the Student Health Center for necessary follow-up care.
- When the Student Health Center is closed
- When service is rendered at another facility during break or vacation periods
- Medical care received when the student is more than 30 miles from campus
- Medical care obtained when a student is no longer able to use the Student Health Center due to a change in student status
- Maternity, obstetrical, and gynecological care
- Dermatological services- Dermatological services are services ordinarily and customarily rendered by a physician specializing in the practice of dermatology.
- 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.