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UK > Graduate School > Student Funding > Health Insurance Coverage FAQs: 2010-2011 > Funded Graduate Students
Health Insurance Coverage for Funded Graduate Students
Frequently Asked Questions
Note: The information below pertains only to the 2011-2012 insurance plan, running from August 26, 2011 to August 25, 2012.
This guide is an overview designed to assist you in seeking additional information and is not a guarantee of coverage. |
It is the intent of the University and the insurance company to provide the greatest benefits to the majority of students and to keep the premium cost at a level that all students, usually on a limited income, can still afford. Therefore, certain limitations and exclusions must be applied to the student insurance coverage as a means of cost containment. It is your responsibility to read and understand the insurance plan, its exclusions, limitations, and schedule of benefits.
How do I know if I am eligible for the University-funded student health insurance?
There are three criteria used to determine eligibility for University-funded health insurance for graduate students. Funded Graduate Students must be:
* Currently enrolled in the Graduate School (Note: Zero and two credit hour classes can fulfill this requirement.)
* Degree-seeking
* In UK payroll with an assignment as a full-time teaching assistant (TA), research assistant (RA), graduate assistant (GA), or as an institutional fellowship recipient. Full-time generally means an assignment of 20 hours a week or a fellowship of $9000 or more. A combination of these positions may also fulfill this requirement.
Only the Graduate School can determine eligibility for fully funded status. Contact your insurance coordinator with eligibility questions at grad.fundedhealth@uky.edu.
NOTE: Changes with your assignment, fellowship or status may affect your eligibility. Summer health insurance coverage is linked to your status in the spring semester.
If I am eligible, what action do I need to take to sign up for student health insurance?
None. The enrollment process is designed to be completely hassle-free. There is no paperwork or enrollment form for you to complete. Students who meet the eligibility criteria above do not need to take any action to enroll in the plan. Funded Graduate Students will be enrolled automatically.
When will I be enrolled?
There is a 30-day processing period for enrolling funded graduate students in the insurance plan at the beginning of each semester. Should you need your coverage verified for a provider during this enrollment period, contact the insurance coordinator at the Graduate School Insurance Office at grad.fundedhealth@uky.edu.
I am an international funded graduate student, but the insurance charge is still on my student bill. What do I do?
As an international student at the University of Kentucky you are required to have health insurance. The University automatically adds the health insurance charge to the student accounts of all international students. The Funding Office will remove the charge after verifying your eligibility as a funded graduate student. You may see the charge on your first bill for the fall and spring semesters. Please allow time for processing. Check your online student bill; if the charge has not been paid one month after the first day of classes contact your insurance coordinator by email at grad.fundedhealth@uky.edu .
How will I receive an insurance card?
An insurance card will be mailed to your home address after the Funding Office is able to verify your eligibility as a Funded Graduate Student. Please allow one month at the beginning of each semester for processing. If you believe you qualify as a Funded Graduate Student and you do not receive a card one month after the first day of classes contact your insurance coordinator by email at grad.fundedhealth@uky.edu. If you need to seek medical care prior to receiving your insurance ID card, contact your insurance coordinator by phone at (859) 257-6608.
If you lose your card, you can download a temporary ID card from the "Student Login" located under the Enrollment section on this site. You can also email a request for a replacement card info@ahpcare.com.
What is my policy number?
The University of Kentucky Student Health Insurance Policy Number is 564249. Your policy number is located on your plan brochure and ID card.
What is the insurance coverage period?
The terms of the policy are from August 26 to December 31 and from January 1 to August 25. Your dates of coverage correspond with the dates you meet the eligibility criteria above. See the chart below for further clarification:
Assistantship or fellowship term -- Periods of coverage for the 2011-2012 policy year:
August-December -- August 26, 2011 to December 31, 2011
August-April or beyond -- August 26, 2011 to August 25, 2012
January-April or beyond -- January 1, 2012 to August 25, 2012
Can I continue my coverage, even though the University is no longer paying my premium?
Yes. Students not meeting eligibility criteria for funded insurance have the opportunity to continue coverage at their own expense. If you are still enrolled in a class you can simply purchase insurance coverage on the company website.
If you are no longer a student, Post Student Status (PSS) Continuation Coverage may be purchased, with a maximum coverage period not to exceed a period of 12 months. PSS Continuation Coverage cannot be purchased through the online enrollment system. Contact the University Health Services insurance coordinator at studentinsurance@uky.edu or in person at the University Health Service for details.
Can dependents be enrolled in the student health insurance plan?
Yes. If you are insured under the student plan, you may choose to enroll your dependents in this health insurance plan at www.ahpcare.com/uky by selecting the “Enroll Online” link under the Enrollment section. You have the option of submitting a check or credit card payment online. See the plan brochure for full eligibility guidelines.
What does the insurance cover?
The University of Kentucky Student Health Insurance Plan covers Injury and Sickness. Some of the benefits include but are not limited to Inpatient Hospitalization, Outpatient doctor’s visits, x-rays, laboratory charges, surgery and emergency care. There are limitations and maximums that may apply to each benefit. Please refer to the “Schedule of Benefits” section in the University of Kentucky Student Health Insurance Plan Brochure available at www.ahpcare.com/uky. This will provide specific details regarding your policy.
Can I go to any doctor?
The University of Kentucky Health Insurance Plan uses the University of Kentucky Providers for its local Preferred Provider Network and the HUMANA Health Plan, Inc for its national Preferred Provider Network. These networks consist of facilities and doctors who have joined together to offer their services at reduced rates. Expenses may be less in the preferred provider network than charges from non-preferred providers. For a list of local doctors please go to: www.ahpcare.com/uky and look under the Benefits section and click on “Find a Doctor or Hospital”.
This policy is a PPO, so your out-of-pocket expenses are determined by the provider’s network. Covered benefits for the 2011-2012 policy year are payable at 100% (University Health Service), 90% (University of Kentucky Providers), 80% (Network Provider-HUMANA) or 60% (Non-Network), unless otherwise specified in the policy, up to the policy maximum. There are specific benefit limitations and exclusions on the policy as well. Please review the plan brochure available at www.ahpcare.com/uky for more details.
What is the difference between the student insurance and the mandatory student health fee?
The student health insurance is an injury and sickness plan that includes diagnostic testing, hospitalization, and prescription benefits. It does not provide for preventive care or coverage of treatment in the absence of illness or injury, except as specifically provided in the policy.
All full-time students pay a mandatory health fee in the fall and spring semesters that entitles them to most services at University Health Service (Student Health) at no cost, including many routine or preventative services. The health fee is voluntary for most students in the summer.
Part-time students and students categorized as full-time by their enrollment in 0 or 2-credit hour residency classes must request from Student Account Services or University Health Service that the fee be added to their student account each semester. Deadlines for this add request do apply, see below for details.
2010-2011 UHS Health Fee Deadlines
Fall 2011 - September 14, 2011
Spring 2012 - February 01, 2012
Utilize University Health Service
The University of Kentucky University Health Service (UHS) is a large outpatient clinic available to all UK students for their healthcare needs including primary care, gynecology, behavioral health, nutrition counseling and health education. Utilizing UHS is an excellent way to receive fast, efficient and high quality clinical care.
Since UK is the preferred provider for the student health insurance plan, University Health Service and student health insurance work well together. For example, students who receive treatment at University Health Service for medical services not covered by the health fee may file their claims with the insurance company. All visits are by appointment. For an appointment call (859) 323-APPT (2778).
For more information on University Health Service and your health fee, call (859) 323-5823 or see http://www.ukhealthcare.uky.edu/uhs/.
How does the prescription drug benefit work?
Your insurance identification card will double as your prescription identification card. The plan provides prescription benefits up to $1,000 (per policy year) when filled at the Kentucky Clinic Pharmacy and prescribed by a University clinician. Your total annual prescription benefit may not exceed $1,000. There is $10.00 generic drug copay and a $30.00 brand name copay at Kentucky Clinic Pharmacy. There is a $15.00 generic drug copay and a $45.00 brand name copay at all other pharmacies. The copay will be due at the time of purchase at the Kentucky Clinic Pharmacy and participating Humana network pharmacies. (Use the company website to locate Humana network pharmacies.) You will be required to pay the entire purchase price at a Non-Preferred Pharmacy.
|
Kentucky Clinic Pharmacy |
Humana Network Pharmacy |
Non-Network Pharmacy |
Aggregate maximum of $1,000 per policy year |
Copay |
$10 generic, $30 brand name |
$15 generic, $45 brand name |
check with insurance company |
Note: When purchasing prescriptions, always present your insurance identification card in order to receive the best prescription rate.
When will I receive my prescription card?
Your insurance identification card will double as your prescription identification card. You will receive the card at your home address one month after the first day of classes.
Does this policy pay all medical bills in full?
No. There are several areas for which you could be responsible for payment, including, but not limited to, a deductible, a coinsurance (patient percentage of covered medical expenses), medical costs for services excluded by the plan, and amounts above the maximum benefits provided. (For example, the maximum for the “outpatient benefit” is $5,000 per sickness or injury per policy year.)
Covered benefits for the 2011-2012 policy year are payable at 100% (University Health Service), 90% (University of Kentucky Providers), 80% (Network Provider-HUMANA) or 60% (Non-Network), unless otherwise specified in the policy, up to the policy maximum. There are specific benefit limitations and exclusions on the policy as well. Please review the 2011-2012 plan brochure available at www.AHPCare.com/uky.
Limitations apply:
The student insurance plan is a preferred provider organization (PPO), and UK Hospital and UK College of Medicine physicians are the preferred providers (in-area). When receiving treatment away from UK, you may experience significantly higher out-of-pocket costs. Additionally, the plan is an illness and injury plan only; it does not provide for preventive care or coverage of treatment in the absence of illness or injury, except as specifically provided in the policy.
For Example: Allergy treatment is not payable under the student insurance plan. However, allergy visits are available at the University Health Service under the health fee.
Will the student insurance plan cover maternity benefits?
Conception must have occurred while the covered person was insured under the policy or a policy determined as creditable coverage by Humana. If not insured at the time of conception, the pregnancy could be considered a pre-existing condition. For more details, please see the plan brochure or contact your insurance coordinator at grad.fundedhealth@uky.edu.
Does this plan include Vision Benefits?
Your health insurance plan includes a benefit for an eye examination only. For details, see the Plan Brochure available at www.ahpcare.com/uky. Please note that a deductible will apply at Humana and Non-network providers.
There is an optional vision discount plan available for purchase through this website. This vision discount program is not administered by the University of Kentucky; all inquiries should be handled directly with the customer care representatives, whose information you can find on the back of your discount card.
Does this plan include Dental Benefits?
No; this health insurance plan only addresses claims “for the treatment of accidental injury to sound, natural teeth.” (See your plan brochure for details.) Dental benefits are not built into this insurance plan.
There is an optional dental plan available for purchase through the company website through Humana One. This dental insurance is not administered by the University of Kentucky; all inquiries should be handled directly with Humana
Where do I get a claim form?
Claim Forms are not required.
How do I file a claim?
Submit all medical and hospital bills incurred to: HUMANA Health Plan, Inc. at Humana Claims, PO Box 14601, Lexington, KY 40512-4601 for processing within 90 days of treatment. The claim procedure is listed on the back of your ID card and plan brochure.
Is my student insurance valid outside of the United States?
Yes, though in some instances you may be required to make a payment to the provider and then submit your medical bills directly to the insurance company yourself. Remember, this policy is a PPO, so your out-of-pocket expenses could be affected.
See the plan brochure or https://www.academichealthplans.com/docs/EuropAssistance.pdf regarding the Academic Emergency Services (AES) provided by Europ Assistance USA. This coverage is included with the Academic HealthPlans/HUMANA policy with no additional premium cost. However, when using the Academic Emergency Services, all arrangements must be made by them for the expenses to be covered or paid.
May I decline the coverage?
If you are a domestic Funded Graduate Student, you may decline coverage by completing a Health Insurance Declination Form. Return the form to the Graduate School Insurance Office, 203B Gillis Building, by the first day of class for the semester(s) for which you are declining coverage.
Health insurance coverage for international students is mandatory.
If I have questions, who should I call?
If you have questions regarding funded graduate eligibility, please contact the Graduate School Insurance Office at (859) 257-6608 or grad.fundedhealth@uky.edu.
For questions regarding dependent enrollment, premium or to obtain a member ID card, please call Academic HealthPlans at (855) 247-2273.
If you have questions regarding claims or benefits, please call Humana at (800) 622-9529.
Additional websites of interest:
University Health Service, (859) 218-3208
Academic Health Plans, (888) 308-7320
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