For your convenience, we have provided translations of the plan summary in the languages listed below.
This plan has incorporated into the coverage access to a network of medical professionals, including doctors and hospitals, known as the Preferred Provider Organization (PPO), offered through Cigna. While you are allowed to visit any provider of your choosing, if you use an in-network PPO doctor or facility, you will pay less money out-of-pocket.
Contact the provider prior to your visit to confirm their membership in the network.
You may go to any pharmacy to have prescriptions filled. You must pay for your prescriptions in full at the time of pickup and then submit a claim (see below for claim form) for reimbursement for the portion the company is responsible for paying.
Outpatient prescription drugs are covered at 100% after the copay, and the deductible is waived. The copay applies to each 30-day supply. Prescription contraceptives are covered (copay waived for generic contraceptives). Medication for the management and treatment of diabetes is included.
- Generic: $20 copay
- Preferred Brand Name: $40 copay
- Non-preferred Brand Name: $60 copay
- Specialty Drugs: $75 copay
- Insured students are strongly advised to use the services of Student Health Services (SHS) first, where treatment will be administered or referral issued. NOTE: If you receive a referral from the SHS, please submit it to Personal Insurance Administrators Inc., at the address below.
- When the SHS is closed or you are away from campus, you should go to the nearest PPO Doctor’s office, urgent care, or Hospital. While you may choose any Doctor or Hospital, using the providers available through the PPO network may greatly decrease your costs. For a complete listing of the PPO Doctor or Hospital facilities, visit www.cigna.com.
- If you go to a Doctor’s office or to the Hospital, be sure to bring your insurance identification card. If the Doctor or Hospital needs to verify your coverage, they may call Personal Insurance Administrators, Inc., at (800) 468-4343. Carry your insurance ID card with you at all times.
- If you need to be admitted to a hospital for a planned surgery or inpatient treatment, Pre-Certification is required at least 5 days in advance of hospitalization. For Pre-Certification prior to hospitalization, call Personal Insurance Administrators, Inc., at (800) 468-4343.
- After you receive treatment at a PPO provider, your provider will submit a claim to the insurance company.
Providers should submit claims electronically to PAYER ID 62308, or mail to Cigna at the following address:
Cigna, P.O. Box 188061, Chattanooga, TN 37422-8061.
- In some circumstances, such as using a non-PPO provider, you may be asked to pay up front. In this case, submit a claim for reimbursement for the portion of the charges the company is responsible for paying by sending all itemized Hospital and medical bills, along with your referral (if applicable) and either a copy of your health insurance ID card or a completed claim form (available below) to:
Personal Insurance Administrators, Inc.
P.O. Box 6040
Agoura Hills, CA 91376-6040
- If you have paid for a prescription, submit a claim for reimbursement to Personal Insurance Administrators, Inc., at the address above. Submit the full itemized receipt (must include name of drug, dosage, and prescribing doctor), with either a copy of your health insurance ID card or a completed claim form (available below). Be sure to write the Cigna group # 0193185 on the receipt.
- Always keep a copy of all documents submitted for claims.
- If you have questions about the status of your claim after it has been submitted, please call Personal Insurance Administrators, Inc., at (800) 468-4343, Monday–Friday, 8:00 a.m. to 5:00 p.m. (4:00 p.m. on Fridays) PT.
- The completed claim, including all Hospital and medical bills, must be submitted for payment within 90 days after the date loss occurs, or as soon thereafter as is reasonably possible.
If you would like to have confidential medical information from the claims administrator sent to an address other than the address on file with the College, you can download a Confidential Communication Request, fill out the form, and send it to the address listed. This form is available below.
View a glossary of commonly used insurance terms, provided by the Department of Health and Human Services.
Get help while you are traveling
As a student participating in this Graduate Student Health Insurance Plan, you are automatically enrolled as a Member in the UnitedHealthcare Global Program.
UnitedHealthcare Global is a comprehensive program providing you with 24/7 emergency medical assistance—including emergency evacuation and repatriation—and other travel assistance services when you are outside your home country or 100 or more miles away from your permanent residence in your home country. Expatriates are eligible regardless of distance from home.
UnitedHealthcare Global provides you with Medical Assistance Services, Medical Evacuation and Repatriation Services, Travel Assistance Services, Worldwide Destination Intelligence, and Security and Political Evacuation Assistance Services. These services are subject to certain Conditions, Limitations, and Exclusions.
For additional information, please see your insurance brochure. To download your UHC Global membership card, see below.