Please see links below for plan materials.
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 UnitedHealthcare Choice Plus. 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 enroll your eligible dependents by downloading the enrollment form below, filling it out completely, and mailing it to the address on the form.
Application must be made and premium must be paid directly to Ascension and be received within 14 days after the expiration date of your student coverage. For further information on the Continuation privilege, please contact Ascension at (800) 537-1777.
Benefits are available for outpatient prescription drugs provided by OptumRx, the UnitedHealthcare Pharmacy. You can find information on drugs on the UnitedHealthcare Prescription Drug List (PDL). Benefits are subject to supply limits, and copayments vary depending on which tier of the PDL the outpatient drug is listed. There are certain Prescription Drugs that require your Physician to notify UHC to verify their use is covered within your benefit.
You are responsible for paying the applicable copayments. Your copayment is determined by the tier to which the Prescription Drug Product is assigned on the PDL. Tier status may change periodically and without prior notice to you. Please access www.uhcsr.com/RUHS or call (855) 828-7716 for the most up-to-date tier status.
- $20 Copay per prescription order or refill for a Tier 1
- $40 Copay per prescription order or refill for a Tier 2
- $55 Copay per prescription order or refill for a Tier 3
- Mail-order Prescription Drugs are available at 2.5 times the retail Copay up to a 90-day supply
Please present your ID card to the network pharmacy when the prescription is filled.
If you do not present the card, you will need to pay for the prescription and then submit a reimbursement form (see below) for prescriptions filled at a network pharmacy along with the paid receipt in order to be reimbursed.
When prescriptions are filled at pharmacies outside the network, the Insured must pay for the prescriptions out-of-pocket and submit the receipts for reimbursement to:
P.O. Box 809025
Dallas, TX 75380-9025
Information about getting your medical bills paid
In the event of Injury or Sickness, students should:
- Report to the Student Health Service for treatment or referral, or when not in school, to their Physician or Hospital.
- Mail to the address below all medical and hospital bills along with the patient’s name and insured student’s name, address, SR ID number (insured’s insurance company ID number), and name of the university under which the student is insured. Attach a Company claim form (see below) though it is not required for filing a claim.
- Submit claims for payment within 90 days after the date of service. If the Insured doesn’t provide this information within one year of the date of service, benefits for that service may be denied at our discretion. This time limit does not apply if the Insured is legally incapacitated.
- Submit the above information to the Company by mail:
P.O. Box 809025
Dallas, TX 75380-9025
Medical advice when you need it - 24 hours a day, 365 days a year
- Students have immediate access to nurse advice, a health information library, and counseling support 24 hours a day by calling the toll-free number listed on their medical ID card.
- NurseLine is staffed by both English- and Spanish-speaking Registered Nurses who can provide health information, support, and guidance on when to seek medical care.
- The Student Assistance Program coordinates services using a network of resources. Services available include financial and legal advice, as well as mediation. Counseling is also available by Licensed Clinicians who can provide students with someone to talk to when everyday issues become overwhelming.
- Translation services are available in over 170 languages for most services.
- Students also have access to LiveAndWorkWell.com, where they can take health risk assessments, use health estimators to calculate things like their target heart rate and BMI, and participate in personalized self-help programs.
- More information about these services is available by logging into My Account at the UnitedHealthcare StudentResources website, link below.
Get help while you are traveling
As a student participating in this 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.
View a glossary of commonly-used insurance terms, provided by the Department of Health and Human Services.