90.学生健康保险要求

A. 目的. The purpose of this policy is to ensure the health and wellness of students by setting forth requirements for student health insurance.

B. 范围. This policy applies to all students at the University of Idaho.

C. 政策

C-1. 在一般情况下. At the University of Idaho, preserving our student’s health and wellness is paramount. Access to health services and payments for healthcare services can hinder a student from achieving their academic goals. This policy was founded on removing as many obstacles as possible for our students to reach graduation.

C-2. 需要健康保险. All domestic full-time degree-seeking undergraduate students enrolled in 12 or more credits, graduate and law students enrolled in 9 or more credits, student athletes enrolled in 1 or more credits and all international students with sponsored government health insurance as part of their educational program are required to show proof of personal health insurance before they can complete enrollment of academic classes each semester. 在每个学期, if proof of personal health insurance is not provided, the student will be enrolled automatically into the 学生健康保险计划 (SHIP) and will be responsible for the associated charges.

C-3. Coverage requirements for all non-SHIP policies. All personal health insurance policies for both domestic and international students must adhere to the Affordable Care Act. In order to opt out of the 学生健康保险计划 (SHIP), a student must provide proof of a health insurance policy that meets the following requirements:

a. The plan does not have any limitations or exclusions on pre-existing conditions.

b. The plan covers hospital stays for medical and surgical care and inpatient care for mental health conditions.

c. The plan covers doctors’ office visits for medical care and outpatient care for mental health conditions.

d. The plan covers prescriptions written by a doctor. Prescription benefits through a third-party vendor such as CVS Caremark, etc. 是可以接受的.

e. The plan provides access to a provider network within the 莫斯科/Pullman area. Coverage must be available for routine, diagnostic, urgent and hospital care. Coverage for only telehealth, urgent and emergency care is not acceptable.

f. The plan covers services related to injury from participation in all types of recreational sports, 包括校际运动.

g. 如果计划有免赔额, either 1) the deductible is less than $1500 ($500 for J1 visa holders) or 2) the student provides proof of financial means to meet the higher deductible amount. A funded FSA or HSA account may be used to meet this requirement.

h. 该计划包括产妇护理, 包括产前护理和分娩, 没有既存状况限制.

i. The plan provides coverage for diagnostic services, including laboratory tests.

j. 该计划支付通常的70%或更多, 习惯, 每次事故或疾病的合理收费, 在达到免赔额后, 对于网络内提供商, 和平时的50%或更多, 习惯, reasonable charges for out-of-network providers per accident or illness.

C-4. Medical evacuation and repatriation coverage for students in J visa status. The University provides the medical evacuation and repatriation coverage required by the Department of State for international students in J visa status.

C-5. 不接受保单. 健康 care sharing ministries as defined by Idaho Code § 41-121, 旅行计划, 县医疗服务计划(一).e., Medicaid) outside the state of Idaho or Washington, 固定赔偿计划, 短期计划, and supplemental or reimbursement plans are not accepted as comparable coverage.

C-6. 保险的生效日期. All plans must meet the following requirements:

a. The plan is effective on or before the first day of the semester with no break in coverage.

b. The plan is effective on the first day of the calendar month following the first day of the semester.

c. The plan is effective on or before the first day of the calendar month following an involuntary loss of previous coverage.

d. The plan does not have a gap in coverage of more than seven days. If the plan has a gap in coverage longer than seven days, the student must provide proof of COBRA coverage.

C-7. 审计. 确保法律合规, information provided by students is forwarded to a third-party auditor each semester for verification. Students who are discovered to be uninsured or to have insurance that does not meet the minimum requirements will be enrolled in the 学生健康保险计划 and the charge will be placed on the student’s account.

D. 过程. For SHIP program procedure, including enrollment, appeals, and policy coverage, please see the 学生健康保险计划 网站.

版本历史

小编辑2023. 颈- 3节.g. revised to clarify deductible requirement for J1 visa holders.

修改2023. 完全重写.

采用2005.