Stetson University

Campus Life and Student Success

How to Use Student Insurance

If you are enrolled in the Student Insurance Health Plan, please review the following important information regarding the basics of the student insurance plan and how to use the plan.

Try Student Health Service First

Student Health Service is conveniently located on campus and accepts the Student Insurance Health Plan. When seeing a doctor or other medical staff, you are responsible for the co-pay and or deductible at the time services are rendered. If the treatment needed is beyond the care of Student Health Service, you will be referred to an external doctor.

Please make sure you use a doctor who is in the student insurance network (see below on finding an in-network doctor).

If you have an emergency (e.g., life-threatening issue or injury), you should go to the emergency room and/or call 911 if you need an ambulance. If the issue is not an emergency, and Student Health Service is closed, please see Student Health Service as soon as the office reopens, or schedule an appointment with an in-network doctor (see below).

When Student Health Service is Closed: 24/7 Nurse Assistance Program

If Student Health Service is closed, if you need advice about a health issue, or if you are unsure whether or not your issue is considered an emergency and warrants going to the emergency room, you can call the 24/7 Nurse Assistance Program for advice on any health problem. This service is free and is part of your plan benefits. The phone number is 877-643-5130.

If you go to the emergency room and your condition is not considered a true emergency, your coverage may be limited.

Finding an In-Network Medical Provider

If you need treatment by a doctor, facility or hospital, you should check the United Healthcare Provider List to make sure you go to an "in-network" medical provider. It is important to try and use in-network providers to keep your out-of-pocket costs down. Use approved in-network providers as much as possible so that your bills will be paid at the 90 percent in-network co-insurance coverage rate (out of network treatment only pays 70 percent of the cost).

You can use the First Student website to search for in-network doctors and services (e.g., radiology, labs, MRI imaging centers, etc.) This network is nation-wide, so if you are traveling in the U.S. or are home on break and need medical treatment, you can search for in-network providers in your home area as well (if within the U.S.).

Prescriptions

If you get a prescription from a medical provider, it can be filled at any local pharmacy.

Walmart, CVS and Walgreens are in the Stetson University area in DeLand.

The deductible is $15 for generic prescriptions and $40 for brand-name prescriptions. If your prescription cost is less than the deductible, then that is your final cost. Some prescriptions are not covered. For coverage questions, please contact First Student Customer Service at 800-505-4160.

Filing Claims

If you go to a medical provider and are billed directly, you will need to file a medical claim and submit it along with your bills to the insurance company claims office for processing. The insurance company will review your claim and let you know what portion of the bill is covered by insurance and what portion you will owe. Please see the insurance company's Student Injury and Sickness Insurance Plan document for a summary of benefits that are covered and for a list of exclusions.

If you are not sure if something is covered, or have billing questions or issues, please call First Student Customer Service at 800-505-4160.

Claim forms and instructions for filing claims can be found at the First Student Insurance website. Remember, in-network medical providers have a 90 percent co-insurance coverage (you pay the remaining 10 percent), whereas out-of-network providers only have a 70 percent co-insurance coverage (you pay the remaining 30 percent), and some out-of-network providers have lower coverage limits or no benefits (such as preventive care). It is important to try and use in-network providers to keep your out-of-pocket costs down.

If you have coverage questions, please contact First Student Customer Service at 800-505-4160.

Important Information

The following information is available at the First Student Insurance website:

  • Brochure/Flyer (includes student insurance plan benefit summary and exclusions)
  • Temporary insurance card (print out and use until the permanent card is received)
  • How to file a claim
  • Discount card for prescriptions, dental and vision care
  • Free information on health topics
  • 24/7 Nurse Assistance Program: 877-643-5130

Coverage or Insurance Issues

If you encounter coverage or insurance issues and need help in resolving them, please contact First Student Customer Service at 800-505-4160.

Stetson University's risk management contact is Terry Gordon, who can be reached at 386-822-7701 or tgordon@stetson.edu.

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