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Student Health Insurance

Underwritten by UnitedHealthcare Insurance Company

Campus Student Health Insurance Office


McKinley Health Center
1109 South Lincoln Avenue
Room 112A on 1st FL & Room 29 on Lower level
Urbana, Illinois 61801
Office Hours:
Phone/Walk-In Hours: 8:00AM-4:30PM
Phone: 217-333-0165
Email: insure@illinois.edu
Website: http://www.si.Illinois.edu
Fax: 217-244-9886

Student Insurance is a separate service and a separate fee


from that of McKinley Health Center.

Exchange Students are automatically enrolled in Student


Health Insurance. The premium for Student Health
Insurance ($320 per semester) is billed to your student
account.

Examples of when Student Insurance


can be used:
Anytime (such as after hours for McKinley)
Surgeries
Hospitalization
Emergency Room Visits
Mental health care/therapy
When student needs Medical Attention outside of the
Urbana-Champaign area.
Student Health Insurance provides worldwide coverage
you can pick the doctor or hospital of your choice.

Schedule of Benefits for Undergraduate Students


In-Patient Benefits

Out-Patient Benefits

$100 deductible

For
For injuries
injuries and
and sickness:
sickness: $150
$150 deductible
deductible per
per
insured
person
per
policy
year,
then
80%
of
insured person per policy year, then 80% of
Usual
Usual &
& Customary
Customary (U/C)
(U/C)

80% of Usual & Customary (U/C)


for first $10,000 in charges then
remaining balance paid at 100%.

Emergency
Emergency Room
Room visits:
visits: $50
$50 deductible
deductible per
per
visit
visit
Preventive
Preventive routine
routine care:
care: covered
covered at
at 100%
100% of
of
billed
billed charges
charges with
with no
no deductible
deductible or
or coinsurance
coinsurance
Prescription
Prescription Drug
Drug Care:
Care: Covered
Covered via
via tiered
tiered copay
copay
(more
(more information
information on
on following
following slide)
slide)

Please refer to the


brochure for more
specific
information about
your coverage.

There is a total maximum out-of-pocket of


$6,350 for all covered services per person
per academic year ($12,700 for entire family)

Prescription Drug Coverage: Tiered Copay

Tier

Includes

Copay

Lower cost drugs.


Some brands and
generics are also
included.

$15

Mix of brand and


generic.

$30

Mix of brand and


generic.

$50

Mostly higher-cost
brand
as well as select
generic
drugs .

20% Coinsurance per


prescription up to a
31 day supply.

Waivers/Opting out
If a student has other equivalent or better health insurance to
the University of Illinois Student Injury and Sickness
Insurance Plan, the student can waive themselves from the
Universitys plan during the Enrollment Change Period at the
beginning of the semester.
The waiver form is found online at www.uhcsr.com/illinois,
under the link entitled waiver form.

Website:
www.uhcsr.com/illinois

Waiver form link

What is considered equivalent health insurance?

The other insurance plan must be at least an 80/20 plan.

The other insurance plan must have at least $500,000 worth of medical coverage
per injury or illness.

The other insurance must have a low deductible (up to $2,000/$5,000 if plan is an
HSA).

The insurance must cover health care received within a 50 mile radius of the
Urbana-Champaign campus.

Effective dates of the other insurance must be on or before the first day of student
coverage; therefore, if the student wishes to do a Waiver during Spring Semester
2017, their other insurance must be effective by January 14, 2017, and must not
terminate before May 12, 2017.

If asked to show proof of insurance, examples would be; a Certificate of Coverage


letter and Schedule of Benefits. Documentation must be translated into English
and show amounts in US dollars.

When can a student apply for a Waiver?

The Enrollment Change Period is the


ONLY time a student can apply for an
Waiver.
The Enrollment Change Period for the
Spring Semester 2017 is 1/13/17
through 2/03/17.

Do you still have questions?


Visit the Student Insurance Office table at the
Resource Fair
Visit the FAQs page at si.Illinois.edu/faqs/
Contact the Student Insurance Office by phone or
walk-in

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