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Graduate and Professional Student Health Insurance

Complete information regarding the Vanderbilt Student Health Insurance Plan is covered below.  To jump to a specific section, select one of the following links:

 

Insurance Requirements

Vanderbilt University requires all graduate and professional students registered in degree programs of four or more credits – or who are actively enrolled in research courses (including, but not limited to dissertation or thesis courses) and are designated by Vanderbilt University as maintaining full-time enrollment – to be covered by a health insurance plan that is comparable to or exceeds the Vanderbilt Student Health Insurance Plan – referred to as “SHIP.”  UnitedHealthcare StudentResources is the insurance company and SHIP is administered by Gallagher Student Health & Special Risk, and provides coverage from August 12, 2019 through August 11, 2020. 

 Students who meet eligibility requirements are automatically enrolled in and billed for SHIP. The annual premium is $3,650. Graduate and professional students are enrolled for annual coverage, but the annual premium is billed equally over the fall and spring semesters ($1,825 each semester).

Insured students must actively attend classes for at least the first 31 days after the date for which coverage is purchased to remain enrolled in SHIP. 

All domestic students who wish to waive coverage are required to complete an online waiver form at the beginning of each academic year by the waiver deadline – August 1, 2019. International students are not eligible to waive; enrollment in SHIP is mandatory.

SHIP is fully compliant with the Affordable Care Act (ACA), meets all state and federal regulations, and has a gold metallic actuarial value. If a domestic student has comparable insurance coverage that meets the waiver criteria, and does not wish to participate in SHIP, they must complete an online waiver form documenting their other insurance information. As stated above, the online waiver form must be completed no later than August 1, 2019 or the student will remain enrolled in SHIP and will be responsible for paying the insurance premium. Each submitted waiver will be audited to ensure the student is actively enrolled in the plan stated on the waiver form and that the student has access to providers and services within the Nashville area. Please see the waiver process below for more detail.

 

2019-2020 Rates

The following rates are for Graduate/Professional and International Students and their Dependents.

 

 2019-2020 Graduate/International/Professional Plan  Annual Rate
 Student only  $3,650
 Spouse  $3,630
 One Child  $3,630
 Two or More Children  $7,260
Spouse & Two or More Children $10,890

 

Changes to the Student Health Insurance Plan

If you are a returning student, please be aware of the following plan design change for the 2019-2020 policy year:

The In-Network (UHC Options PPO) coinsurance will change from 85% to 80% and the Out-of-Network coinsurance will change from 65% to 60%. The coinsurance for the Vanderbilt University Medical Center (preferred provider) will remain at 90%.

 

Coverage through the Student Health Insurance Plan

The Student Health Insurance Plan:

  • Coordinates services with the Student Health Center.
  • Is fully compliant with the Affordable Care Act and all other federal and state mandates.
  • Offers comprehensive benefits that include hospital room and board, inpatient and outpatient surgical procedures, labs and x-rays, chemotherapy and radiation, inpatient and outpatient mental health services, physician office visits, consultant visits, ambulance, emergency care, and prescription drugs.
  • Includes Preventive Care Services that are available at no cost sharing when received from an In-Network Provider.
  • After the $250 per person per policy year deductible, Preferred Providers (VUMC) are generally covered at 90%; and In-Network (UHC Options PPO) providers are generally covered at 80%.
  • After the $500 Out-of-Network per person per policy year deductible, providers are generally covered at 60%.
  • After a separate $100 pharmacy per policy year deductible, you will pay a $15 copayment for a generic drug, a $50 copayment for a brand name drug, and a $75 copayment for a brand name drug which has a generic equivalent at participating retail pharmacies.

A full plan description of benefits, limitations, and exclusions, Frequently Asked Questions, and links to provider look-up, pharmacy, and claims information are available at www.gallagherstudent.com/vanderbilt.

 

Waiver and Verification Process

 International students are not eligible to waive SHIP; enrollment in SHIP is mandatory.

If domestic students are currently enrolled in a health insurance plan that meets or exceeds the SHIP offered through Vanderbilt University, and do not wish to enroll in the student plan, you must complete an online waiver form (http://www.gallagherstudent.com/vanderbilt) documenting other insurance information no later than August 1, 2019 deadline. A domestic student is required to complete an online waiver form at the beginning of each academic year.

In order to waive coverage, your current insurance plan must:

  1. Be fully compliant with the provisions of the Affordable Care Act and all state and federal mandates;
  2. Be underwritten by an insurance and claims company based in the United States (no international insurance companies, travel insurance or short term medical plans);
  3. Provide access to local doctors, specialists, hospitals and other health care providers in the Vanderbilt University area;
  4. Cover accident and sickness at a minimum of 80% with no lifetime maximum (i.e. unlimited benefit) per accident or sickness;
  5. Cover inpatient and outpatient hospital expenses, outpatient surgical expenses, inpatient and outpatient mental health, prescription drugs, laboratory tests and x-rays, physical therapy, maternity, and home health care;
  6. Must provide coverage for the period of August 12, 2019 to August 11, 2020.

The intent of the waiver verification process is to assess whether your insurance plan will cover you when you’re at school. The verification process checks the insurance company information you entered on your form and confirms the information submitted is accurate and that your coverage is currently active. Most waivers will be verified within 24-48 hours. Once your waiver has been verified, an email notification will be sent to the email address submitted on the form informing you of the acceptance or denial of the waiver. If your waiver is denied, the email will explain the reason for the denial and provide instructions on how to revise and resubmit your form and any applicable supporting documentationFailure to submit supporting documentation by the deadline will result in your automatic enrollment in SHIP.

 

For Students Responsible for their own Premium Payment

Students who meet the eligibility requirements are automatically enrolled in and their student account is billed for SHIP. The premium is $3,650 and is billed over the fall and spring semesters ($1,825 each semester).

Domestic students who have comparable insurance coverage, and do not wish to participate in SHIP must follow the waiver process described above or they will remain enrolled in and billed for SHIP. 

 

Enrolling Dependents

Students who are enrolled in SHIP may enroll their eligible dependents with an additional cost. Eligible dependents include a student’s married spouse (husband or wife) or children (under the age of 26). Domestic partners (same sex or opposite) are not covered.

It is your responsibility to enroll your eligible dependents each year.  Dependents are not automatically enrolled.  The deadline to enroll dependents for annual coverage is September 12, 2019. To enroll eligible dependents, go to www.gallagherstudent.com/vanderbilt and click on “Dependent Enroll.” 

Coverage for eligible dependents must be purchased for the same time period as the student’s period of coverage and cannot exceed coverage purchased by the student. For example, a student enrolled for annual coverage has to purchase annual coverage for a dependent unless a qualifying event occurs (described below).

The deadlines to enroll dependents are as follows:

  • September 12, 2019 for newly enrolled and returning annual students to have an effective date of August 12, 2019.
  • February 1, 2020 for newly enrolled spring students to have an effective date of January 1, 2020.
  • June 1, 2020 for newly enrolled Maymester students to have an effective date of May 1, 2020.
  • July 1, 2020 for newly enrolled summer students to have an effective date of June 1, 2020.

 

Dependent Premium Payment

Students who purchase annual coverage for their dependents can either pay for the entire annual premium in one payment (via credit card, debit card, or checking account) or by the payment plan option. Your student account cannot be billed for dependent coverage. The installment option is not available for students purchasing dependent coverage for any other coverage period.

The payment plan option allows students to make an initial payment of three (3) months of premiums from a checking account and pay the balance in equal monthly installments via automatic drafts from their checking account. Payments will be deducted via ACH (automatic checking account) on the same day each month based upon the date the initial payment was set-up.

 

Qualifying Events for Students and Dependents

Students who initially waive coverage can submit a Petition to Add coverage if they lose coverage under that plan (for example due to no longer being covered as a dependent).  This is called a ‘Qualifying Event’.  The premium will be pro-rated based on the date coverage begins. The applicable premium will be added to your Student Account.

Eligible dependents may also be added if the student experiences one of the following qualifying events: (a) marriage, (b) birth of a child, (c) divorce, (d) if the dependent is entering the country for the first time, or (e) if the dependent loses coverage under another insurance.

A link to the Petition to Add and the Dependent Petition to Add form is found at www.gallagherstudent.com/Vanderbilt under “Student Access”. The Petition to Add or Dependent Petition to Add form and supporting documentation (i.e. proof of qualifying event) must be received by Gallagher Student Health & Special Risk within 31 days of the qualifying event. Forms received more than 31 days after the qualifying event will not be processed.

Students who are adding dependents due to a qualifying event will be responsible for paying the premium for their dependent(s). Once a dependent is enrolled, coverage cannot be terminated unless the student loses eligibility. The premium is pro-rated based on the date coverage begins.

 

Information for Graduate/Professional Students Graduating in December 2019

Graduate and professional students who are enrolled in SHIP and who graduate in December are allowed to terminate their 2019-2020 Student Health Insurance Plan coverage as of December 31, 2019.  PLEASE NOTE THAT REQUESTS FOR INSURANCE TERMINATION MUST BE SUBMITTED  NO LATER THAN DECEMBER 31, 2019.

Eligibility:

  • The student has completed all degree requirements;
  • The student has not incurred claims with a date of service after December 31, 2019;
  • Dependent coverage will be terminated when the student’s coverage is terminated.
  • Dependents also must not incur claims with a date of service after December 31, 2019.

  Procedure:

 

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