Today is Tuesday, Dec. 10, 2019

Department of

UC Student Health Insurance

UC Student Health Insurance Certificate of Coverage

Policy Certificate of Coverage

For detailed coverage benefits please review your UC Student Health Insurance Plan Certificate  (PDF) for the 2019 – 2020 policy year.

Please note that this certificate is valid through August 9, 2020.

Policy Benefits - Certificate of Coverage

Below is a list of covered expenses.  Please note that “covered” does not mean that there will not be an out of pocket expense.  Depending on if the care is received from an In-Network or Out-of-Network Provider, and if the proper referral is received, you will have a deductible, and co-insurance that you will be required to pay. 

Please refer to the full certificate of details above, for more detailed information.

Covered Essential Health Benefits for an In-Network Provider, when a proper referral is obtained, are covered at 80% after the deductible, and Out of Network Providers are covered at 60% after the deductible, unless otherwise noted.

Inpatient:

  1. Room and Board Expense
  2. Intensive Care
  3. Hospital Miscellaneous Expense
  4. Routine Newborn Care- Based on setting where service is performed
  5. Surgery
  6. Assistant Surgeon Fees
  7. Anesthetist
  8. Registered Nurse’s Services
  9. Physician Visits
  10. Pre-Admission Testing

Outpatient:

  1. Surgery
  2. Day Surgery Miscellaneous
  3. Assistant Surgeon fees
  4. Anesthetist Services
  5. Physician Services - $35 co-pay per visit, plus 20% co-insurance
  6. Physiotherapy
  7. Medical Emergency Expenses- $150 co-pay per visit, plus 20% co-insurance.Waived co-pay if admitted.Co-pay can be reduced to $50 with a UHS referral prior to the visit.
  8. Disgnostic X-Ray Services
  9. Radiation Therapy
  10. Laboratory Procedures
  11. Tests and Procedures
  12. Injections
  13. Chemotherapy
  14. Prescription Drugs

Other:

  1. Ambulance Services
  2. Durable Medical Equipment
  3. Consultant Physician Fee
  4. Dental Treatment (Injury to sound natural teeth) Does not include routine dental care.
  5. Mental Illness Treatment - $35 co-pay per visit for in-network providers only.  Out of Network is based on the setting where the service is performed.
  6. Substance Use Disorder Treatment – based on setting where service is performed.
  7. Maternity – based on setting where service is performed.
  8. Complications of Pregnancy – based on setting where service is performed.
  9. Preventive Care Services
  10. Reconstructive Breast Surgery Following Mastectomy -– based on setting where service is performed.
  11. Diabetes Services – based on setting where service is performed.
  12. Home Health Care
  13. Hospice Care
  14. Inpatient Rehabilitation Facility
  15. Skilled Nursing Facility
  16. Urgent Care Center
  17. Hospital Outpatient Facility or Clinic
  18. Approved Clinical Trials – based on setting where service is performed.
  19. Transplantation Services – based on setting where service is performed.
  20. Pediatric Dental and Vision Services – See pediatric dental and vision benefits in certificate of coverage.
  21. Reconstructive Procedures – based on setting where service is performed.
  22. Allergy Testing and Treatment – based on setting where service is performed.
  23. Male Sterilization – based on setting where service is performed.
  24. Ostomy Supplies
  25. Temporomandibular Joint Disorder – based on setting where service is performed.
  26. Vision Correction (when due to an injury or sickness)
  27. Wigs

Covered Non-Essential Health Benefits

  1. Bloodborne Pathogens – covered 100% of preferred allowance
  2. Extended Dental - for removal of impacted wisdom teeth and dental abscesses
  3. Tuberculosis Screening and Testing – based on setting where service is performed.
  4. Weight Management /Dietician

 

UC Student Health Insurance

Richard E. Lindner Center,
Suite 334
2751 O'Varsity Way,
Cincinnati, OH 45221

studins@ucmail.uc.edu

Phone (513) 556-6868
Fax (513) 556-6655

Office hours: 8:30 a.m. - 4:30 p.m.