FAQs

Student Health Insurance 2016 - 2017 Plan Year

In order to better serve you, the answer to most questions for enrolling or waiving the Premier Plan can be found on this website. Below are the answers to the most frequently asked questions.

Enrollment

If I am charged for the Premier Plan, will I remain eligible for the Plan?

To remain eligible for the Premier Plan, students must be enrolled in the required number of credit hours and actively attend classes for the first 31 days.

If I waive the Premier Plan in the Fall, can I enroll in the Plan during the Spring Open Enrollment Period?

Generally, no. Late enrollment is allowed only if one is involuntarily dropped from other coverage due to age or employment and the late enrollment application is received within 31 days of being involuntarily dropped. If you know you will be involuntarily dropped due to age or job status during Open Enrollment, include the termination date of your other coverage in question #4 when completing the waiver survey. SHI will then e-mail you a Temporary Waiver agreement, so the Premier Plan charge can be temporarily removed from your Student Account.

I will be eligible to enroll in another plan in November, can I purchase the Premier Plan from August 15 through November?

No, the Premier Plan coverage ends August 14 of each Plan Year and prorated refunds are not granted. You may purchase other private "gap" coverage until the new insurance is in effect. To notify the Student Health Insurance Office of these special circumstances, indicate in question #4 the termination date of your "gap" coverage when completing the waiver survey.

Can I extend/continue my insurance for 6 months?

Students are eligible to voluntarily extend or continue their coverage for six months under the Continuation Plan provision if they were:

  • Insured on or before February 15, 2016 through August 14, 2016; and,
  • Are no longer eligible for the 12 month Premier Plan

E-mail the Student Health Insurance Office for Continuation Plan information at shi@georgetown.edu. Continuation Plan payment must be received post marked no later than August 28.

Waiver

I submitted my waiver, was it approved?

Allow five business days before confirming if your waiver was approved. To confirm that your waiver has been approved, view your Student Account in MyAccess to see if a credit for the Premier Plan has been posted to your account. If the waiver is not approved, the Student Health Insurance Office will send a request for additional information or an explanation for the denial to your GU e-mail address.

If I waive the Premier Plan in the Fall, can I change my mind and enroll in the Plan during the Spring Open Enrollment Period?

No, each student has only one Open Enrollment opportunity per Plan Year. However, you may change your mind during your applicable Open Enrollment Period.

If I waived the Premier Plan and then become involuntarily uninsured in the middle of the academic year due to age or employment, can I pick up the Premier Plan in mid-year?

Yes, as long as you enroll within 31 days of being "involuntarily dropped" and provide official written proof that you were involuntarily dropped from your other insurance due to age or job status. Please contact the GU Student Health Insurance Office for access to the online late enrollment form. The premium will be prorated for late enrollments.

My son is covered under my plan, but he will be involuntarily dropped from my coverage in the Spring semester because he is turning age 26. He is also reducing his credit hours to part-time in the Spring. Can he enroll in the Premier Plan in the Spring?

If he is taking less than 9 credit hours (Undergraduate) or less than 8 credit hours (Graduate) in the Spring term, he will not meet the eligibility requirements. However, you may opt to enroll your son in your employer COBRA Plan. Otherwise, he should enroll in the Premier Plan in the Fall.

Benefits

Why was coverage for my Emergency Room visit denied?

Charges for Medical Emergency Expenses are covered only when the condition is a true Medical Emergency as defined in the Description of Benefits. If you have a non-emergent condition that needs to be treated after regular business hours:

  • Contact the on-call Student Health Center physician at 202-444-PAGE for advice; or,
  • Go to the UHCSR Urgent Care center after hours. UHCSR Urgent Care centers can be found through the online provider search tool at www.uhcsr.com

Does the Premier Plan provide coverage worldwide?

Yes, reimbursement for treatment outside the U.S. would be paid according to Schedule 3 in the Schedule of Benefits Summary in the Description of Benefits Booklet.

Does the Premier Plan cover dental or vision care?

No, the Premier Plan is a medical injury and sickness Plan. However, insureds have access to Basix Dental Discount Network and EyeMed Discount Network, which are linked on the Premier Plan Service web page. In addition, check Arthur J. Gallagher & Co., Student Health & Special Risk website to enroll in a voluntary dental plan or to explore other Discount Networks provided through Gallagher Insurance Agency that complement the Premier Plan.  Note: Georgetown University does not make vendor service/product recommendations.

Are pre-existing conditions covered?

Pre-existing conditions are covered if the condition or treatment is not specifically excluded or limited per the Exclusions and Limitations in the Description of Benefits Booklet.

Are medications to prevent pregnancy or procedures to prevent or terminate pregnancy covered?

No, medications and procedures for birth control are not covered. The following notice is required by the Patient Protection and Affordable Care Act:

NOTICE TO PLAN PARTICIPANTS

The organization that sponsors your health plan has certified that it qualifies for a temporary enforcement safe harbor with respect to the Federal requirement to cover contraceptive services without cost sharing. Coverage under your health plan will not include coverage of contraceptive services.

Are medications to prevent pregnancy covered when prescribed for treatment of a covered sickness?

Yes, your health care provider can document the medical necessity and a medical override for non-contraceptive reasons to allow for coverage for insureds. 

Will UnitedHealthcare StudentResources pay for medications to prevent pregnancy at no cost to the Premier Plan, effective August 15, 2014 to Accommodate Georgetown University's religious objection because federal regulations will require birth control to be covered?

Yes, UnitedHealthcare StudentResources will Accommodate Georgetown University and pay for your birth control as required by law. Present your UnitedHealtcare/Premier Plan ID Card with your prescription to a UnitedHealthcare Pharmacy network pharmacist to obtain your medication with no out-of-pocket expense.

Other

I've reviewed the materials on the website, but I still have questions, who should I contact?

If you can't find the answer to your question on this website, refer to the contact page inside the front cover of the Description of Benefits Booklet for information on who to contact with specific concerns. The Student Health Insurance Office is also available to direct you to the appropriate contact to answer your questions.