West Texas A&M University

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Medical Services Student Health Insurance

 

Purchasing Health Insurance

and Student Health Insurance Billing

 

The Texas A&M University System  2014-2015

Student Health Insurance Plan  -

BlueCross BlueShield of Texas Academic Health Plans

Texas A&M University System is proud to offer ACA compliant Insurance for TAMU's students and their dependents. 

 

 Information will be available at Academic HealthPlans, Inc.,   877-624-7911. Click on enrollment. 

 

  • No Annual Maximum

  • Preventative Services covered at 100%

  • Student Health Services paid at 100% (deductible wiaved)

  • Blue Cross and Blue Shield of Texas PPO Network and Blue Card for traveling

  • Easy Online Enrollment

  • Includes Global Emergency Services

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  • Any enrolled Texas A&M University System Student taking at least (6) credit hours of classes is eligible to enroll in this insurance plan.  Students who are enrolle d in special classes and take less than six (6) credit/contact hours of classwork will be determined eligible for this Student Health Insurance Plan if the reduced coursework meets the criteria for the completion of a degree plan or International program as defined and approved by the Texas A&M Universiy System. 

  • International Students (those who are not United States citizens or permanent residents of the United States) ARE REQUIRED to maintain approved health insurance coverage continuously while enrolled and attending a Texas A&M System institution, unless the student provides proof of coverage that meets the Texas A&M University System waiver requirements (See the TAMUs Policy #266.99.01).

  • All registered and enrolled Texas A&M University GRADUATE STUDENTS employed by the System are eligible to enrol in this insurance plan (no minimum hour requirment). 

    Insurance Premiums
  • Student Health Insurance Billing 

    West Texas A&M University Student Medical Services is excited to announce that our facility will begin billing the student’s health insurance plans in the Fall 2014 semester.  WTAMU Student Medical Services will utilize a third party billing company.  The student health fee which is paid by the student with each semester’s academic charges will cover the co-payment. Students may opt to have their primary insurance company billed for services (lab tests, x-rays, medical procedures, medications, etc) or they may choose to self pay.  This service will be specifically for fees incurred within Student Medical Services. 

     FAQs

    ·         Who is required to have insurance and why?

    All United States citizens and all international students are required to have health insurance.  On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reformshttps://www.healthcare.gov/

    ·         What documents or information will the student need for SMS to bill their health insurance company (ies)?

    Please provide SMS with the most current health insurance card.  This will include the insurance carrier, policy number and group number of the insured. 

    o     If you would like to  e-mail a PDF copy of health insurance cards to medical@wtamu.edu or fax   806-651-3287.  Please be sure that the copy of the insurance card is legible and includes a the name of the student and the student's Buffalo Gold Card number.  Please also provide a telephone number in case we have questions. 

    ·         Will the student need to pay a co-pay for the visit?

    No.  Because students pay tuition that includes a health fee, which supports the basic operations of WTAMU Student Medical Services, it will NOT be necessary for us to charge a co-pay for services.

    ·         What is a deductible?

    A deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses

    ·         Will the student have to pay the deductible?

    Insurance claim denied due to deductible not met

    If the student has not met the deductible on the insurance policy, it may be declared as uncollectible.  The charges will be adjusted to accommodate the self pay fee schedule. 

    Insurance does pay but has a deductible for fees

    If the insurance company pays for the service, the charges will be adjusted and deductibles will be waived due to the student health fee coverage. 

    ·         Is it the student’s responsibility to file a claim?

                No.  The WTAMU Student Medical Services Department will submit the claim to the billing agency.  This billing agency will file the claim with the insurance  company(ies).

    ·         Will an academic hold/restriction be placed on the student’s account until the insurance claim is paid?

    No.  We will not place an academic hold/restriction on the student’s account if the account is being processed by the insurance company (ies).  If the claim is denied or deemed as uncollectible, the student will receive a bill by mail and have an additional 14 days to pay the balance before a hold is placed.  The student has a right to file an appeal with the insurance company.  If an appeal is filed, please notify Student Medical Services so that a hold/restriction is not placed on the student.   

    ·         What if my claim is denied or uncollectible by my insurance company?

    Your account balance will be returned by the third party biller to WTAMU Student Medical Services.  You have the right to file an appeal with your insurance carrier, but must notify Student Medical Services if an appeal is being filed.  You will receive a bill in the mail for the basic fees incurred (lab, medications, x-rays and certain procedures).   As with all non-insured patients, you will have up to 14 days to pay the balance before an academic hold and a $2.00 processing fee is placed.  Once the balance is paid the hold will be removed. 

    ·         What will NOT be billed by WTAMU Student Medical Service’s 3rd Party Biller?

    o   Meningitis Vaccine that has been documented as a tuition payment.  (The student can either submit their insurance claim for the vaccine or place the payment on their tuition bill.  We cannot do both.)

    o   Referrals, health care or health expenses incurred outside WTAMU Student Medical Services.  The patient or the outside facility must file the claim. 

    o   No shows/non cancellation fees

    o   Processing fees/late fees

    o   Thermometers

    o   CPR/AED, First Aid or BLS classes

             What if the student doesn’t want a confidential lab, medication or procedure to be submitted to insurance?

    The student can self pay for any lab test, medication or procedure that they do not want to have submitted to insurance. 

     If I am in the military, what region do I choose?

      Tricare South

     

August 15, 2014