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 2015-2016

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 waived)

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

  • Easy Online Enrollment

  • Includes Global Emergency Services

  • 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 enrolled 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 University 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 TAMU's Policy #266.99.01).

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

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

  1. 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/
  2. 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.­
  • 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.­
  1. ­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.
  2. 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).
  3. 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.­ ­
  4. What if my claim is denied or uncollectible by my insurance company?­ 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.­­
  5. What will NOT be billed by insurance?
  • Pharmaceuticals/Medications
  • TB Testing
  • Varicella Titers
  • 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.)
  • Referrals, health care or health expenses incurred outside WTAMU Student Medical Services.­ The patient or the outside facility must file the claim.­
  • No shows/non cancellation fees
  • Processing fees/late fees
  • Thermometers
  • CPR/AED, First Aid or BLS classes
  • Boot Liners
  • Rabies Vaccines must be paid in advance
  1. ­­­­­­­­ 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.­ Please inform the receptionist or nurse to remove the insurance billing for this procedure or daily submission.­
  2. ­If I am in the military, what region do I choose? ­ Tricare South

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Revised July 23, 2015