5.3.3 - OUHSC Health Insurance Policy

Per the University of Oklahoma Regents’ Policy, all students enrolled in an OU Health Sciences Center program are responsible for maintaining health insurance and providing coverage information each semester of enrollment in their programs. A student who is found to be uninsured will receive notification from HSC Student Affairs and their academic dean’s office regarding lack of compliance and possible delay academic program, including clinical participation, and advancement.

All students enrolled in an OU Health Sciences Center program who do not enroll in OUHSC Health Coverage must submit alternate coverage information through the Academic HealthPlans Waiver System by the deadlines respective to your program. The COD deadline is ALWAYS one week before the OUHSC campus deadline.

Frequently Asked Questions:

1. Do I have the option to not have medical coverage?

No. As an OUHSC student, this is an enrollment requirement to attend class and clinic. You must purchase the OU Student Health Insurance Plan or provide coverage information that you are covered by alternate healthcare coverage.

Students who do not have coverage or acceptable medical coverage may purchase the OU Student Health Insurance plan. To purchase the plan, visit: https://ouhsc.myahpcare.com/ 

Students can also enroll their spouses and dependents on the plan. Rates are based on which plan you choose. Other benefits of the plan include:

• $500 deductible, many services covered at 100%
• Needle stick coverage IS included in the plan
• Opt-out waiver is NOT required
• ACA compliant
• Coverage at home, school, and while traveling abroad
• BCBS participating provider network
• Multi-lingual 24/7 Nurseline
• Prescription drug coverage

Frequently Asked Questions:

1. If I purchase the OU Student Health Insurance Plan, do I still have to complete a waiver?

No. You only need to submit a waiver if your insurance coverage is not through the OU Student Health Insurance Plan.

2. If I purchase the OU Student Health Insurance Plan, do I need to purchase Needle Stick coverage?

No. Needle Stick coverage is an included perk of the OU Student Health Insurance Plan.

3. The premium is very high; can I make monthly payments?

No. The premium amounts quoted are for the full semester and must be paid for at the time of purchase. 

4. I was able to get cheaper insurance after I paid for the Student Health Insurance Plan. Will they refund me the difference?

Unfortunately, they will not. Your coverage will stay in effect until the end of the semester and if you have other coverage, you will have primary and secondary coverage.

5. How much is the OU Student Health Insurance Plan?

There are different coverage options and periods, but the plan is roughly $305 per month for student coverage. For the most up-to-date information, go to: https://ouhsc.myahpcare.com/ for the Student Health Insurance Benefit Summary.

6. I am not attending classes during the summer, which plan should I purchase?

Your best option would be to choose the plan that covers dates from August 1 to December 31 (FALL 2) and January 1 to May 31 (SPRING).

7. If I purchase the OU Student Health Insurance Plan, will that cover any immunizations and titers that I need for enrollment?

The student health insurance will cover all of your vaccinations and most of the cost of the titers.

8. I received a notice to renew my OU Student Health Insurance Plan before my current plan expires. Can I renew this plan now for fall?

Yes. You can enroll for the next semester; be sure to select the plan that expires at the end of the next semester. For example: If currently in the Summer semester, the Fall semester would end on December 31^st. Pick the plan that also expires on December 31^st. 

Students can opt out of purchasing the OU Student Health Insurance Plan if they have alternate healthcare coverage that meets OUHSC criteria. All students with alternate healthcare coverage must submit proof of coverage through the Academic HealthPlans Waiver System by the designated COD deadline each semester. If the COD’s deadline passes and you have NOT opted out or purchased the Student Health Insurance plan, you will have instruments held, chart locks applied, or be removed from class/clinic.

Waiver will be approved for any OUHSC student who has coverage as an employee or dependent on the OU or OUHSC Employee Group Health Plan, other Affordable Care Act (ACA) compliant employer group health plan, Tribal coverage, Military coverage, or SoonerCare coverage. ACA-compliant individual and family plans will be evaluated by Academic Health Plans to determine if the policy meets the OUHSC requirements. If the waiver is denied, the student must find suitable coverage or purchase the semester's OU Student Health Insurance Plan. Failure of a student to maintain coverage as required under this policy violates Regent’s Policy and can delay enrollment and program advancement.

For more details on alternate healthcare coverage criteria, click this link: https://ouhsc.myahpcare.com/waiver 

Frequently Asked Questions:

1. Where do I go to submit my waiver?

Domestic students can complete their waiver here:  https://www2.academichealthplans.com/school/5002.html

International students (F1-J1 visa holders) can complete their waiver here:  https://www2.academichealthplans.com/school/5007.html

2. What is my waiver site password?

Unless you previously changed it, your password is your 8-digit date of birth in MMDDYYYY format.

3. How often do I have to submit a waiver?

All students enrolled in OU Health Sciences Center (OUHSC) programs are responsible for maintaining health insurance and providing coverage information each semester of enrollment in their programs. Dental students will submit their waiver in the Summer and Spring semesters. Hygiene students will submit their waiver in the Fall and Spring semesters.

4. What is the waiver deadline? 

The deadline varies each semester; however, the COD deadline is ONE WEEK before the OUHSC campus deadline. 

5. How long does it take to receive notification that my waiver was approved?

A separate email explaining if the waiver request has been approved or denied will be sent from Academic Health Plans within seven business days.

6. Should I wait until the last minute to complete my waiver?

NO. Complete your waiver as soon as possible. If AHP requests additional paperwork, you will still beat the deadline. If your insurance coverage is not compliant, you must purchase the OU Student Health Insurance Plan or coverage through the Healthcare Marketplace Insurance before the deadline. If you have trouble signing in, let Student Affairs know immediately.

7. What happens if I do not complete my waiver or purchase insurance before the deadline?

The system automatically closes and you will not fulfill your OU Board of Regents requirement for enrollment, therefore, you will not be able to attend classes or clinic.

8. Should I upload my medical insurance information in Complio?

Only if you purchased the OU Student Health Insurance Plan; otherwise, no. To fulfill your needle stick coverage requirement, a receipt must be uploaded into Complio. If you purchased the OU Student Health Insurance Plan, you can upload your two-page emailed receipt, in the Needle Stick category, under OUHSC Insurance. 

9. I have medical insurance already; what should I upload as proof of coverage for the waiver system?

You must ensure that your medical card has your name listed. If your name is listed, then you can upload a front and back copy of the insurance card. You may be asked for a Letter of Coverage and a summary of plan benefits from your insurance company. This information can be found on most insurance company’s patient portal. If your name is not listed, you must get a new card with your name on it or ask your insurance carrier for a Letter of Coverage stating you are covered under that policy. Medical coverage policy must be a) active on, or before, the first day of classes, b) list coverage dates until the end of the semester, c) be printed in English, and d) quoted in United States currency.

10. I have military or Veteran’s insurance, what can I upload as proof of coverage?

You can submit a front and back copy of your military ID and Social Security card as proof or ask your insurance carrier for a Letter of Coverage stating your policy is in effect.

11. I have Tribal coverage, what can I upload as proof of coverage?

You can submit a front and back copy of your Tribal ID, CDIB card, or a Letter of Coverage from your tribe stating you have coverage and a front and back copy of your Social Security card.

12. I have a Health Sharing Plan; is this acceptable medical coverage?

No. Health Sharing Plans are not compliant with ACA coverage. You must purchase the OU Student Health Insurance Plan or another plan through the Healthcare Marketplace.

13. What do I do if my insurance card is in my maiden name and I haven’t changed it yet?

You must upload your marriage license with your proof of medical coverage.  Be sure to save all your documents with the last name you are enrolled with before uploading.

14. If my deductible is too high, will my waiver be denied?

Yes, medical coverage must be comparable to the HSC student health insurance plan including a $1000 or less deductible for Domestic students or a $500 or less deductible for International students plus a similar benefit model.

15. What are some other reasons why my waiver would be denied?

Medical coverage must meet the Minimum Essential Coverage as required by the Affordable Care Act (ACA) such as

a) no exclusions for pre-existing conditions - Your plan may have pre-existing exclusions.

b) preventive care and women’s health care as required by the ACA covered at 100% - Your plan may not cover either benefit at 100%. 

c) no annual or lifetime limits. - Your plan may have an annual or lifetime limit for the amount they will pay out. 

Healthcare-sharing groups, discounts, or indemnity plans do not meet the criteria for acceptable alternative health insurance. Membership in healthcare-sharing groups, discounts, or indemnity plans will not be accepted for waiver approval. You must purchase the OU Student Health Insurance Plan or a comparable plan through the Healthcare Marketplace.

16. I tried to log in to complete my waiver and got a message that “my school had not authorized me to fill out this form”; what should I do?

Please refer to the email sent out by Student Affairs titled Student Health Insurance & Waiver Information. Although you may be currently enrolled with the COD, you cannot access the waiver system until the new term activation date. This date varies by semester, but it will be listed in the email from Student Affairs.

17. The waiver site is asking for proof of my insurance; what does that mean?

Proof of coverage consists of:

Required

Insurance Card: Copy the front and back with the student’s name listed OR

Letter of Coverage: Contains beginning and end dates of coverage and who is covered. Found on the insurance company’s online portal.

Any Letter of Coverage must be dated within 30 days of the start of each semester.

Military coverage: Letter from Tricare.

Tribal coverage: Front and back of your tribal or CDIB card and SSN or letter of coverage from Tribal insurance carrier.

SoonerCare coverage: DET-9001-D approval letter.

Optional

Summary of Benefits: a document that details plan deductible, copay, and coinsurance. Found on the insurance company’s online portal.

1. Medical coverage must meet the Minimum Essential Coverage requirements of the Affordable Care Act (ACA). Student must provide evidence that they are eligible for, and enrolled in, ACA compliant individual coverage purchased through the Exchange (HealthCare.gov) or other ACA compliant individual coverage purchased from an insurance carrier based in the United States.

2. Medical coverage must be CURRENTLY active, in effect, and list coverage dates that cover the entire semester/trimester being waived. Medical coverage cannot become effective AFTER classes have started, if you are seeking a waiver.

3. Policy must be in English and any premiums or amounts quoted must be in US currency/dollars.

4. Policy cannot exclude pre-existing conditions and must include a list of the exclusions.

5. International Students must also maintain coverage for repatriation of remains to their home country and medical evacuation to their home country. The benefit for repatriation may not be less than $25,000, and the benefit for medical evacuation may not be less than $50,000.

6. If an International Student’s health plan does not include medical evacuation and repatriation, a rider must be purchased providing coverage at equal limits to the student health insurance plan as follows:

• A deductible not to exceed $500 per accident or illness
• Medical benefits of at least $100,000 per accident or illness
• Repatriation of remains in the amount of $25,000
• Expenses associated with the medical evacuation of the exchange visitor to their home country in the amount of $50,000

International Students may waive the Student Health Insurance Plan if:

1. Student is eligible for, and enrolled in, coverage that is backed by the full faith and credit of the government of the exchange visitor’s home country and is provided through an ACA compliant plan.

2. Student is sponsored by the US government or other sponsoring entity that has guaranteed payment of all health expenses, and repatriation and evacuation expenses.

3. Student is enrolled exclusively in distance learning classes at the university.

Needle stick insurance is required and is available through the Academic Health Plan’s insurance company at:

https://ouhsc-needlestick.myahpcare.com/

For students enrolling in the OUHSC Student Health Insurance Plan through Blue Cross and Blue Shield of Oklahoma, this benefit is included and does not have to be purchased separately. Students with alternate healthcare coverage should check with their insurance carrier to see if their current policy includes needle stick coverage. If needle stick coverage is not an included benefit, College of Dentistry students MUST purchase a separate needle stick policy through the Academic Health Plan. Upload the two-page emailed receipt in the Needle Stick category. Add the receipt to the Needle Stick requirement and update the expiration date. 

The cost of the policy is $74 per policy year and it is NOT pro-rated. The policy year begins on June 1 and ends on May 31 each year. 

Plan benefits include:

• $2000 plan maximum per policy year
• 100% coverage at OU Student Health
• Covered expenses
  • Outpatient doctor visits
  • Outpatient lab tests
  • Medications necessary to treat exposure to a needle stick, body fluid splatter, or bloodborne pathogen
• Emergency room visits

Frequently Asked Questions:

1. How do I prove I have Needle Stick Insurance if I didn’t receive a new card?

You only receive a Needle Stick card your first year; do not lose it. For Complio, upload the two-page emailed receipt in the Needle Stick category; add the receipt to the Needle Stick requirement, and update the expiration date.

2. Do I have to buy Needle Stick Insurance?

Yes; if your alternate healthcare coverage does not cover needle sticks, you must purchase a plan. Needle Stick coverage is a benefit if purchasing the OU Student Health Insurance Plan.

• If you have medical coverage that includes Needle Stick as a benefit (must be comparable to the AHP Needle Stick plan (NSP)), the student must complete a Medical Insurance Verification Form.
• The student must call their insurance company via the phone number on the back of their insurance card to complete the form.
• Upload the completed form to the Needle Stick category as an EXCEPTION.
• Ms. Carter will review the exception for approval. If not approved, the student MUST purchase the AHP Needle Stick plan for $74.

3. SoonerCare states that my Needle Stick coverage is my primary insurance. How do I correct this to show SoonerCare as my primary insurance?

Contact SoonerCare by calling 405-522-7300 or 800-987-7767. Select the "Third Party Liability" (TPL) department if given options via the automated system. You will need your Needle Stick coverage information from your BCBS card. If directed to an online form, complete it, and return it to SoonerCare. SoonerCare will verify your coverage information with BCBS and remove the TPL information indicating SoonerCare is the primary payer for medical claims.

IF SoonerCare does NOT remove the TPL from your account, your claims will still be paid.

• Your provider will submit claims to BCBS as your primary medical payer.
• BCBS will deny the claims because the charges are not covered by the plan.
• Your provider must submit your claim to SoonerCare with the primary Explanation of Benefits (EOB) indicating no payment was made.
• SoonerCare will pay the claim as the primary payer.
• In this scenario, it takes longer for your provider's claims to be paid; however, they will still be paid at the SoonerCare rate. 

4. If I have SoonerCare coverage, should I purchase the Needle Stick plan?

Yes, SoonerCare does NOT provide occupational coverage for bloodborne pathogen exposure. 

5. Why would my Needle Stick exception be denied?

If your coverage offered by your alternate healthcare coverage is NOT comparable to the AHP Needle Stick plan. Which would include:

• Having a deductible - The NSP does not have a deductible for students.
• Having a coinsurance percentage - The NSP does not have a coinsurance percentage. The student pays $0 out-of-pocket costs.
• Copays totaling more than $74 per year - If you have a high copay per office visit, it may be more cost-efficient to purchase the NSP. In the event of a BBP exposure, you may have to see a provider up to four times or more.
• Out-of-network with OU Health - If your plan does not offer you any in-network benefits with OU Health, you must purchase the NSP.
• Requires a referral - time is of the essence when faced with a BBP exposure. You cannot wait for a primary care provider or insurance carrier to refer you to a provider or lab for treatment.
• Requires an authorization - time is of the essence when faced with a BBP exposure. You cannot wait for a primary care provider or insurance carrier to refer you to a provider or lab for treatment.