Student Health Benefit Waiver Criteria
Comparable coverage to the university plan must meet all of the waiver criteria requirements below.
- Coverage must be currently active
- Coverage must be ACA Compliant
- Out-of-State Medicaid/Medicare is not acceptable
- Out-of-State HMOs are not acceptable
My plan covers the following essential health benefits:
- Emergency Services: care received for conditions that could lead to serious disability or death if not immediately treated, not penalized for going out-of-network or not having prior authorization.
- Hospitalization: treatment in a hospital for inpatient care including laboratory services and medication during the hospital stay.
- Laboratory services: testing provided to help a doctor diagnose an injury, illness or condition, or to monitor the effectiveness of a particular treatment.
- Mental health services and addiction treatment: inpatient and outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. Limits must comply with state or federal parity laws.
- Outpatient Care: care received without being admitted to a hospital such as a doctor’s office or clinic.
- Prescription drugs, including birth control coverage: medications that are prescribed by a doctor to treat an illness or condition, some prescription drugs can be excluded.
- Rehabilitative services and devices: Services to help recover or develop skills and devices to help gain or recover mental and physical skills due to injury, disability or chronic condition.
- My plan covers me while in the state I will be residing in for the upcoming semester. [Note: if your current health insurance plan is a Medicaid plan, it must provide coverage for you in the state you will be residing in for the upcoming semester.]
- I will remain enrolled in health care coverage for the duration of the academic year.
