Frequently Asked Questions

• Do I have to have the UNC Student Health Insurance in order to use the Student Health Center?

  No. All students, staff and faculty are eligible to use the Student Health Center. In order to get the most benefit from your insurance carrier, we recommend checking your specific plan to see if the health center is in-network. Call your insurance carrier and ask if University Health Services is in-network. If the health center is NOT in your carrier's network, you might be paying more for your medical care.

• If I have the UNC Insurance Plan do I have to see someone at the UNC Student Health Center first?

  Yes, in many cases the student is required to seek care at the Student Health Center before seeking care elsewhere. If you are more than 20 miles from campus or the health center is closed, you can see anyone in the Cigna Network. If you need to see a Specialist, the health center will need to submit a referral in order for your claim to be covered. If you do not obtain the necessary referrals for care outside the Student Health Center, your claim will be denied.

• Do I have to get a referral to see another provider?

  Yes, in most cases you will need a referral to see another provider. A referral for outside care is NOT necessary ONLY under the following conditions:

  • Medical Emergencies
  • When the Student Health Center is closed
  • When service is rendered at another facility during break or vacation periods
  • Medical care received when the student is more than 20 miles from campus
  • Medical care obtained when a student is no longer eligible to use the Student Health Center due to a change in student status
  • Maternity care
  • Psychotherapy
  • For services not offered at the Student Health Center
• What are the benefits of choosing the Student Health Center over other providers?

  Students insured with the UNC Student Health Insurance plan will pay $20.00 for a regular visit. The $20.00 will cover the office visit and simple care. You will not be subject to the $500 deductible for simple care received at the health center (lab work sent to an outside lab will still be subject to the deductible).

• Will the UNC Student Health Insurance cover charges from my family doctor at home?

   Yes, provided they are for covered expenses. Your UNC Student Health Insurance is good any where in the world. However, some providers may request that you pay for the charges and submit the charges to the insurance company yourself for reimbursement, rather than billing them directly. Keep in mind, in-network providers will give you the most benefit.

• I am graduating in May, will my UNC Insurance end when I graduate?

   No, if you are covered by the UNC Student Health insurance plan for Spring Semester of the academic year you are graduating, coverage will be in force until the end of that plan year, which is usually August 16th at 12:00 am. This means that paying your Spring Semester coverage will give you coverage over the entire summer after you graduate. (If you graduate in December, coverage ends December 31st at 12:00 am).

• Is my UNC Student Health Insurance good when I am home or elsewhere during winter break, spring break or summer break? 

   Yes. Paying the premium for Fall Semester gives your coverage from August 17th through December 31st, including winter break. Spring Coverage takes effect January 1st through apring and summer break, ending August 16th. You are automatically enrolled in coverage if you have not waived the premium for fall and you are taking at least 9 credit hours for undergraduates and at least 6 credit hours for graduate students.

• I filled out a waiver last fall, do I have to do a new one again this fall?

   Yes. A new waiver is required from every UNC student that has comparable coverage every academic year. This is because many people change jobs during the course of a year, and their insurance coverage may change. This assures the University of having up-to-date insurance information from each student.

• Who do I pay my deductible to?

   The deductible is paid to the provider supplying the covered services. You do not pay the deductible to the insurance company or the university.

  After you receive your Explanation of Benefits (EOB) from the insurance provider, you will be able to tell which provider you need to pay the deductible to. The first claims for covered expenses that you submit for processing will be applied to your deductible. Once you have reached the deductible amount, the insurance will begin reimbursing covered expenses at 80% for in-network care and 50% for out-of-network care.

  Note: If you are seen in the Student Health Center, you will not have to meet the deductible. You will pay a $20.00 copay and the insurance will pay covered expenses at 100%.

• Can I submit receipts for medications I've purchased?

   The UNC Student Health Insurance plan is part of HealthSmart RX pharmacy network. This means that in order to received coverage for prescription medications you must use a HealthSmart RX pharmacy.  Please see the Policy Brochure for further information regarding coverage of medication.

• What is an out-of-pocket maximum?

   This is the maximum amount of money the student has to pay for claims per plan year. The out-of--pocket maximum for 2016-2017 is $6,350. After the deductible has been met, the plan will pay 80% for PPO and 50% for Non-PPO.

• Does the UNC Insurance cover dental expenses?

   The UNC plan does not cover dental care except for a $500 benefit for impacted wisdom teeth removal. You do have the option of adding Cigna Dental Coverage for an additional fee. For more information see Cigna Dental.