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Frequently Asked Questions

Frequently Asked Questions

Eligibility & Enrollment:

  1. How do I enroll in the NIU Student Insurance Plan?
  2. Is coverage available for my dependents?
  3. If I cancel the NIU insurance and then lose my other insurance, can I sign up for the NIU plan?
  4. Is there a deadline to enroll in the NIU plan?
  5. Is coverage available for over the summer?

Canceling:

  1. If I have other health insurance coverage, why should I keep this one?
  2. How do I waive enrollment in the NIU insurance plan??
  3. If I waive the insurance, is that waiver good for the whole time I’m at NIU?
  4. What happens if I miss the deadline to waive the NIU plan??
  5. May I still go to Health Services if I waive the NIU plan?

Coverage:

  1. What does the NIU plan cover?
  2. Are pre-existing conditions covered?
  3. Can I go to any doctor or hospital I want?
  4. What happens if I get sick or hurt while I am traveling?
  5. Where do I get an ID card?

Costs:

  1. What is a deductible?
  2. Does it cost extra to go to the emergency room?
  3. Will the NIU plan pay all my medical bills?

 Claims:

  1. How do I file a claim?
  2. How do I file a claim for birth control?
  3. Where do I submit claims?
  4. How do I check on the status of my claim?

Eligibility & Enrollment:

  1. How do I enroll in the NIU Student Insurance Plan?
    Students registered for 9 or more on-campus (DeKalb) hours and all International Students are automatically charged for the NIU Student health insurance plan.  Any student registered for 6 or more credit hours, on or off campus, may enroll in the NIU insurance plan by filling out the online enrollment form by the 15th calendar day of the semester.
  2. Is coverage available for my dependents?
    A student can add a spouse or domestic partner to the plan as long as the student is covered by the NIU plan.  The online enrollment form must be submitted every semester that coverage is needed.
  3. If I cancel my NIU insurance and then lose my other insurance, can I sign up for the NIU plan?
    Yes – when you are notified that you are going to lose your current coverage, just fill out the Qualifying Event Form and return to the student insurance office along with proof from the prior insurance company that you are losing or lost coverage.  Your NIU policy will be effective the day we received both forms.
  4. Is there a deadline to enroll in the NIU plan?
    Yes, you must sign up for the insurance within the first 15 days of classes, unless you lose coverage from your insurance company.
  5. Is coverage available for over the summer?
    If you are enrolled for the spring semester, you are covered for the summer for no additional cost.  If you do not have spring coverage, you may enroll for summer only coverage as long as you are enrolled in at least 6 credit hours or if you are a continuing student at NIU. 

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Canceling:

  1. If I have other health insurance coverage, why should I keep this one?
    You should consider keeping this as supplemental coverage.  Very few group plans cover all medical expenses.  The NIU plan is designed to coordinate benefits with your primary coverage to reduce or eliminate many out-of-pocket expenses that you would be responsible for without additional coverage.
  2. How do I waive enrollment in the NIU insurance plan?
    During the waiver process period, you must go to our online waiver request form to waive the insurance.  Completing the waiver request form, does not guarantee that the waiver will be accepted.  We verify coverage and will let you know if the waiver is approved.
  3. If I waive the insurance, is that waiver good for the whole time I’m at NIU?
    No!      When you waive the insurance, a fall waiver is only good for 1 year.  Each fall you have to cancel the insurance for that school year.  A spring waiver is only good through August. 
  4. What happens if I miss the deadline to waive the insurance?
    If you miss the deadline to cancel the insurance, you may file an Appeal.  There is a deadline to file an appeal.  Please remember that filing an appeal does not guarantee that the appeal will be approved.  For more information on Appeals please go to the Appeals page.
  5. May I still use Health Services if I waive the NIU plan?
    Yes!      Health Services is NOT connected with Student Insurance.  All NIU Students who have at least one on campus credit hour can use Health Services. 

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Coverage:

  1. What does the NIU plan cover?
    This is a PPO plan. It covers preventive care, well-care, doctor’s visits, hospitalization, diagnostic and lab services, physical therapy, maternity, mental healthcare and birth control.
  2. Are pre-existing conditions covered?
    Effective 8/17/12, we have a 6 month pre-existing condition clause for students and dependents 19 years old and older.  This is waived if you have had at least 6 months of consecutive coverage or creditable coverage.
  3. May I go to any doctor or hospital I want?
    Yes, you can.  If the provider is part of the UnitedHealthcare network, you will have lower out-of-pocket costs for covered medical expenses.  This simply means that if you go to a doctor or hospital in the UnitedHealthcare network, it will cost you less than if you go to a doctor or hospital not in the network.  However, the NIU student health insurance plan will cover you even if the doctor is not in the UnitedHealthcare network.
  4. What happens if I get sick or hurt while I am traveling?
    Just call Academic Emergency Services and they will make all the arrangements to get you medical treatment or to get you home.  For more information please go to Academic Emergency Services. 
  5. Where do I get an ID card?
    You can either call or stop by the student insurance office or you can print a temporary ID card at United HealthCare StudentResource’s website – www.myuhc.com

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Costs:

  1. What is a deductible?
    A deductible is the amount you pay before the insurance company pays your claim.  The plan has an annual deductible of $250.
  2. Does it cost extra to go to the emergency room?
    Yes – you will have to pay the extra emergency room co-pay each time you go there and then 20% of the remaining bill.  Only go to the emergency room for emergencies!  If you are sick, go to Health Services – it won’t cost you to see most doctors!
  3. Will the NIU plan pay all my medical bills?
    No – you will have to pay your deductible and co-insurance.

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Claims:

  1. How do I file a claim?
    The doctor’s office or hospital will usually file a claim directly with United HealthCare StudentResouces.  If they haven’t, you can file a claim directly with United HealthCare StudentResources.  Claims must be submitted one year (52 weeks) from date of service to be eligible for benefits.
  2. How do I file a claim for birth control?
    If you are getting your birth control at Health Services, you don’t have to do anything except pick up the prescription!  There is no cost to you.  We submit the paperwork on your behalf. 

    If you are getting the prescription filled at an outside pharmacy, you will have to pay for the prescription in full and then submit a claim to United HealthCare StudentResources. You will be reimbursed for the entire cost of the prescription.  Submit the prescription receipt or computer printout from the pharmacy which should include the name of the medication, the date it was dispensed and the price with the name of the student, the student’s United HealthCare ID number and their address to the address listed below.
  3. Where do I submit claims?
    Claims should be mailed to:

    UnitedHealthcare Student Resources
    P.O. Box 809025
    Dallas, TX 75380-9025

    Or Fax claim to: 469-229-5625

  4. How do I check on the staus of my claim?
    You can call United HealthCare StudentResources directly at 1-800-767-0700; email them at customerservice@uhcsr.com or call us at 815-753-0122. 

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