Mandatory Health Insurance:

Health care is very expensive in the United States and is not paid for by the government. Individuals are responsible for their medical costs unless they are covered by health insurance, and it is important that you have health insurance coverage effective as soon as possible after your arrival to protect your well-being. All our international students must have health insurance coverage.

To make things easier for you, the University will automatically enroll you in the International Student Accident & Illness Insurance Coverage. This will be automatically billed to you by Student Accounts & you will see this labeled as “insurance” on your student bill. The insurance rate for the academic year is $900.

Family members of the F-1 students and Students on OPT are required to have health insurance coverage and are eligible to enroll individually through ISO International Student Health Insurance (isoa.org)

Students on OPT also have an option to enroll with EIIA and must inform the International Student Support Coordinator by the end of May. 

Important Deadlines:

Coverage dates of the University of Lynchburg International Plan for each academic year:

• August 1st through July 31st
• Coverage by EIIA
• Coverage is adjusted for single-semester exchange students or students beginning in January. 

Coverage dates for International Health Insurance

• Fall Semester: August 1st, 2024-December 31st, 2024
• Spring Semester: January 1st, 2025-July 31st, 2025

F2 Dependent Health Insurance Enrollment

F1 International Students are responsible for their dependent’s health insurance. Since dependent health insurance is very expensive for our dependent students, we highly encourage caretakers to enroll in ISO health insurance for the F2 students. 

OPT Health Insurance Enrollment

We will not enroll you in the EIIA insurance plan as many companies offer their employees health insurance. You are more than welcome to enroll in the health insurance plan. You will reach out to the International office at [email protected] before the deadlines below if you would like to enroll in OPT. 

Deadlines
Fall Semester: Aug. 1, 2024

Spring Semester: Jan. 1, 2025 

New International Students (Summer Semester) 

Unfortunately, at this time, we do not offer new International students summer insurance plans until they have already attended the university for the Fall Semester. Contact the International Office for health insurance offered to new international students. 

Summary of Benefits:

• Global coverage with no out-of-network providers
• $100 deductible
• 80% coverage after the deductible
• Wellness benefits

A full summary of benefits can be found here.

For a guide to International Insurance Basics, click here.

Dental and Vision Coverage:

EIIA Insurance does not cover dental and vision. However, if you are not sure if any procedure related to dental and vision injury/accident will be paid for or not, you can call NAHGA at 877-497-4980.

You can also get dental care done at the Free Clinic of Lynchburg or pay out of pocket at a dental clinic in the area. We highly suggest you call the clinics before arrival and inquire about the out-of-pocket costs. 

You can also visit vision clinics in the area and pay out of pocket for services; make sure to inquire about costs before the appointment. 

Health Insurance Card:

A digital copy of your health insurance card will be emailed to your Lynchburg inbox before or at the beginning of the semester. Make sure to print it out and carry it with you at all times. If you find any errors (name, date of birth, etc.) on the card, immediately reply to the email with the correct information. 

How to Use Your Health Insurance Card:

1. Take your health insurance with you to the healthcare provider along with a photo ID.
2. We strongly advise you to first visit our Health Center located at the Hundley Hall, Terrace level, during the operation hours. If you need further assistance, the Health Center staff will refer you to the appropriate health care provider. Remember that you can visit any health care provider with your health insurance card.
   1. For hours of operations and medical care service provided at the Health Center, visit here.
   2. For emergency and after-hours care, visit here.
3. For non-emergency health care outside the hours of the Health Center, visit an Urgent Care/Immediate Care facility. 
4. If you have a life-threatening emergency, you can visit the Centra Emergency Care department or dial 9-1-1.

Student Health Form

Welcome to the University of Lynchburg! As you begin your academic journey with us, we kindly ask that all international students complete the required Student Health Form and other required health information. You can access the forms within your student portal. For more information, please visit the Health Center’s web page or feel free to reach out to the Health Center if you have any questions. They want to help! 

What to expect from the health care provider:

At the University Health Center,

1. When you visit the Health Center, you will need to give your health insurance card and fill out the patient forms before you can see the health care professional.
   1. You must submit all your required health forms on the Student Health Portal at the beginning of the semester.
2. The medical cost will be waived when you visit the Health Center.

At other health care providers:

1. You will need to provide your health insurance card you (may need to show your photo ID) and fill out paperwork. 
2. You may or may not have to pay the deductible before or after seeing the healthcare professional. If you’ve met your deductible, you do not have to pay at the time of your visit.

What to do after you’ve been to the health care provider outside the Health Center:

1.  If you did not provide your health insurance information during your visit, make sure to call the health care provider to provide the insurance information so they can bill your insurance company.
2. Make sure to check your mailbox once a week for your medical bill. Keep in mind that you may be getting more than one bill as the medical billing system could operate very differently than where you are from. 
3. Carefully read your bill to see the cost of the services received, how much insurance is covered, and how much you need to pay (deductible and/or co-pay).
   1. You will also receive an EOB (Explanation of Benefits) letter from the health insurance company once it covers the portion of your medical bill. If you do not receive it, make sure to call NAHGA at 877-497-4980.
4. It is a good practice to call your healthcare provider to find out how many bill(s) you should expect to receive if there’s any financial assistance you’re eligible for, and if there’s any payment plan you can enroll into if you can not pay the entire amount.
5. Remember that you can always call your healthcare provider’s billing department if you have any questions.

Medical Billing in the U.S.:

As an international student, it is important to understand that the medical bill is not one big total cost that you can pay all at once. The medical cost will come to you in smaller bills for the services and procedures you receive from the medical professionals. So it is your responsibility to make sure that you receive all the medical bills, check to make sure that insurance covers its portion of the bills, check to make sure the correct payment is made, and pay your part of the bill. 

Deductible: It is the amount of money you, as an insured individual, need to pay in order to kickstart your insurance policy. $100 is the deductible amount if you are enrolled in the university EIIA plan.

Coinsurance: It is the percentage of the medical cost you will have to pay after you meet your deductible. 20% of the medical bill is what you will need to pay. 

Alternative Insurance:

If you already have health insurance that offers coverage in the United States or would like to purchase an alternative plan, you will need to submit proof of alternative insurance coverage that meets the requirements below and a waiver form to the international student support Services Staff before your arrival to the University of Lynchburg.

In order to meet the University’s health insurance standard, please see the minimum requirements listed below and ensure your policy provides the equivalent or greater.

1. Medical Benefits of at least $250,000 per accident or illness
2. Repatriation of Remains in the amount of at least $50,000
3. No out-of-network providers (global coverage)
4. Wellness Component 
5. Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $50,000
6. A deductible not to exceed $100 per accident or illness
7. Must include coverage for both accident and illness (travel insurance and insurance that covers emergencies only is not acceptable)
8. Coverage must begin no later than the student’s date of arrival in the U.S. and last until at least July 31 for degree-seeking students or through the end of your time at the University of Lynchburg for exchange students.

Please remember, if we do not have proof of health insurance within two weeks of your arrival, you will be automatically enrolled in the school policy, and you will be responsible for the fee by the date communicated by Student Accounts. 

Helpful Resources:

• List of Walk-in/Immediate care/Urgent Care
  • MinuteClinic inside CVS Pharmacy
  • Physicians Treatment Center
  • MedExpress
  • Johnson Health Center
• For dental: Free Clinic of Central Virginia

Insurance Definitions You Should Know:

Accident means an unforeseeable event which:

• 1)  Causes Injury to one or more Plan Participants; and
• 2)  Occurs while coverage is in effect for the Plan Participant.

Benefit Period means the period from the date of the Accident causing the Injury or Sickness for which benefits are payable, as shown in the Schedule of Benefits, and the date after which no further benefits will be paid.

Coinsurance means the percentage of Eligible Expenses for which the Company is responsible for a specified covered service after the Deductible, if any, has been met.

Covered Accident means an Accident that occurs while coverage is in force for a Plan Participant and results in a Covered Loss for which benefits are payable.

Covered Loss or Covered Losses means an accidental death, dismemberment, Sickness, or other Injury covered under the Policy and indicated on the Schedule of Benefits.

Deductible means the dollar amount of Eligible Expenses that must be incurred and paid by the Plan Participant before benefits are payable under the Policy. It applies separately to each Plan Participant.

Eligible Expenses means the Usual, Reasonable, and Customary charges for services or supplies which are incurred by the Plan Participant for the Medically Necessary treatment of an Injury or Sickness.

Emergency means a Sickness or Injury for which the Plan Participant seeks immediate medical treatment at the nearest available facility. The condition must be one which manifests itself by acute symptoms which are sufficiently severe (including severe pain) that without immediate medical care, a prudent layperson possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would cause:

• His life or health would be in serious jeopardy, or, with respect to a pregnant woman, serious jeopardy to the health of the woman or her unborn Child;
• His bodily functions would be seriously impaired, or
• A body organ or part would be seriously damaged.
  Experimental/Investigational means that a drug, device, medical care, or treatment will be considered experimental/investigational if:
•  The drug or device cannot be lawfully marketed without approval of the Food and Drug Administration, and approval for marketing has not been given at the time the drug or device is furnished; 

• The informed consent document utilized with the drug, device, medical care, or treatment states or indicates that the drug, device, medical care, or treatment is part of a clinical trial, experimental phase, or investigational phase or if such a consent document is required by law;
• The drug, device, medical care or treatment or the patient informed consent document utilized with the drug, device, or medical care or treatment was reviewed and approved by the treating facility’s Institutional Review Board or other body serving a similar function, or if federal or state law requires such review and approval;
• Reliable Evidence shows that the drug, device, medical care, or treatment is the subject of ongoing Phase I or Phase II clinical trials, is the research, experimental study, or investigational arm of ongoing Phase III clinical trials, or is otherwise under study to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment of diagnosis; or
• Reliable Evidence shows that the prevailing opinion among experts regarding the drug, device, medical care, or treatment is that further studies or clinical trials are necessary to determine its maximum tolerated dose, its toxicity, its safety, its efficacy, or its efficacy as compared with a standard means of treatment of diagnosis.
• Reliable evidence means only published reports and articles in the authoritative medical and scientific literature; written protocol or protocols by the treating facility studying substantially the same drug, device, or medical care or treatment; or the written informed consent used by the treating facility or other facility studying substantially the same drug, device or medical care or treatment. Eligible Expenses will be considered in accordance with the drug, device, or medical care at the time the expense is incurred. Management staff in Our Claims Department or a Claims Payor acting on Our behalf will determine if the drug, device, or medical care is experimental/investigational based on the above criteria.
  Injury means bodily harm that results independently from disease or bodily infirmity, such as an accident. All injuries to the same Plan Participant sustained in one Accident, including all related conditions and recurring symptoms of the Injuries, will be considered one Injury.

Inpatient means a Plan Participant who is confined in an institution and is charged for room and board. 

Insurance means the coverage that is provided under the Policy.

Intensive Care Unit means a cardiac care unit or other unit or area of a Hospital that meets the required standards of the Joint Commission on Accreditation of Hospitals for Special Care Units.

Maximum Benefit means the largest total amount of Eligible Expenses that the Company will pay for the Plan Participant as shown in the Plan Participant’s Schedule of Benefits.

Medically Necessary means a treatment, drug, device, service, procedure, or supply that is:

• 1)  Required, necessary,y and appropriate for the diagnosis or treatment of a Sickness or Injury;
• 2)  Prescribed or ordered by a Physician or furnished by a Hospital;
• 3)  Performed in the least costly setting required by the condition;
• 4)  Consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered.

When specifically applied to Hospital confinement, it means that the diagnosis or treatment of symptoms or a condition cannot be safely provided on an outpatient basis.

The purchasing or renting of air conditioners, air purifiers, motorized transportation equipment, escalators or elevators in private homes, swimming pools or supplies for them, and general exercise equipment are not considered Medically Necessary.

A service or supply may not be Medically Necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. We may consider the cost of the alternative to be the Eligible Expense.

A treatment, drug, device, procedure, supply, or service shall not be considered Medically Necessary if it:

• Is Experimental/Investigational or for research purposes;
• Is provided for education purposes or the convenience of the Plan Participant, the Plan Participant’s family, Physician, Hospital, or any other provider;
• Exceeds in scope, duration, or intensity that level of care that is needed to provide safe, adequate, and appropriate diagnosis or treatment and where ongoing treatment is merely for maintenance or preventive care;
• Could have been omitted without adversely affecting the person’s condition or the quality of medical care;
• Involves the use of a medical device, drug, or substance not formally approved by the United States Food and
  Drug Administration;
• Involves a service, supply, or drug not considered reasonable and necessary by the Healthcare Financing Administration Medicare Coverage Issues Manual or
• It can be safely provided to the patient on a less cost-effective basis, such as out-patient, by a different medical professional, or pursuant to a more conservative form of treatment.

Network Provider means a Physician, Hospital, and other healthcare providers who have contracted to provide specific medical care at negotiated prices.

The availability of specific providers is subject to change without notice. You should always confirm that a Network Provider is participating at the time services are required by calling us at 1-800-226-5116 and/or by asking the provider when you make an appointment for services.

A non-network provider is a physician, hospital, or other healthcare provider who has not agreed to any pre-arranged fee schedules. A Plan Participant may incur significant out-of-pocket expenses with these providers. Charges in excess of the insurance payment are the Plan Participant’s responsibility.

Occurrence means all losses or damages that are attributable directly or indirectly to one cause or one series of similar causes. All such losses will be added together, and the total amount of such losses will be treated as one Occurrence without regard to the period of time or the area over which such losses occur.

Policyholder means the entity shown as the Policyholder in the Schedule of Benefits.

Service Provider means a Hospital, convalescent/skilled nursing facility, ambulatory surgical center, psychiatric Hospital, community mental health center, residential treatment facility, psychiatric treatment facility, alcohol or drug dependency treatment center, birthing center, Physician, Dentist, chiropractor, licensed medical practitioner, Registered Nurse, medical laboratory, assistance service company, air/ground ambulance firm, or any other such facility that the Company approves.

Sickness means illness or disease that requires treatment by a Physician while covered by this Policy. All related conditions and recurrent symptoms of the same or a similar condition will be considered the same Sickness.

Third Party means a person or entity other than the Plan Participant, the Policyholder, the Participating Organization, or the Company.

Usual, Reasonable, and Customary means the most common charge for similar professional services, drugs, procedures, devices, supplies, or treatment within the area in which the charge is incurred. The most common charge means the lesser of:

• The actual amount charged by the provider;

• The negotiated rate; or

• The charge that would have been made by the provider (Physician, hospital, etc.) for a comparable service or supply made by other providers in the same geographical area, as reasonably determined by us for the same service or supply.

“Geographic Area” means the three-digit zip code in which the service, treatment, procedure, drugs, or supplies are provided; a greater area, if necessary, to obtain a representative cross-section of charge for a like treatment, service, procedure, device, drug, or supply.

Usual, reasonable, and customary charges, fees, or expenses as used in the policy to describe expenses will be considered to mean the percentile of the payment system in effect at policy issues, as shown on the Schedule of Benefits.