Florida Memorial University Student Health Plan

Florida Memorial University believes it is important that all students maintain health care coverage to help ensure academic success and well-being. The University is pleased to offer our students a Health Plan that provides excellent levels of health coverage, with low out-of-pocket costs when compared to plans offered commercially or through the ACA marketplace.

COVERAGE REQUIREMENT

All registered full-time undergraduate, international students, and athletes are automatically enrolled in the new 2017-2018 Student Health Plan A and B, effective August 1, 2018 to July 31, 2019. The cost is included in your tuition and billed to your student account each academic semester.

Students who have adequate health care coverage may elect to waive out of Plan B by completing the online waiver request. If you do not complete a waiver request by the semester deadline, you will automatically be enrolled for the full academic year and the cost of this plan will be charged to your student account. There are no refunds or cancellations (unless you are no longer a student) after the deadline.

Students may not waive out of Plan A.International Students may not waive out of Plan A or B. Graduate and part-time students may elect to purchase this plan on a voluntary basis.


WAIVER PROCESS

The deadline to waive out of the FMU Student Health Plan B, for the fall 2018-2019 academic year is by August 15, 2018.   Students who waived out for the fall semester do not need to waive out again for the spring semester.

APPROVED WAIVERS:  If you have an approved waiver and want to find out the status of the credit that will be applied to your student account or refund check, please contact FMU Student Accounts at  (305) 626-3737 or send an email to katrenia.blue@fmuniv.edu.

Waiver Requirement

Students who have other health insurance and do not want the Comprehensive Student Health Plan may complete this waiver request form.  You will need a valid Florida Memorial University Student ID number to login and proceed to the waiver application request.

Your plan must meet the following criteria to receive an approved waiver:

  • You will need to complete this waiver form if you are on a Medicaid plan that provides full health care benefits in the state of Florida. If you are on an out of state Medicaid plan or HMO that will not cover you in the state of Florida your waiver form will not be accepted.
  • The claims administrator of the plan is based in the United States and has a U.S. telephone number and address for submission of claims.
  • Is not a high deductible plan (over $5,000).
  • Is not an international travel only policy.
  • Provides both emergency and non-emergency health care and mental health benefits.
  • Includes the minimum essential benefits as defined under the Affordable Care Act.
  • Provides in-network coverage for hospitalization, outpatient physician visits, urgent care, emergency room, labs, x-rays and preventative wellness visits.

Out-of-state Medicaid and state Children’s Health Insurance Plans, HMOs, and Kaiser Permanente plans may not cover non-emergency care in this area. If this is the case, you will not qualify for a waiver. Please contact your medical insurance carrier to confirm that your insurance covers non-emergency care and that you have a deductible small enough to allow you to afford your portion of the bill.

International travel insurance or medical insurance policies issued from your country of origin or outside the U.S. is not adequate health care coverage under the University's insurance requirement unless it meets the above criteria.

All waiver requests will be reviewed by the University and/or is plan administrator.

If the waiver submitted does not meet the waiver criteria, you will be enrolled in this plan for the full academic year.

Waiver Request Form

The deadline to waive out of the 2018-2019 Student Health Plan for fall is September 15, 2018.

If approved, your waiver is good for the full academic year and you do not need to do another waiver for spring/summer.

Click Here To Waive Plan B

If you lose your health insurance plan mid-year, you may elect to enroll in Plan B at any time throughout the year due to a qualifying event.  For more information, contact Academic Insurance Solutions to enroll at (888) 776-9920.

Request Waiver Status

ABOUT THE PLANS

Plan Information

Plan A Supplemental (Outpatient Only) Student Health and Accident Coverage

  • Services rendered at the Jesse Trice Student Health Center (on campus) are covered at 100%, with no plan deductible or copays.
  • Has a limited outpatient medical and pharmacy benefit that will supplement your primary health care plan’s deductible or coinsurance.
  • 24 Hour Accident Coverage (Non-Intercollegiate Sports related) up to $10,000 Per Injury.

Plan B Comprehensive (Inpatient & Outpatient) Major Medical Health Coverage

  • This plan is mandatory for full-time undergraduate students who do not have other health insurance or an approved waiver while attending FMU.
  • Plan B is to serve as a student’s primary health care plan and provides comprehensive inpatient, outpatient and pharmacy benefits.
  • Services rendered at the Jesse Trice Student Health Center are covered at 100%, no copay or deductible applies.
  • Unlimited lifetime maximum on all essential health benefits. In-network medical expenses covered at 80% after the $150 plan year deductible has been satisfied.
  • Coverage for preventative care and routine well visits at 100%, no copay or deductible applies.
  • 24/7 access to speak with a registered nurses or telemedicine physician services.
  • Worldwide medical coverage and travel assistance services while studying abroad.

Need assistance?  Contact Academic Insurance Solutions at 888-776-9920.  Please read the Florida Memorial University Summary of Benefits located online at www.FMUstudentinsurance.net carefully before enrolling.

Plan A - Limited Supplemental Limited Health and Injury Benefits

PLAN A is intended to cover 100% of acute medical care when treated at the Jesse Trice Student Health Center, located on the FMU campus. Full-time undergraduate students, international students, and athletes are automatically enrolled in this plan at the time of registration. The cost of this coverage is billed to your student account in two equal semester payments. Students may not waive out of Plan A.

This plan DOES NOT include coverage for inpatient hospitalization or any other specialty care.

This plan includes:

    • A limited outpatient medical and pharmacy benefit that will help supplement your out of pocket cost under your primary health care plan, i.e. deductibles, co-insurance and copayments.
    • Accident Coverage up to $10,000 per Injury (Non-Sports related injuries).
    • Accident Coverage up to $25,000 per Injury (Intercollegiate Sports related injuries).
    • 24 hour, 7 days a week access to a registered nurse and physician services.

View Plan Coverage

 

Plan B - Comprehensive Primary Medical Health and Injury Benefits

PLAN B is to serve as a student’s primary health care plan and provides more comprehensive inpatient hospital, outpatient primary and specialty coverage, and pharmacy benefits.  Students who do not have other adequate health insurance while attending Florida Memorial University are required to have Plan B.

Students with an approved waiver will receive a credit for the cost of this plan of $322.50 per semester that will be applied to your student account after the September 10th waiver deadline.  If you have questions about this, please send an email to info@aisstudentinsurance.com.

This plan includes:

    • The cost for medical services rendered at the Jesse Trice Student Health Center.
    • In-network medical expenses are covered at 80% after the $150.00 plan year deductible has been satisfied.
    • Coverage for preventative and wellness benefits at 100%, no copay or deductible applies.
    • 24 hour, 7 days a week access to a registered nurse and telemedicine physician services.
    • Worldwide coverage and travel assistance services while traveling or studying abroad.

View Plan Coverage

Florida Memorial University's Student Health Center

The Student Health Services health forms include a Statement of Health Insurance Coverage Form, Meningitis Information/Declination, Physical Examination, and Immunization Documentation forms.

Download the Health Forms

The Jesse Trice Student Health Clinic provides minimal healthcare services to full-time students.  Students can be evaluated and treated for acute and chronic medical conditions as well as guidance on practices that promote good health and disease prevention.   You are advised and encouraged to visit the clinic for information on the services offered before you get sick. The clinic staff includes a Nurse Practitioner, Registered Nurse, Medical Assistant and a Customer Service Representative.

Click Here For More Information

Location & Hours
The on-site clinic is located in Building 3.  Business hours are Monday to Friday from 8.00 am to 5.00pm

Appointments
Appointments may be made by calling 305-626-3110.  Walk-ins are seen on a "first come, first, serve basis." Students are evaluated by the nurse and based upon the severity of illness may be immediately seen by a provider, given an appointment for a later time, or referred to a specialist or hospital. Students with scheduled appointments have priority over walk-ins unless there is a life-threatening emergency.

Locate Off-Campus Providers


ATHLETIC INJURY COVERAGE

Plan Information

Florida Memorial University provides an excess medical athletic injury policy for all (full or part-time) of its intercollegiate athletes to cover injuries sustained during official intercollegiate athletic activities.

This policy, at no cost to the athlete, provides secondary coverage; that is, it pays after the primary insurance carrier has paid their portion.

Excess Provision. No benefit under this Plan is payable for any expense incurred for Injury or Sickness which is paid or payable by other valid and collectible insurance or under an automobile insurance policy. Covered medical expenses exclude amounts not covered by the primary insurer due to penalties imposed on the Covered person for not complying with plan provisions or requirements.

BASIC PLAN SUMMARY - MEDICAL EXPENSES INCURRED UP TO $25,000 (Per Injury)

Plan Benefit Summary (coverage up to $25,000)


CATASTROPHIC PLAN SUMMARY - MEDICAL EXPENSES FROM $25,000 (Per Injury) to $5,000,000 (Per Injury)

Plan Summary (from $25,000 to $5,000,000)

How To File A Claim

Florida Memorial University provides an excess medical athletic injury policy for all of its intercollegiate athletes to cover injuries sustained during official intercollegiate athletic activities. This policy, at no cost to the athlete, provides secondary coverage; that is, it pays after the primary insurance carrier has paid their portion.

Complete the Online Claim Form

PLEASE BE SURE TO FOLLOWING THESE INSTRUCTIONS TO HAVE YOUR CLAIMS PAID PROPERLY:

ALL CLAIMS MUST BE FILED WITHIN 180 DAYS OF INJURY IN ORDER FOR VALID CLAIMS TO BE PAID.

  • This claim form must be signed by you and a school official.
  • All athletes must file claims with any other primary insurance that you are insured under (if applicable). This means that any claims for athletic injury must first be filed with the student, parent or guardian’s insurance plan or any other valid and collectible medical insurance coverage. Not following this step will delay the claim process.
  • Be sure to submit a copy of this form to the claims address listed below along with copies of all itemized bills and any Explanation of Benefits (EOB) from any other insurance company that has processed your bills.  The FMU student insurance WILL NOT pay your claims if you have other insurance and the other insurance company has not processed your claims.
  • The FMU student insurance will pay the charges for eligible injuries which the other primary coverage has not covered or fully paid, up to the usual and customary charge in our area.
  • In order to meet filing guidelines, all primary insurance carriers’ explanation of benefits (EOBs) must be mailed to the FMU student insurance claims office within one year of the date of service or your claims will be denied.
  • The Claim's Department will coordinate all other aspects of the claim with the athlete/parent/guardian.

MEDICAL EXPENSES THAT EXCEED $25,000

Students must complete the Catastrophic Intercollegiate Sports Accident Claim Form if medical expenses exceed $25,000.  Please complete the claim form and fax it to 1-913-327-7520.

Catastrophic Plan Claim Form

Check Claim Status

This web portal will provide you with helpful information specific to your health and benefits plan through Continental Benefits. This includes:

  • Viewing your plan design and Summary Plan Document
  • Checking status of claim payments and your member responsibilities
  • Reviewing the provider network or finding a provider
  • Finding forms that are useful to you with your benefits plan
  • Contacting customer service via e-mail

If you have any questions regarding your enrollment, eligibility or claims, please call the number on the back of your card. If you are experiencing issues creating a web portal account, please contact MesaInquiries@continentalbenefits.com

FIRST TIME USERS:   

  1. To begin, click on the button below and then select "Employee";
  2. Then type in your FMU student email address.
  3. Complete all of the information requested.  If you do not have a social security number, please type in your government ID or student ID number i.e. FMU000______.

Create Member Account

ALREADY HAVE AN ACCOUNT:

Login Here


If you need assistance with your claims, please complete the Personal Authorization Form and take this form to  the athletic department on campus.

Personal Authorization Form


ONCE ENROLLED

Print an ID Card

Students on Plan B or C ONLY may print an ID card by clicking on the link below.  Students on the supplemental Plan A, do not need an ID card.

This card is not a guarantee of coverage or benefit payment.  The provider will verify coverage at the time of your visit with the information provided on this card.

  1.  Fill in your name and FMU student ID number (omit the "P" and it should be a 9 digit number starting with zeros).
  2. Then hit the "Merge Document" button.
  3. It will then generate a PDF of your ID Card for you to print or save to your computer or phone.

Generate an ID Card

Create Your Member Account

This web portal will provide you with helpful information specific to your health and benefits plan through Continental Benefits. This includes:

  • Viewing your plan design and Summary Plan Document
  • Checking status of claim payments and your member responsibilities
  • Reviewing the provider network or finding a provider
  • Finding forms that are useful to you with your benefits plan
  • Contacting customer service via e-mail

If you have any questions regarding your enrollment, eligibility or claims, please call the number on the back of your card. If you are experiencing issues creating a web portal account, please contact MesaInquiries@continentalbenefits.com

FIRST TIME USERS:   

  1. To begin, click on the button below and then select "Employee";
  2. Then type in your FMU student email address.
  3. Complete all of the information requested.  If you do not have a social security number, please type in your government ID or student ID number i.e. FMU000______.

Create Member Account

ALREADY HAVE AN ACCOUNT:

Login Here

For assistance with creating your online member account, please call 1 (844) 223-2607.

Find an In-Network Preferred Provider

Aetna Signature Administrators (ASA) has a new Find a Provider tool that does not require you to select a plan option.

Click Here to Begin Search

Then click on Medical to begin your search.

Please note, Dental is not included in this student health plan.  Dental is sold separately.

File a Claim

To submit an Online Claim Form

Click Here to Submit Claim

Mail Paper Claims should be mailed to:

Continental Benefits, PO Box 3610, Brandon FL 33509-3610

For Claim Questions, call: 1 (844) 223-2607

Contact Information

 

 

For questions about this plan, please call Academic Insurance Solutions at: 1 (888) 776-9920.

To pre-certify call:  1 (800) 641-5566
Pre-certification must be made prior to an inpatient hospital admission (or within 48 hours if an emergency).
Failure to pre-certify may result in reduced benefits.