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Billing and Insurance
Health Care Reform & Affordable Care Act
Eligibility: Students who have paid the University Health fees are eligible to utilize Student Health Services (SHS). Office visits are subsidized by the health fees. Students must present a valid student ID at each visit. Spouses of enrolled students may use the SHS; please contact the office for current fee schedule.
SHS Fees: Charges are incurred for the following:
- Ancillary services such as laboratory, x-ray, prescriptions, minor surgery, immunization, wart treatment and allergy injections.
- Physical examinations for pre-employment, pre-operative, FAA (flight), women's and men's annual exam.
All charges are billed through Student Account Services and identified on your student account as a "Student Health Service" charge. Insurance claims will be filed for those individuals providing health insurance information at their visit(s). Pharmacy claims will also be filed for participating insurance plans. Any balance remaining after insurance payment is the responsibility of the student. Students are advised to notify their insurance carrier prior to receiving services outside of their normal network.
Please present your current health insurance card at each and every visit at SHS to ensure accurate billing.
Students are strongly encouraged to have health insurance coverage in the event of a health care crisis.
- International students are required by the state of North Dakota to purchase health insurance.
- Many students are eligible to stay on their family health insurance program. Consult your insurance provider to determine if this option is available to you. Due to new insurance laws, most young adults can stay on their parent's family plan until they turn 26. The Department of Health & Human Services Facebook page has more information for students and parents regarding the new laws.
- Students also have the option of subscribing to the Student Health Insurance Policy available through the North Dakota University System.
Click above for more information.
Use the link below to learn more about Undergraduate and Graduate credit hour requirements, eligibility, and specific criteria for Domestic, Graduate, and International Student populations. Eligible dependents, including Domestic Partners, of students enrolled in the plan may participate on a voluntary basis. Links on this site also provide you with information about Open Enrollment window, Participating Providers, Rates & Payment Schedule, Summary of Benefits, and Exclusions & Limitations.
Use My Account portal to receive electronic correspondence, access your ID Card, claims status, EOBs, locate provider links and other account information 24/7 directly from United Healthcare Student Resources.
Policy Endorsement for Referrals (United HealthCare)
The student must use the services of the Student Health Center first where outpatient treatment will be administered or referral issued. Expenses incurred for medical treatment rendered outside of the Student Health Center for which no prior approval or referral is obtained are excluded from coverage.
A referral issued by Student Health Services must accompany the claim when submitted. Only one referral is required for each injury or sickness per policy year.
A Student Health Services referral for outside care is not necessary only under any of the following conditions:
- Medical emergency. The student must return to the Student Health Center for necessary follow-up care.
- 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 50 miles from campus.
- Medical care obtained when a student is no longer able to use the SHC due to a change in student status.
- Maternity, obstetrical, and gynecological care.
- Mental illness treatment and substance use disorder treatment.
Dependents are not eligible to use the SHC and, therefore, are exempt from the above limitations and requirements.
Health Care Reform & Affordable Care Act
Affordable Care Act Open Enrollment Information
Health Care Reform Brochures
Learn how to get help with your Marketplace application. Visit LocalHelp.HealthCare.gov to find help in your area.
Health Insurance Subsidy Calculator - This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or "Marketplaces") created by the Affordable Care Act (ACA). Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges.
Affordable Care Act (ACA) created a new Medicaid group called "Medicaid Expansion". These newly eligible individuals must meet the following criteria:
- Are between the ages of 19 through 64; have incomes below 138% FPL (for a single person, that's an annual income of $15,856); are legal citizens; are not incarcerated; and are not entitled to Medicare.
The expansion opens the program to an estimated 20,000 residents in North Dakota so they can have health insurance. Currently, only children, pregnant women and families (i.e. parents/caretaker/relatives of dependent children) are eligible for Medicaid. In April 2013, North Dakota lawmakers signed legislation expanding Medicaid.
Who is administering the new Medicaid Expansion Program?
The North Dakota Department of Human Services has contracted with Sanford Health Plan to provide benefits to this new group of Medicaid Expansion recipients beginning on January 1, 2014.
For more information click on the following: Sanford Health Plan Provider FAQs on ND Medicaid Expansion