Douglas Olsen
Texas State University offers a range of health insurance options for its students. It is important for students to understand the different types of insurance plans available and choose the one that best suits their needs. Students at Texas State University have the option to enroll in the Student Health Insurance Plan, which is provided by Aetna for the 2024-2025 Plan year. The university also accepts students with Tricare insurance, and those with out-of-network insurance or no insurance. Additionally, students may also be covered under their parents' insurance plans or choose from other insurance options available in Texas. Understanding the requirements, coverage, and costs of each insurance plan is essential for students to make an informed decision about their healthcare while studying at Texas State University.
| Characteristics | Values |
|---|---|
| Insurance carrier | Aetna |
| Plan year | 2024-2025 |
| Enrollment period for Spring and Summer | October 17, 2024 - February 1, 2025 |
| Enrollment eligibility for Domestic Graduate students | Enrolled in 6 or more hours (3 or more for Summer), with at least 50% face-to-face |
| Enrollment eligibility for Domestic Undergraduate students | Enrolled in 9 or more hours (3 or more for Summer), with at least 50% face-to-face |
| Enrollment eligibility for students in the last semester | Fall below the above credit hour requirement but were enrolled in the student health insurance plan the previous semester |
| Payment options | Payment plans are available |
| Bill disputes | Contact the Student Health Center Billing Department at 512.245.2161 |
| Insurance plans | Vary in coverage; learn what your plan covers and how your plan assigns patient responsibility |
| Coverage for lab work | You may receive a separate bill from Clinical Pathology Laboratories (CPL) |
| Discounts | Patients without insurance or with out-of-network insurance may be eligible for a Prompt Pay discount |
| Transferring balance | The balance will be transferred to your Texas State student account if unpaid by the due date |
| Tricare Select | Texas State University is a certified provider |
| Tricare Prime | Requires authorization from the Primary Care Manager (PCM) |
| Qualifying Life Event | Special enrollment available if you lost health coverage after the enrollment period has closed |
| Waiver submission | Submit online through the AHP website by the designated deadline |
| Waiver approval criteria | Level of benefits must be Affordable Care Act (ACA) compliant |
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What You'll Learn
- Texas State University's student health insurance carrier for 2024-2025 is Aetna
- Domestic graduate students must be enrolled in 6+ hours to be eligible for the Student Health Insurance Plan
- Students with Tricare Prime can use their benefits at the Student Health Center after obtaining authorisation
- Students without insurance may be eligible for a discounted Prompt Pay rate for some services
- Students can choose between HealthSelect of Texas, Consumer Directed HealthSelect, or HMO
Texas State University's student health insurance carrier for 2024-2025 is Aetna
Texas State University's student health insurance carrier for the 2024-2025 academic year is Aetna. This decision was based on the benefit needs of students, provider access, and costs.
To be eligible to purchase the Student Health Insurance Plan, domestic graduate students must be enrolled in 6 or more hours (3 or more during the summer semester), with at least 50% of classes being face-to-face. Domestic undergraduate students must be enrolled in 9 or more hours (3 or more during the summer semester), again with at least 50% of classes being face-to-face. Students in the final semester of their degree programme who fall below the above credit hour requirement but were enrolled in the student health insurance plan the previous semester are also eligible.
Students at Texas State University are required to provide the Student Health Centre with accurate insurance information before their visit. By providing insurance information, students authorise the Student Health Centre to submit a claim to their insurance company. If students do not wish for the Student Health Centre to file a claim, they must notify the Student Health Centre Cashier Office at the time of their visit and pay in full for any charges incurred.
Students with urgent medical needs who cannot pay will not be refused necessary treatment. Self-pay patients have the right to a Good Faith Estimate if they schedule at least three business days in advance or request one.
It is important to note that insurance plans vary in their coverage. Students should learn about their plan's coverage and how their plan assigns patient responsibility for different types of services. Students are responsible for any charges applied to patient responsibility by their insurance company.
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Domestic graduate students must be enrolled in 6+ hours to be eligible for the Student Health Insurance Plan
Texas State University offers a Student Health Insurance Plan for its students. This insurance plan is provided by Aetna for the 2024-2025 Plan year. To be eligible for the Student Health Insurance Plan, domestic graduate students must be enrolled in 6 or more hours (3 or more for the summer semester), with at least 50% of classes being face-to-face. This is a lower threshold than for domestic undergraduate students, who must be enrolled in 9 or more hours (again, 3 or more for the summer semester) with at least 50% face-to-face, in order to be eligible for the Student Health Insurance Plan.
Students in their last semester of study who fall below the above credit hour requirements but were enrolled in the student health insurance plan the previous semester are also eligible for the Student Health Insurance Plan. Students with urgent medical needs who cannot pay will not be refused necessary treatment.
It is important to note that the criteria for eligibility for the Student Health Insurance Plan may vary depending on the specific university and state. For example, at the University of Miami, domestic undergraduate students enrolled in six or more credit hours per semester and full-time domestic graduate students are required to obtain adequate health insurance.
Additionally, federal health reform laws allow children to remain on their parents' insurance plans until the age of 26, regardless of their enrolment in school. However, it is essential to check with the Texas State Department of Insurance or the insurance carrier for specific rules and eligibility requirements.
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Students with Tricare Prime can use their benefits at the Student Health Center after obtaining authorisation
Texas State University offers a range of insurance options for its students. It is important to note that students are responsible for providing accurate insurance information to the Student Health Center prior to their visit.
For students with Tricare Prime, benefits can be used at the Student Health Center clinic, but only after obtaining authorisation from their Primary Care Manager (PCM). The university provides a document, "How to Use Tricare Prime in the Student Health Center Clinic", which guides students in requesting authorisation. It is important to note that the Student Health Center does not accept any HMO products or government programs like Medicare or Medicaid.
Students with Tricare Prime should understand the process of obtaining authorisation to utilise their benefits at the Student Health Center effectively. Firstly, they should confirm their eligibility by checking with their regional contractor or referring to the designated Prime Service Areas (PSAs). If the university is outside of the home PSA, it may be necessary to discuss referral options with the PCM.
Once eligibility is confirmed, students can request authorisation by following the guidelines in the "How to Use Tricare Prime in the Student Health Center Clinic" document. This document outlines the specific steps required to obtain authorisation. After receiving authorisation, students can utilise their Tricare Prime benefits at the Student Health Center clinic.
It is worth noting that insurance plans vary significantly, and students should understand their specific coverage and patient responsibilities. Some services, like preventive care, may be covered at 100%, while other charges may fall under deductibles, coinsurance, or copay. Students are responsible for any charges applied by their insurance company. Additionally, students with urgent medical needs who cannot pay will not be refused necessary treatments.
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Students without insurance may be eligible for a discounted Prompt Pay rate for some services
Texas State University students who are uninsured, have out-of-network insurance, or choose not to use insurance for privacy or personal reasons may be eligible for discounted Prompt Pay rates for some services. This is in line with Texas State Law, which allows healthcare providers to "grant discounts for health or medical care provided to any patient the healthcare provider has reasonable cause to believe is not eligible for, or is not entitled to, insurance reimbursement or coverage".
The Student Health Center will send a Balance Due Notification email if your insurance does not cover any part of your charges, or if you do not have insurance. You can discuss payment options or questions about your bill by stopping by the Student Health Center Cashier or calling 512.245.2161, option 4. Payment plans are available.
It is important to note that insurance plans vary greatly, and your coverage and patient responsibility will depend on your specific plan details and the services you receive. Your insurance plan may apply charges to a deductible, coinsurance, or copay. Some services, like preventive care, may be covered at 100%. You are responsible for any charges your insurance company applies to patient responsibility.
If you are a full-time student, you may be eligible to remain on your parent's insurance plan. According to federal health reform law, children are allowed to stay on their parents' insurance plans until the age of 26, regardless of their enrolment in school. However, if you attend school out-of-state, your coverage levels may not be as comprehensive as they would be in your home state.
Texas State University's Student Health Insurance Plan carrier for the 2024-2025 Plan year is Aetna. Domestic graduate students must be enrolled in 6 or more hours (3 or more for the summer), with at least 50% face-to-face interaction, to be eligible to purchase the Student Health Insurance Plan coverage. Domestic undergraduate students must be enrolled in 9 or more hours (3 or more for the summer), with at least 50% face-to-face interaction, to be eligible for the same.
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Students can choose between HealthSelect of Texas, Consumer Directed HealthSelect, or HMO
Texas State University students have multiple options when it comes to health insurance. Firstly, it is important to note that Texas State University requires students to have some form of health insurance coverage. For the 2024-2025 plan year, the university's student health insurance plan carrier is Aetna.
Students can choose to remain on their parent's health insurance plan, which is a convenient option as parents will handle the billing. However, out-of-state students should be aware that their coverage levels may be lower than in their home state.
Alternatively, students can choose between HealthSelect of Texas, Consumer Directed HealthSelect, or HMO. HealthSelect of Texas is a point-of-service plan offered by Blue Cross and Blue Shield of Texas. It typically has lower upfront out-of-pocket costs, but premiums are higher if you are covering dependents. This plan requires selecting an in-network primary care provider (PCP) to coordinate care and provide referrals to specialists.
Consumer Directed HealthSelect is a high-deductible health plan, also administered by Blue Cross and Blue Shield of Texas. It is paired with a tax-free health savings account (HSA) that allows you to use pre-tax dollars to pay for qualified health care costs, including dental and vision services. This plan has a lower monthly dependent premium, but higher out-of-pocket costs for healthcare services and prescriptions. The State of Texas contributes to the HSA each month, and individuals can also contribute additional funds tax-free.
HMOs, or Health Maintenance Organizations, offer lower dependent premiums and low out-of-pocket costs. They provide access to a dedicated network that coordinates care, although these networks are smaller and limited to certain regions. HMO plans do not cover out-of-network services, except in emergencies, and may require PCP referrals.
It is important for students to carefully consider their health needs and financial situation when choosing a health insurance plan.
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Frequently asked questions
Texas State University does not specify any mandatory health insurance requirements. However, students are encouraged to have some form of health insurance coverage. Domestic graduate students must be enrolled in 6 or more hours (3 or more for summer), while domestic undergraduate students must be enrolled in 9 or more hours (3 or more for summer) to be eligible to purchase the Student Health Insurance Plan coverage.
Students at Texas State University can choose from various insurance plans, including HealthSelect of Texas, Consumer Directed HealthSelect, HMO, DeltaCare USA DHMO, and State of TX Dental Choice PPO. Additionally, Texas State University partners with insurance providers like Aetna for the Student Health Insurance Plan, which is selected based on benefit needs, provider access, and costs.
To enrol in the Student Health Insurance Plan at Texas State University, you should provide accurate insurance information to the Student Health Center before your visit. By providing this information, you authorize the centre to submit a claim to your insurance company. Enrolment periods vary, with spring enrolment open from October 17 to February 1 and spring and summer enrolment covering the same period.
Students without health insurance at Texas State University are considered self-pay. If you cannot pay for necessary treatments for urgent medical needs, you will not be refused treatment. However, you may receive a Balance Due Notification email, and the balance will be transferred to your student account if left unpaid, potentially incurring late fees. Alternatively, you may be eligible for discounted rates or special enrollment due to qualifying life events.
