Using your Student Health Insurance and Filing Claims
Access In-Network providers to save money
It will always be to your financial advantage to seek care from an in-network provider. The student health insurance plan uses a Preferred Provider Organization (PPO). Preferred Providers are doctors, hospitals, and other health care services that have agreed to offer care at lower, set prices. The “PPO Allowance” is the discounted price that these providers accept as full payment—so you pay less!
To get the most out of your insurance, always try to use PPO providers for hospital visits, office visits and other healthcare services. If you use a provider in the CIGNA network, your insurance will usually pay 80% of the allowed cost once the deductible has been met, unless stated differently.
To find healthcare providers in the PPO network, visit www.myahpcare.com/unco. Click on “Find a Provider” on the main screen. This will direct you to the Cigna website. Do NOT create a login, just continue as a guest. You can also call 877-657-5030 for assistance–help is available 24/7.
Important Information about the Activation of Student Health Insurance Coverage
UNC student health insurance needs to be activated at the start of each semester. This automatically happens within two weeks of the waiver period closing and open enrollment ending. If you need to access your student health insurance benefits prior to your coverage being activated for the semester, contact the UNC Health Insurance Office at 970-351-1915 or email nicky.weglin@unco.edu.
Accessing Care
North Colorado Medical Center (NCMC) 1801 16th St. Greeley, CO 80631
UC Health 6767 W. 29th St. Greeley, CO 80634
Note: Out patient Emergency Room care is subject to a $150 copay for each ER visit. Ambulance benefit paid at 70% of “Usual & Customary” charges.
If you go to a provider that is outside of the PPO network, your insurance will only pay 50% of the usual & customary charges, unless it says otherwise. These Out-of-Network providers haven’t agreed to set prices, so you’ll likely pay more out of pocket. Any costs above what the insurance covers or above the usual amount (that is, “usual and customary” charges) are your responsibility.
You will always save money by going to a Preferred Provider. Preferred Providers are physicians, hospitals, and other healthcare providers who have contracted to provide specific medical care at negotiated prices. “PPO Allowance” means the reduced allowance that a Preferred Provider will accept as payment in full.
|
Physician’s Charges |
PPO – $500 | Non PPO – $500 |
| Discount | PPO discount – $100 | Non PPO discount – $0 |
| Net Charge | PPO – $400 | Non-PPO – $500 |
| Coinsurance – What you pay after insurance payment | PPO – 20% | Non-PPO – 50% |
| Your Cost – After deductible has been met | PPO – $80 | Non-PPO – $250 |
Check out these videos for additional tips about accessing the benefits in your student health insurance plan.
If you receive services from an in-network provider, the provider is responsible for billing your insurance. If you receive services from an out-of-network provider, you may need to pay the provider up front and then file a claim with Wellfleet for reimbursement.
- Fill out a claim form with all required details.
- Include copies of your itemized medical bills and receipts.
- Make sure your name, student ID, and insurance info are on all documents.
- Send your claim to:
Cigna PPO
PO Box 188061
Chattanooga, TN 37422-8061
EDI Payer ID: 62308
If you need help with filing a claim or have other questions about your policy, contact:
Academic HealthPlans, Inc.
P.O. Box 1605
Colleyville, TX 76034-1605
Academic HealthPlans customer service phone: 1-855-825-3985 www.AcademicHealthPlans.com