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Insurance

Beginning January 1, 2019, Student Health Service will begin submitting health insurance claims for students who receive clinical services. With this change, students will charged an office visit for provider visits. 

Please reference our Fact Sheet for more information regarding this change. 

Students are responsible to contact their insurance company to verify coverage including, but not limited to, determining network status (in-network versus out of network), coverage for services, and referral requirements for prior to receiving care. It is important to verify this information with the insurance company as some policies state that if a student is further than 50 miles from home, or if utilizing a Student Health Center, that they will recognize that facility as in-network. If a referral is required, please provide this to Student Health Service so visits can be covered as in-network. All questions regarding a specific insurance policy should be directed to the insurance company. 

If you would like more information on the billing process, please see our Billing page. 

PLEASE MAKE SURE TO BRING THE FOLLOWING INFORMATION TO ALL APPOINTMENTS:

  • Current insurance information including front and back of card (a photo of this information is acceptable)
  • The policy holder's full name, address and date of birth

Without this information, we are unable to submit the claims to the insurance company. If the insurance information is not received within 3 business days from the date of service, all charges will be posted to the student's account. 

How can I submit my insurance information?

Students can send their insurance information to Student Health Service any of the following ways. Please make sure to include both the front and the back of the insurance card. 

  • Upload through to the Student Health Portal
  • Email Teri.Shepherd@ndsu.edu 
  • Bring in a physical copy to Student Health Service

Need to enroll in a health insurance plan?

See our Resources page for additional information. 

What is Health Insurance?

Health insurance can be very complicated and confusing and some people do not know where to start or what questions to even ask. United Healthcare provides information called Health Insurance 101 to help those individuals better understand the basics of how it all works. 

Common Insurance Term Definitions

  • Coinsurance: The amount of money you owe to a medical provider once the deductible has been paid. Coinsurance is usually a predetermined percentage of the total bill. If the policy’s co-insurance is set at 15% and the bill comes to $100, the policy-holder owes $15 in co-insurance.
  • Continuation of coverage: This is essentially an extension of insurance coverage offered to individuals no longer covered under a particular plan; it most often applies to former employees and retirees of companies that offer employee coverage. COBRA benefits (see Group Coverage section below) qualify as continuation coverage.
  • Coordination of benefits: This process is applied by individuals who have two or more existing policies to ensure that their beneficiaries do not receive more than the combined maximum payout for the plans.
  • Co-pay: This type of insurance plan is similar to co-insurance, but with one key exception: rather than waiting until the deductible has been paid out, you must make their copayment at the time of service. Most often, copayments are standardized by your plan, meaning you’ll pay the same $30 each time you see a physician, or the same $50 each time you see a specialist.
  • Deductible: The amount of money you must pay out-of-pocket before coverage kicks in. Deductibles are usually set at rounded amounts (such as $500 or $1,000). Typically, the lower the premium, the higher the deductible.
  • Dual coverage: The act of maintaining a health plan with more than one insurer. For example, many married people receive coverage from both their employers and their spouse’s employer. Others may opt to receive individual coverage from more than one insurer.
  • Enrollment period / open enrollment: The window of time during which you can apply for health insurance or modify a plan to include your spouse and/or children. Policy-holders are unable to adjust their plan until the next open enrollment unless they experience a qualifying life event. These include a marriage, divorce, birth of a child, changes to individual/household income, or interstate residence relocation.
  • Network Coverage:

    • In-network: This term refers to physicians and medical establishments that deliver patient services covered under the insurance plan. In-network providers are generally the cheapest option for policyholders. Insurance companies typically have negotiated lower rates with in-network providers.
    • Out-of-network: This term refers to physicians and medical establishments not covered under your insurance plan. Services from out-of-network providers are usually more expensive than those rendered by in-network providers. This is because out-of-network providers have not negotiated lower rates with your insurer.

  • Out-of-pocket maximum: The amount of money you pay for deductibles and coinsurance charges within a given year before the insurance company starts paying for all covered expenses.
  • Pre-existing condition: Any chronic disease, disability, or other condition you have at the time of application. In some cases, symptoms or ongoing treatments related to pre-existing conditions cause premiums to be higher than usual.
  • Premium:  The amount you pay your insurance company for health coverage each month or year.
  • Referral: An official notice from a qualified physician to an insurer that recommends specialist treatment for a current policy-holder.
  • Waiting period: Many employer-sponsored insurance plans mandate a period of 90 days before employees can enroll in their insurance plans. 

**Definitions provided by MedicalBillingAndCoding.org


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North Dakota State University
Phone: +1 (701) 231-7331/ Fax: (701) 231-6132
Campus address: Wallman Wellness Center 102
Physical/delivery address: 18th Street and Centennial Blvd., Fargo, ND 58102
Mailing address: NDSU Dept. 2842 / PO Box 6050 / Fargo, ND 58108-6050
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Last Updated: Wednesday, April 10, 2019 4:02:16 PM
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