University of Florida University of Florida

 

 

University of Florida ȳ

 

 

1. Coverage Period: Coverage must include the full year, including annual breaks, regardless of the students terms of enrollment. The policy must provide continuous coverage for the entire period the insured is enrolled as an eligible student. Payment of benefits must be renewable. ____

 

2. Basic Benefits: Room, board, hospital services, physician fees, surgeon fees, ambulance, outpatient services, and outpatient customary fees must be paid at 80% or more of usual, customary, reasonable charge per accident or illness, after deductible is met, for in-network, and 70% or more of usual, customary, and reasonable charge for out-of-network providers per accident or illness. ____

 

3. Inpatient Mental Health Care: Must be paid at 80% in-network or 60% out-of-network of the usual and customary fees with a minimum 30-day cap per benefit period. ____

 

4. Outpatient Mental Health Care: Must be paid at 80% in-network or 60% out-of-network of the usual and customary fees for a minimum of 30 (preferably 40) sessions per year. ____

 

5. Maternity Benefits: Must be treated as any other temporary medical condition and paid at no less than 80% of usual and customary fees in-network or 60% out-of-network. ____

6. Inpatient/Outpatient Prescription Medication: Must include coverage of $1,000 or more. ____

 

7. Repatriation: $10,000 (coverage to return the students remains to his/her native country).

 

8. Medical Evacuation: $25,000 (to permit the patient to be transported to his/her home country and to be accompanied by a provider or escort, if directed by the physician in charge). ____
 
9. Exclusion for Pre-Existing Conditions: First six months of policy period, at most. ____

 

10. Deductible: Maximum of $50 per occurrence if treatment or services are rendered at the Student Health Center; maximum of $100 per occurrence if treatment or services are rendered at an off-campus ambulatory care or hospital emergency department facility. ____

 

11. Minimum coverage: $200,000 for covered injuries/illnesses per accident or illness, per policy year. ____

 

12. Insurance Carrier must have an A rating or above per Part 62.14(c)(1) of Section 22 of the Code of Federal Regulations. ____

 

13. Policy must not unreasonably exclude coverage for perils inherent to the students program of study. ____

 

14. Claims must be paid in U.S. dollars payable on a U.S. financial institution. ____

 

15. Policy provisions must be available from the insurer in English. I hear by confirm that ......

 

 

 

 

 

The dates for the terms for which you may enroll are as follows:

 

  Fall: 08/14/2011- 01/08/2012
 

Fall/Spring:

 

08/14/2011-05/13/2012
 

Annual:

 

8/14/2011 - 8/13/2012
 

Spring:

 

01/09/2012-05/15/2012
 

Spring/Summer:

 

01/09/2012-08/13/2012
  Summer 2012:

05/14/2012-08/13/2012

 

 

 

 

 

 

insurance waiver form ִ Ʈ

 

http://www.ufic.ufl.edu/iss/Forms/Insurance%20Verification.pdf 

 

 

 

 

 

 

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https://www.uhcsr.com/uhcsrBrochures/Public/ClientBrochures/2012-330-2-Pseudo%20Brochure-vD.pdf

 

 

 

 

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https://www.uhcsr.com/uhcsrBrochures/Public/EnrollmentCards/2011-330-2%20%20International%20Enroll%20Form-v1.pdf

 

 

 

 

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Shands at the University of Florida
Specialties: Ambulatory Surgical Center, Cardiac Rehabilitation, Critical Care Medicine, Emergency Medicine, Hospital - General, Hospital - Pediatric, Hospital - Psychiatric, Hospital - Rehabilitation, Laboratory, Neonatal and Perinatal Medicine, Obstetrics, Occupational Medicine, Outpatient Facility, Pediatric Psychiatry, Physical Therapy, Psychiatry, Radiology, Rehabilitation, Occupational & Physical Therapy, Substance Abuse, Surgery - Cardiovascular, Surgery - Transplant, Surgery Center
Estimated Distance: 0.3 miles
1600 Sw Archer Rd
Gainesville, FL 32610-3003
352-265-0111

 
Select Specialty Hospital-Gainesville
Specialty: Hospital - General
Estimated Distance: 1.3 miles
2708 SW Archer Rd
Gainesville, FL 32608-1316
352-337-3240
 
North Florida Regional Medical Center
Specialty: Hospital - General
Estimated Distance: 4.2 miles
6500 W Newberry Rd
Gainesville, FL 32605-4309
352-333-4000
 
Shands Rehabilitation Hospital
Specialties: Hospital - Chemical Dependency, Hospital - Psychiatric, Hospital - Rehabilitation, Outpatient Facility, Rehabilitation, Occupational & Physical Therapy, Substance Abuse
Estimated Distance: 6.4 miles
4101 NW 89th Blvd
Gainesville, FL 32606-3813
352-265-5491
 
Shands Rehabilitation Hospital
Specialties: Hospital - Chemical Dependency, Hospital - Psychiatric, Outpatient Facility, Substance Abuse
Estimated Distance: 6.4 miles
4101 NW 89th Blvd
Gainesville, FL 32606-3813
352-265-5497
 
Tri County Hospital-Williston
Specialties: Ambulatory Surgical Center, Cardiac Rehabilitation, Critical Care Medicine, Emergency Medicine, Hospital - General, Occupational Therapy, Outpatient Facility, Physical Therapy, Rehabilitation, Occupational & Physical Therapy, Surgery Center
Estimated Distance: 19 miles
125 SW 7th St
Williston, FL 32696-2403
352-528-2801

 

 

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