Enrollment Forms and Policy Brochures

 
*Please be sure to review the updated Coverage Periods* 

Enrollment Information:

 

  • Review your student account after registration for the current term
  • Domestic students registered for 5 or more Athens credit hours (Includes Athens online, Cleveland and Dublin credit hours; excludes eCampus credit hours) and international students registered for 1/2 or more credit hours, will be automatically charged for the student health insurance upon registration. Please review our webpage for details about automatic enrollment. 
    • Students that have received an approved Waiver during the same academic year will not be automatically charged for the insurance and will require voluntary enrollment. 
  • Students automatically charged for the Student Health Insurance do not need to submit an enrollment form
  • Changes to a student's schedule, such as a reduction in credit hours or a class change, may require voluntary enrollment in the student health insurance
  • Voluntary enrollment requires submission of an enrollment form during the designated Open Enrollment period each semester
  • Voluntary enrollment does not automatically continue

 

Voluntary Enrollment 

 

2023/24 Enrollment Form

Use the link above to access the Enrollment Form for Athens and Regional campus students and their dependents.

 

 Enrollment Form Submission:

EMAIL: studentinsurance@ohio.edu 

 

CAMPUS LOCATION :

 

OHIO University

Attn: Student Health Insurance

82 South Green Drive

140D Ping Center

Athens, OH, 45701

 

 

 

Policy Materials for 2023/24

 

Policy Summary 2023/24

Provides information regarding annual deductible, coinsurance, copays, policy exclusions, coverage periods, and premium rates.

Policy Certificate 2023/24 

Provides detailed information regarding payable benefits for covered services and additional policy information.

Online Account Directions 2023/24

Instructions to create your online account with the insurance company once they have processed your enrollment.  Access health insurance ID cards, claims and explanation of benefits, personal information, member balances, coordination of benefits, provider locator tools, free resources, and more!

VSP Vision Insurance Summary

Summary of benefits for the included basic vision insurance package included in the cost of the student health insurance premium. Dependents under the age of 19 and J1 Visiting Scholars are not enrolled in the VSP coverage.

Enrollment Form: 2023/24 Policy Year

Enrollment Form for Athens and Regional campus students and their dependents. Enrollment Forms must be completed for only the current coverage period and returned prior to the posted semester deadline for processing. Open Enrollment for additional coverage periods will be available at a later time. 

 

 

  Policy Out of Pocket Expenses

Detailed Coverage Information is Located in the Policy Summary and Full Policy Certificate located via the links provided above.

 

 

       COPAYS
 

 

Provider Appointment, Laboratory, and Radiology at Campus Care (Per Visit)  

$15.00

Office Visit/Appointment with a Network Provider

$25.00

Urgent Care 

$35.00

Emergency Department at a Hospital (waived if admitted to hospital) 

$250.00

 

 

ANNUAL DEDUCTIBLES
 

 

Individual In-Network

$500

Family In-Network

$1,000

Individual Out-of-Network

$5,000

Family Out-of-Network

$10,000

 

OUT OF POCKET MAXIMUMS
 

 

Individual In-Network

$5,000

Family In-Network

$10,000

Individual Out-of-Network

$10,000

Family Out-of-Network

$15,000