Enrollment Forms and Policy Brochures
Please Note: The 2025/26 policy materials will be posted as soon as they become available. Payable benefits are not anticipated to change for the 2025/26 policy year.
Policy Materials for 2024/25
Voluntary Enrollment Form | 2024/25 Policy Year
Voluntary Enrollment Form is for students that have not been automatically charged for the insurance and Dependents.
*Students that require enrollment due to a Qualifying Life Event (QLE) must contact the University Student Heath Insurance Department for assistance with their enrollment. Please review our website for additional information.
Submission of Enrollment Form
SUBMIT ENROLLMENT FORM TO: studentinsurance@ohio.edu
OR
OHIO University
Attn: Student Health Insurance
82 South Green Drive
140D Ping Center
Athens, OH, 45701
Policy Flyer 2024/25
Provides a basic 2-page overview of premium rates, dates of effective coverage, and out of pocket expenses.
Policy Summary 2024/25
Provides information regarding annual deductible, coinsurance, copays, policy exclusions, coverage periods, and premium rates.
Policy Certificate 2024/25
Provides detailed information regarding payable benefits for covered services and additional policy information.
Online Account Directions 2024/25
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 Basic Vision Insurance Summary 2024/25
Summary of benefits for the basic vision insurance package that is included in the cost of the student health insurance premium. (Dependents under the age of 19 , J1 Visiting Scholars, and QLE enrollments do not include the VSP coverage.)
TeleDoc Health and Wellbeing 2024/25
Talk to a doctor or therapist by phone or video. UnitedHealthcare Student Resources and HealthiestYou have partnered together to provide access to doctors and mental healthcare from anywhere you are. All services are free for students covered under the UHCSR insurance plan. Services are available for all other students for a fee.
Optional Dental Insurance 2024/25
Information for Dental insurance plans available for purchase directly from United HealthCare.
Optional Vision Insurance 2024/25
Information for Vision insurance plans available for purchase directly from United HealthCare.
2025/26 Policy Information
Detailed Coverage Information is Located in the Policy Summary and Policy Certificate.
| Copays | Price |
|---|---|
| Visit to Campus Care (for covered services) | $0.00 |
| Provider Appointment outside of Campus Care (Per Visit) | $25.00 |
| 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 | Price |
|---|---|
| Individual In-Network (Reduced for 2024/25) | $250.00 |
| Family In-Network (Reduced for 2024/25) | $500.00 |
| Individual Out-of-Network | $5,000.00 |
| Family Out-of-Network | $10,000.00 |
| Out of Pocket Maximums | Price |
|---|---|
| Individual In-Network | $5,000.00 |
| Family In-Network | $10,000.00 |
| Individual Out-of-Network | $10,000.00 |
| Family Out-of-Network | $15,000.00 |