Redfern Health Center

Student Insurance FAQ


Why do college students need health insurance?
What is the Affordable Care Act?
How do students enroll in the Clemson University Student Health Plan (SHP)?
Does the Clemson University Student Health Plan (SHP) cover medical expenses only at Redfern Health Center?
How much does the Clemson University Student Health Plan cost?
When may students begin enrolling in the Clemson University Student Health Plan?
What if I am charged for the Clemson University Student Health Plan as a condition of enrollment and I already have health insurance? What is the "hard waiver requirement"?
How do I submit a waiver?
How will I know when the insurance charge is removed from my account?
What is the student health fee?
Does RHC file my private insurance?
My program is located off campus in another city. Will I still be able to use the Student Health Insurance Plan?
Can I add my family to my Student Health Insurance Plan?
Is there any way for a student or student's family member(s) to enroll in the Student Health Insurance Plan outside of open enrollment?
When will I get my insurance card?
Will the Student Health Insurance Plan cover me if I go to any doctor?
Am I still covered by the Student Health Insurance Plan if I am not enrolled for any classes during the summer?
Why is the spring premium higher than the fall premium?
If I am not enrolled for any classes during the summer, why do I still have to pay for insurance?
Does my insurance coverage end on the day I graduate?
How can I find a list of doctors and hospitals who are in-network providers?
Does the Student Health Insurance Plan cover dental?
Does the Student Health Insurance Plan cover vision?
Does the Student Health Insurance Plan cover other wellness and preventive services?
Are there exclusions in the insurance plan?
Definitions of insurance terms.
Where is the Student Insurance Office?

Why do college students need health insurance?
Health care is incredibly expensive. While Redfern Health Center (RHC) provides economical primary care, students sometimes require hospitalization, surgery or other specialty care. The resulting large medical bills can be overwhelming for students on a budget. Having and maintaining adequate health insurance will allow students to receive needed health care. All individuals, including college students, need health insurance. Additionally, legislation will soon require everyone to have health insurance under the Affordable Care Act and the Clemson University Student Health Plan meets that requirement.

Back to Top

What is the Affordable Care Act?
The Patient Protection and Affordable Care Act, commonly referred to as the Affordable Care Act (ACA), will affect the health insurance and federal income taxes of nearly every American over the next few years. How small or big the impact primarily depends on whether you have health insurance and from where your insurance is obtained. The Clemson University Student Health Plan meets all ACA requirements.

Health insurance is mandatory for international undergraduate students and the charge for the Student Health Plan will be added to tuition & fees.  International students who have alternative insurance may submit a waiver to have the insurance charge removed from the student account. 

Back to Top

How do students enroll in the Clemson University Student Health Plan (SHP)?
Enrollment in the Clemson University Student Health Plan is either Mandatory or Voluntary.

Mandatory enrollees are categories of students for which health insurance is required by Clemson University as a condition of enrollment. Students who are mandated by Clemson University to have health insurance will be charged for the SHP with tuition & fees. Students in the following categories are required to have health insurance as a condition of enrollment at Clemson University:

  • Graduate students enrolled in nine or more credit hours on the main university campus
  • Graduate Assistants*
  • International students (graduate and undergraduate)

*Clemson University pays $600 of the billed insurance charge per semester for the SHP only for eligible graduate assistants in the form of the Student Insurance Subsidy. Students who are GA's should check their student account in iRoar to make sure the subsidy has been applied.

Mandatory enrollees pay Clemson University for the health insurance but are encouraged ot create an account on the SHP website at www.studentinsurance.com to print/request an insurance card, complete required Accident Forms or view EOB's (Explanation of Benefits). Choose Mandatory Enrollment after login.  Enrollment for spouse and/or children must be done on the student insurance website. 

For any injuries that require medical treatment, an Accident Form must be completed online before any medical bills will be paid either at Redfern Health Center (RHC), Urgent Care facilities, or emergency room.

Students who are Mandatory for insurance and want to enroll spouse and/or children must complete the process and pay for the insurance on the student website at www.studentinsurance.com. Choose Mandatory Enrollment and the system will prompt you to add spouse and/or dependent children.

Not all graduate students are Mandatory for health insurance. Check tuition & fees in iRoar to determine if the charge of $835 for Student Insurance has been included.  If the charge has not been included, students who want the SHP must enroll as Voluntary and pay the student insurance company online for the insurance. Voluntary enrollment is only allowed during Open Enrollment from mid November until February 2, 104. 

Voluntary enrollees are students who want the SHP but are not mandated by Clemson University to have health insurance as a condition of enrollment and are not charged for the SHP with tuition & fees. Students enroll online and pay the $835 directly to the insurance company online.

Voluntary enrollees login to the student insurance website at www.studentinsurance.com to enroll and pay for the insurance for themselves and family.

Back to Top

Does the Clemson University Student Health Plan (SHP) cover medical expenses only at Redfern Health Center?
The SHP is a major medical health insurance plan that provides health insurance benefits anywhere in the world. The SHP pays a higher percentage of costs at RHC, however.

  • Eligible lab and radiology is paid 100% at RHC, 80% of Allowable Costs outside RHC (after deductible and co-pays) at "in network" facilities and 70% of Reasonable & Customary charges if student chooses to use and out of network provider.
  • The SHP pays 100% of preventive services such as immunizations, physical exam (including women's annual and pap smear) and screenings when these are provided at RHC.
  • The SHP provides preventive dental and vision benefits as well.

Back to Top

How much does the Clemson University Student Health Plan cost?
The cost for spring semester 2014 for a student is $835. The effective dates of coverage are January 1 - August 14, 2014. Spouse premium (cost) is $957 and Child(ren) premium is $876. The one child premium will cover all children, there is no additional cost "per child". Clemson University pays $600 of the SHP charge for graduate assistants for the SHP only.

Back to Top

When may students begin enrolling in the Clemson University Student Health Plan?
Once online tuition & fees are posted in mid November, we will begin Open Enrollment for SHP. Students who are enrolling themselves and/or family will need to complete enrollments and payment before February 1, 2014.

Back to Top

What if I am charged for the Clemson University Student Health Plan as a condition of enrollment and I already have health insurance? What is the "hard waiver requirement"?
Students who are mandated to have health insurance as a condition of enrollment at Clemson University will be charged for the SHP with tuition & fees. Students who are covered by parent, spouse, or employer insurance must submit an online request for waiver to have the charge removed. This is called a "hard waiver requirement". The request for waiver will be reviewed by an outside company to make sure that the health insurance submitted complies with Clemson University health insurance requirements. Once approved, notification will be sent to the student and to the university to have the charge for the SHP removed from the student's iRoar account.

Alternate health insurance must meet the following minimum requirement in order to qualify for a waiver:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services; including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Minimum $500,000 USD per sickness or injury
  10. Preventive and wellness services and chronic disease management
  11. Pediatric services, including oral and vision care
  12. No pre-existing waiting period
  13. Medical Evacuation and Repatriation $1,000,000 USD combine benefit (for international students)

To submit waiver click Waive Online. Choose Waive from the left navigation pane to submit.

ONLINE WAIVER MUST BE SUBMITTED BY FEBRUARY 1, 2014. NO WAIVERS WILL BE ACCEPTED AFTER THIS DATE.

Back to Top

How do I submit a waiver?
Waivers can only be processed online.  To submit an online waiver, go to Waive Online. After submitting the initial waiver request, you should receive an e-mail from the insurance company informing you that the waiver request has been received. Waivers will be processed in real time. You may receive a second e-mail requesting more information in order to verify your coverage if your waiver cannot be processed. You will need the following information to complete the waiver:

  1. Name and address of your insurance company
  2. Policyholder's name and identification
  3. Policy number
  4. Your insurance company's customer service telephone number (for verification of coverage)
  5. For international plans, your documentation will need to show start and end dates of coverage. Also, many international plans must be scanned and e-mailed to the insurance company for verification of benefits. You will get an e-mail from the insurance company requesting this information, or you may check status of the waiver on the student insurance website. Failure to submit the requested documentation by the deadline will result in denial of waiver request.
  6. You will need to look for the e-mail informing you if your request for waiver has been Accepted or Denied.
  7. If your waiver is accepted, the student insurance company will send the approved waiver to Student Accounts and the student insurance charge will be removed.
  8. If you get an e-mail stating that the waiver has been denied and you feel this is in error, please contact the Student Insurance Office.

ABSOLUTE DEADLINE FOR SUBMISSION OF WAIVER IS FEBRUARY 1, 2014. NO  WAIVERS WILL BE ACCEPTED AFTER THIS DATE. Please note that it may take a few days from the time you receive notification that your waiver has been approved for the charge to be removed from your student account.

It is the student's responsibility to follow up with any requests from the company in order to get the waiver approved.  Failure to follow up with requested information could result in denial of waiver.

If you feel your waiver has been denied in error, please contact the Student Insurance Office at Redfern Health Center. You can call the Student Insurance Office at 864-656-3561 or e-mail Vickie Metz, Student Insurance Office Manager, at redfern@clemson.edu.

Back to Top

How will I know when the insurance charge is removed from my account?
It may take a few days from the time you get the e-mail notifying you that your waiver request has been Approved until the charge is actually removed from your student account. If the charge has not been removed after five days of receiving the notification that your waiver has been Approved, contact the Student Insurance Office. It is the student's responsibility to check the student account to make sure the fee for the Student Insurance Plan has been waived.

Back to Top

What is the student health fee ? 
University policy requires all students registered for six or more credit hours (three hours during each summer session) to pay the University health fee. The health fee supports all services at Redfern Health Center and includes:

  • Professional services for primary health care providers, psychologists and counselors, and health educators (this means no charge for office visits for illness/injury).
  • Reduced costs on over the counter pharmaceuticals, laboratory and X-ray services.
  • $500 urgent care EXCESS benefit for after-hours urgent or emergency medical care (insurance carrier determines covered benefit). Contact the Student Insurance Office the next business day after urgent or emergency care is received for more information.

Back to Top

Does RHC file my private insurance?
Redfern Health Center files claims to the Student Health Plan only.  However, the RHC Pharmacy can process prescriptions electronically for many private insurance plans.  If you would like for RHC Pharmacy to electronically file your prescription claims, please complete and submit via drop off, fax, or mail the Pharmacy Prescription Card Information.  Please note that the RHC Pharmacy cannot file electronic prescription claims for international plans unless the insurance information provides a "Bin Number" and a "Group Processing Number" for electronic prescription claims processing.

Back to Top

My program is located off campus in another city. Will I still be able to use the Student Health Insurance Plan?
If your program is located off campus, you would still be able to use the insurance. Since you would not be using Redfern Health Center, you would look on the website to find network providers in your area. Deductibles and co-pays would apply to visits. You would be able to use your insurance card as a pharmacy card for prescriptions, subject to deductibles and co-pays. Referrals would not be required for treatment if you are more than 30 miles from Redfern Health Center. Special arrangements for obtaining medical services and prescriptions have been made for the Bioengineering students located in Charleston, S.C. Special arrangements for obtaining prescriptions have been made for students in the Historical Preservation program located in Charleston, S.C. Students on the SHP should use Rutledge Towers Pharmacy for prescriptions. CU-ICAR students located in Greenville, S.C. may choose to use Redfern Health Center or find local providers from the Find Doctor/Hospital link at www.studentinsurance.com.  Deductibles and copays would apply to these visits.

Back to Top

Can I add my family to my Student Health Insurance Plan?
Students enrolled in the Student Health Insurance Plan may enroll any eligible dependents during Open Enrollment from November 15, 2013 - January 31, 2014.  Additional premium payment required.

The only exception to enrolling outside the Open Enrollment period would be a Qualifying Event (with appropriate documentation) such as:

  1. Adding a newborn (must be enrolled within 31 days of birth)
  2. Adding a newly adopted child (must be enrolled within 31 days of formal adoption)
  3. Marriage (must enroll within 31 days of marriage date)
  4. International dependent arriving after Open Enrollment must enroll within 31 days of arrival in the U.S. (must have copy of passport showing date of arrival in U.S.)
  5. Within the first 31 days of losing coverage under other Creditable Coverage, e-mail qualifier@studentinsurance.com with attached documentation. Payment of premium for dependent(s) must be made at the time of enrollment.

Back to Top

Is there any way for a student or student's family member(s) to enroll in the Student Health Insurance Plan outside of open enrollment?
The following "qualifying events" are the only exceptions that will permit a student to enroll themselves or family outside of open enrollment:

  1. Adding a new dependent (within 31 days of marriage, birth or adoption)
  2. Enrolling as a new or transfer student (within 31 days of date of enrollment)
  3. Becoming ineligible for coverage from prior health insurance company due to age, marriage or loss of employment (within 31 days of loss of coverage with appropriate documentation)

For international students, if family member(s) join you at Clemson, they can be enrolled in the Student Health Insurance Plan within the first 31 days of arrival in the U.S. A passport must be presented at the Student Insurance Office to show the date of arrival.

Enrollment of student and/or family members requires payment of premium due for that enrollment period.

Back to Top

When will I get my insurance card?
Once the charge for student insurance appears in your tuition & fees, go to the Student Insurance website at http://www.studentinsurance.com/. On the right side of the page under Find your institution choose "South Carolina", then "Clemson University". If this is your first time enrolling in the Student Health Plan, choose "Mandatory Plan" and "Enrollment." If you are renewing the coverage, choose "Student Login", enter e-mail address and password. If you do not remember your password, you can reset the account.  Once on the Student Account page, check Student Options, Update Personal Information, and enter or review address and phone number.  If any of this information has changed, please update your information accordingly.  Once you have updated your information click on "New Enrollment" to complete the enrollment process. Read Box 3 very carefully and check ONLY if you have verified that the charge for the Student Insurance has been included with tuition & fees. Your insurance card will be mailed within a week of completing the online enrollment.

Voluntary enrollees should receive the insurance card within a week of enrollment.

Back to Top

 Will the Student Health Insurance Plan cover me if I go to any doctor?
Students and spouses covered by the Student Health Insurance Plan must use Redfern Health Center as their primary care facility. To use the insurance outside of Redfern it must be

  1. A referral by a Redfern provider to another doctor or facility
  2. Medical emergency
  3. More than 30 miles from Redfern and requires immediate medical attention

Deductibles and co-pays apply for any visits outside of Redfern Health Center. If a student requires emergency medical treatment and has paid the health fee, there is a $500 EXCESS benefit (called A&I coverage) that can be accessed to help cover the costs of the emergency visit only. In the event that emergency medical care is received outside of Redfern Health Center, please contact the Student Insurance Office the next business day for information on accessing this benefit. The insurance company determines covered benefit.

If you have an emergency visit and are referred to another provider by the emergency room or urgent-care physician, please contact the Student Insurance Office for a referral or to see if follow-up care can be done at Redfern Health Center.

Back to Top

Am I still covered by the Student Health Insurance Plan if I am not enrolled for any classes during the summer?
Spring enrollment in the SHP includes summer coverage, January 1 - August 14, 2014.

Back to Top

Why is the spring premium higher than the fall premium?
The fall premium covers the fall semester only, August to January, a coverage period of five months. The spring premium includes the premium for summer so the student does not have any lapse in coverage and covers from January to August, a period of seven months, to ensure the student has year-round coverage.

Back to Top

If I am not enrolled for any classes during the summer, why do I still have to pay for insurance?
Students should be covered by insurance year-round. Students can suffer an illness or injury in the summer the same as they could in the fall or spring and would need insurance coverage to cover the costs.

Back to Top

How can I find a list of doctors and hospitals who are in-network providers?
Go to the website at http://www.studentinsurance.com/ to search Find Doctor/Hospital.

Back to Top

Does my insurance coverage end on the day I graduate?
No. If you pay for spring/summer coverage, you are covered until August 14, 2014 even if you graduate in May. Students covered by the SHP may continue to use Redfern Health Center after graduation for the remainder of the coverage period. Students will have a $15 co-pay for office visits at RHC after the graduation date. All other benefits remain the same. 

Back to Top

Does the Student Health Insurance Plan cover dental?
Dental Treatment Benefits

Preventive Services (students and dependents): Two annual cleanings/oral evaluations and one annual bitewing X-ray.  100% of R&C.

Basic Services: 80% of R&C up to $35 per filling.

Other Dental Treatment:  For injury to sound natural teeth or removal of full bony impacted wisdom teeth ONLY: Maximum of $1,000 per accidental injury after the deductible, 80% of Allowable Charge/60% of R&C.  Injury to tooth from biting or chewing is not covered.

See list of local dentists, most of who will file the insurance for you.

Back to Top

Does the Student Health Insurance Plan cover vision?
Vision Benefit: Exam and eyeglasses or contacts up to $300 per Policy year, after $15 copay per procedure.

See list of local eye care providers.

Back to Top

Does the Student Insurance Plan cover other wellness and preventive services?
Preventive services as specified by the Patient Protection and Affordable Care Act (PPACA) are covered at 100% of Reasonable & Customary charges, not subject to deductible, copayment, or coinsurance. To view a list of covered preventive services, log onto www.healthcare.gov.

Back to Top

Are there exclusions in the insurance plan?
There are exclusions in the insurance plan. Not every medical condition is covered by the insurance. Please review the exclusions in the insurance plan so that you will be aware of non-covered services or benefits. To see the exclusions go to www.studentinsurance.com and view pages 6 and 7 of the Plan Brochure, Plan Exclusions and Limitations.

Back to Top

Definitions of insurance terms
There are terms used in these FAQs that you might not know the meaning of or understand. For definitions of insurance terms such a deductible, co-pay, network provider, etc., go to the student insurance website and access their Definitions of Insurance Terms. If there are still issues regarding the Student Insurance Plan that you do not understand, please come by, call or e-mail the Student Insurance Office.

Back to Top

Where is the Student Insurance Office?
The Student Insurance Office is located in Room G-23 downstairs in Redfern Health Center.

Back to Top