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?
What is the deductible and out of pocket maximum for the Student Health Plan?
Does the Student Health Insurance Plan cover dental and 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, the Affordable Care Act legislation requires everyone to have health insurance that meets certain standards of care and the Clemson University Student Health Plan meets that requirement.

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What is the Affordable Care Act?
The Patient Protection and Affordable Care Act, commonly referred to as the Affordable Care Act (ACA), affects the health insurance and federal income taxes of nearly every American by requiring all American citizens to have health insurance that meets certain standard of care. The Affordable Care Act requires insurance plans to cover many preventive services and to provide coverage for pre-existing conditions.  The Clemson University Student Health Plan meets all ACA requirements.  For a list of Preventive Services covered by the ACA, click here.

Clemson University requires all international students to have health insurance that meets ACA and University requirements. The charge for the Student Health Plan will be included with tuition & fees in fall and spring semesters.  International students who have alternate insurance that meets ACA and university requirements may submiit a request for waiver.  If the alternate insurance meets requirements and is accepted for waiver, the insurance charge will be removed from the student account. 

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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. See sections below for Mandatory and Voluntary criteria.

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
  • 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.  Call RHC Insurance Office or e-mail redfern@clemson.edu with questions or concerns.

Mandatory enrollees pay Clemson University for the health insurance but are encouraged to create an account on the SHP website at http://www.studentinsurance.com/Schools/SC/Clemson/ to print/request an insurance card, complete required Accident Forms or view EOB's (Explanation of Benefits). Choose Mandatory Enrollment after login.  Enrollment and payment for health insurance for spouse and/or children must be done on the student insurance website.  Click here for video instructions to set up your Student Insurance account.

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 http://www.studentinsurance.com/Schools/SC/Clemson/. Choose Mandatory Enrollment and the system will prompt you to add spouse and/or dependent children.

Voluntary: Not all graduate students are Mandatory for health insurance. Check tuition & fees in iRoar to determine if the charge for Student Insurance has been included.  Students not in a mandatory category cannont have the charge for Student Insurance included with tuition and fees.  Students who do not have the charge for Student Insurance included with tuition and fees and 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 which is approximately 30 days before and after the beginning of fall and spring semesters.  Undergraduates must be enrolled in a minimum of six credit hours to be eligible to purchase the Student Insurance.  

Voluntary enrollees login to the student insurance website at http://www.studentinsurance.com/Schools/SC/Clemson/  to enroll and pay for the insurance for themselves and family.

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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 an 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 services are provided at RHC.
  • The SHP provides preventive dental and vision benefits as well.

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How much does the Clemson University Student Health Plan cost?
Student Health Plan rates can be found on the student insurance website at Clemson University - AIG Educational Markets, then click on the Plan Brochure.  The effective dates of coverage for fall semester are August 15 - December 31.  The effectuve dates for spring are January 1 - August 14. Spouse premium (cost) and Child(ren) premium is in addition to the student premium. 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 in the form of the Graduate Assistant Insurance subsidy.

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When may students begin enrolling in the Clemson University Student Health Plan?
Open Enrollment is approximately 30 days before and after classes start.  Open Enrollment for fall semester ends Sepember 15 and Open Enrollment for spring ends February 1. 

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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 alternate 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 Affordable Care Act and  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 requirements in order to qualify for a waiver:

  1. Coverage must be effective on or before January 1 (spring) or August 15 (fall) and extend through the semester including breaks and holidays.
  2. Plan must be fully compliant with the Affodable Care Act and provide coverage for
    • Ambulatory paitent services;
    • Emergency services;
    • Hospitalization;
    • Maternity and newborn care;
    • Mental health and substance use disorder services; including behavioral health treatment;
    • Prescription drugs;
    • Rehabilitative and habilitative services and devices;
    • Radiology and Laboratory services;
    • Unlimited Aggregate Maximum Benefit per Accident and Sickness;
    • Deductible no more that $5,000 USD per policy year;
    • Preventive and wellness services and chronic disease management;
    • No pre-existing condition waiting period;
    • Pediatric services, including oral and vision care;
    • Medical Evacuation and Repatriation $50,000 USD combined benefit (for international students);
    • Fulbright Scholars click here for additional waiver requirement.

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

ONLINE WAIVER MUST BE SUBMITTED BY SEPTEMBER 15 FOR FALL ENROLLMENT AND FEBRUARY1 FOR SPRING ENROLLMENT.  WAIVERS WILL NOT BE ACCEPTED AFTER THESE DATES.

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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 Financial Services 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 at 864-656-3561.

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.

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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.

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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.

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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.

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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 Student 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 http://www.studentinsurance.com/Schools/SC/Clemson/.  Deductibles and copays would apply to these visits.

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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 periods.  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.  Click here for information. 

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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).  Click here for information.

For international students, spouse and children only may 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.

Premiums are not pro-rated when enrollment is done outside of Open Enrollment.

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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/Schools/SC/Clemson/. 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.

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 Will the Student Health Insurance Plan cover me if I go to any doctor?
Students and spouses covered by the Student Health 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.

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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.

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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.

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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.

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

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Does my insurance coverage end on the day I graduate?
No. If you pay for spring/summer coverage, you are covered until August 14 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. 

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What is the deductible and out of pocket maximum for the Student Health Plan?
Average Maximum: Unlimited

In-Network Deductible: $500

Out-of-Network Deductible: $750

In-Network Out-of-Pocket Maximum: $5,000

Out-of-Network Out-of-Pocket Maximum: $12,500

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Does the Student Health Insurance Plan cover dental and vision?
Dental & Vision Treatment Benefits.

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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.

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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 http://www.studentinsurance.com/Schools/SC/Clemson/ and view pages 7 and 8 of the Plan Brochure, Plan Exclusions and Limitations.

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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.

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

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