Student Insurance

Is the Spelman College Student Insurance Plan required?

The student health insurance policy is mandatory for all traditional students. This fee will be assessed with the student tuition in addition to the student health services fee. The student insurance is provided by Pearce Administration and is underwritten by the Guarantee Trust Life Insurance Company.

Note: The student insurance plan is secondary to any primary insurance coverage the student may have. Students must obtain a health insurance card every year from the Student Health Services Department.

Part-Time Continuing Education Students have the option of waiving the student health insurance plan. The student must provide proof of comparable coverage by completing the Student Insurance Waiver Form and submitting the information by the posted deadline.

What’s covered under the Student Health Insurance Plan?

The student health insurance plan is an accident and sickness policy that is secondary to any primary insurance the student may currently have. For any covered sickness or injury, whether or not hospitalization is required, the company will pay a percentage of the Covered Medical Expenses in excess of a deductible of $75.00 per incident (reduced to $25.00 if the student is first treated at the Student Health Services Department) to a maximum of $25,000.00 per incident.

Can I go to ny health care provider?

You can, but there is a financial benefit to receiving care through a Network Provider. If a Network Provider renders treatment, the allowable charges are paid at 90% of PPO Allowance and at 70% of Reasonable & Customary Charges if a Non-Network Provider renders treatment. Network Providers have agreed to accept as payment for covered expenses, a preferred provider allowance. A Non-Network Provider has not agreed to any prearranged fee schedule.

Is a referral from the Student Health Services Department required before an outside provider may see me?

Yes , a referral is required from the Student Health Services Department before seeking treatment by either a Network or Non-Network Provider in order to obtain the insurance benefit. The exceptions to the rule regarding this policy are:

• Student Health Services Department is closed
• In cases of medical emergency
• Care is required while more than 30 miles from campus
• During term breaks
• Study-Abroad or Domestic Exchange participation

How are prescriptions filled?

Express Scripts Prescription Plan for students after a co-payment of $15.00 for generic or $35.00 for a name brand drug (per prescription), the cost of prescript drugs for covered injuries and sicknesses is payable in full, up to $500.00 for the policy year (subject to plan maximums). Prescriptions must be filled at Express Scripts participating pharmacies. You can pick up a list of participating pharmacies from the Student Health Services Department.

When I receive services, how and where do I submit my bill?

You only need to file a claim when receiving services outside of the Student Health Services Department. Many of our Network Providers bill the administrator directly. However, if you receive a bill or need reimbursement, you may obtain a claim form from the Student Health Services Department and we will be able to assist you in completing the necessary paperwork. All claims must be sent to:

Pearce Administration
P.O. Box 2439
Florence , SC 29503
1-888-722-1668

What if I leave Spelman College, will I get a refund?

No, you will not be eligible for a refund. Once applicable fees are paid, your coverage will be effective for the full period for which the premiums were paid.

Does the Student Health Insurance cover me if I participate in Study Abroad?

Yes, the student health insurance plan provides worldwide assistance coverage, while studying abroad. This benefit is the same as if you were at Spelman College.

Who do I call if I have questions about eligibility coverage and other service issues?

Pearce Administration
P.O. Box 2439
Florence , SC 29503
1-888-722-1668

Who do I call if I have questions about a specific claim or claims payment?

Pearce Administration
P.O. Box 2439
Florence , SC 29503
1-888-722-1668

Who do I call if I need help finding a Network Provider?

Southcare PPO at 1-800-843-1787

Will my daughter be able to utilize the Student Health Services Department at Spelman College?

Yes, services provided by the Student Health Services Department are available to all traditionally enrolled students.