Health Insurance Requirement & U.S. Health Care

What Students Need to Know

The Cost of Medical Care is High in the U.S.  

Unlike many countries, the United States does not provide “universal access” or “national health care”.  International students are also not eligible for any U.S. federal welfare assistance. When international students receive medical care in the U.S., the doctors and hospitals will look to international students and their insurance companies to get paid for their services.  

According to HealthCare.gov, fixing a broken leg can cost up to $7,500, and the average cost of a 3-day hospital stay is around $30,000.

    Without insurance, international students might face financial ruin resulting from serious accidents or illness. This could prevent them from completing studies in the U.S.

    It is CSU Enrollment Requirement

    F-1 International Students

    The Board of Trustees of the California State University (CSU) requires F-1 international students to have health insurance as a condition of class registration at SF State.

    J-1 Exchange Students 

    As per J-1 immigration regulations and the above-mentioned CSU policy, all exchange students on J-1 visas and J-2 dependents must maintain health insurance coverage for the duration of their program as indicated on the Form DS-2019.

      Academic Health Plans (AHP) (Previously Relation Insurance Services) is a broker that connects SF State with insurance companies that offer comprehensive, affordable health insurance plans.

      The insurance company for the 2023-2024 academic year is GeoBlue

      In some cases, students may be required to pay a “co-pay” to receive a service. Additionally, some non-essential services, such as cosmetic surgery, may not be covered.

      Students can view the SF State pre-approved international student insurance plan at the following link: 

      F-1 International Students

      • F-1 international students are not required to maintain full-time enrollment in the summer session or Winter break. 
      • Students may purchase the SF State pre-approved insurance plan through in summer if they enroll in the following Fall semester.
      • F-1 international students who are not enrolled in Summer:
        • Students who are not enrolled in Summer may choose not to purchase insurance
        • The Division of International Education recommends students to purchase some other form of short-term health insurance to protect their health, safety, and financial wellness.

      J-1 Exchange Students 

      • All J-1 exchange students, research scholars on J-1 visas, and J-2 dependents MUST maintain health insurance coverage for the duration of their program as indicated by the dates on their Form DS-2019 (this includes the Summer Term for Calendar Year students).  
      • Exchange visitors who “willfully fail” to maintain the required health insurance coverage are in violation of their J-1 status and are subject to termination.

      Routine (meaning non-emergency) dental and vision care are NOT covered by the SF State pre-approved insurance plan.

      Students who would like this coverage should purchase additional dental and/or vision insurance or be prepared to pay for such services privately. Dental and/or vision insurance is not required by SF State. Students may use other dental and vision insurance services if they wish. 

      Affordable dental clinics near SF State

      Exceptions

      The following students may be exempt from purchasing the SF State pre-approved insurance plan:

      • F-1 international students on government-sponsored scholarships that provide compatible insurance coverage as a part of the sponsorship. Contact f1@sfsu.edu for instructions.
         
      • F-1 international students receiving insurance coverage through an employer-sponsored plan in the United States (i.e., receipt of insurance as part of a spouse's U.S. employment benefits). This exception does not apply to F-1 students who are receiving employer-sponsored plans from their CPT employers.

      Instructions

      Follow the steps below:

      Step 1: Prepare proof of insurance

      Obtain an electronic copy of your Summary of Benefits and Proof of Insurance, which should include your name on the policy and eligibility dates.

      Step 2: Purchase the Academic Emergency Services (repatriation/evacuation insurance)

      The Academic Emergency Services is repatriation/evacuation insurance (See information). The university requires all F-1 international students to purchase repatriation/evacuation insurance to ensure they have the resources necessary to return to their home country in the event of a catastrophic event or to have their remains returned to their country should an accident occur resulting in a student's death. F-1 students are in non-immigrant status and are therefore subject to this requirement. 

      Contact f1@sfsu.edu for instructions to enroll in AES plan.

      Step 3: Complete waiver

      Health Insurance Waiver Application (Link to DocuSign). While signing the application, students must upload their Summary of Benefits, Proof of Insurance, and proof of AES insurance.

      This video will help international & exchange students understand their 2023-2024 health insurance plan.

      • 0:00 Introduction
      • 0:12 Health Insurance Basics
      • 1:22 Who Do I Contact?
      • 2:58 Insurance ID Card
      • 3:58 Your Plan Benefits Explained
      • 6:41 Choosing Where to Go for Care
      • 8:39 Prescription Medications
      • 9:55 How to Use Your Insurance
      • 11:38 Reacp

      Purchase Health Insurance

      F-1 international students, J-1 exchange students, and J-1 research scholars must purchase and maintain SF State pre-approved international student health insurance at Academic Health Plan's portal: https://sfsu.mycare26.com/

      Students may purchase additional insurance policies if they wish, but they must purchase the international health insurance plan pre-approved by SF State through AHP regardless. 

      What Students Need to Know

      • A non-refundable 3% fee will be charged for all credit card transactions. There is no charge for a debit card or an ACH payment (ACH payment means an electronic fund transfer made from a U.S. bank)
      • First-time new students: Students must create an account at the Academic Health Plan's portal to purchase insurance
      • Continuing students: students must log on to the Academic Health Plan's portal to purchase insurance

      Instructions to Purchase Spring 2024 Insurance

      • Go to https://sfsu.mycare26.com/
         
      • Click Begin Enrollment
         
      • Click the drop-down menu for "International Students"
         
      • Click the "Click Here to Enroll" button
         
      • For "School Email", students can either enter the SF State student email address or their personal email address.
        For "School", select "San Francisco State University" via the drop-down menu.
         
      • Click “Next
         
      • Log in
        • If you have not created an account under Academic Health Plans, click "Create one now!
           
        • When creating an account:
           

          • All current international students should choose "International
             
          • Students should provide their U.S. address if they have one. First-time new international students may provide the university's address which is:

            1600 Holloway Ave, San Francisco, CA 94132

            Students will be able to change the university address to their personal U.S. address later.
             

          • A parent's email is NOT required. 
          • Once all sections are complete, click the Create Accountbutton. An email will be sent to the email addresses students provided to verify their email accounts. 
             
          • Find the AHP email within the SF State email inbox (check the junk folder as well) 
             
          • Once students have verified their email, they will be directed to a new screen to create their password. 
          • Once their password is created, students will return to the main page to log in to their accounts.
             
      • Click the "I want to Enroll" button.
         
      • Students may skip "Credit hours" questions if the system allows them to. If not, students may enter any numbers between 1-99. The answer to this question does not affect the insurance purchase.
         
      • Review the information and click each box to confirm student understands and meets the eligibility requirements. 
         
      • Click "Confirm"
         
      • Click the plan option to purchase:

      Plan Type

      Cost

      Start Date

      End Date

      Intended Population 

      Annual Academic Year Medical:

      $1939 

      August 16, 2023

      May 31, 2024

      New and Continuing students who wish to purchase Fall and Spring coverage together 

      Early Start + Fall Medical:

      $1023 

      August 1, 2023

      December 31, 2023

      New students who will be in the U.S. before August 16, 2023 

      Continuing students who do not have summer insurance coverage

      Fall Medical

      $923 

      August 16, 2023

      December 31, 2023

      New students who will be in the U.S. after August 16, 2023

      Continuing students who have summer insurance coverage 

      Note: Optional plans can be purchased later: Cigna Dental & VSP Vision. 

      • 12. Click "Proceed to Checkout"
         
      • Click on the chosen plan 
         
      • Click "One-time Pay
         
      • Click on the payment method. 
        • Payment by credit card has a non-refundable 3% transaction fee. 
        • Payment by U.S. bank transfer (ACH) does not have additional charges.
           
      • Enter payment information 
      • Click “Pay” to complete the purchase. 

      Students will receive a welcome email from GeoBlue two weeks before the first day of the insurance plan. 

      Students will not receive printed insurance cards by mail. The Welcome Email will contain instructions to create an account at GeoBlue Student Insurance's website at https://www.geobluestudents.com/ and download an insurance card. Students will not receive insurance cards via mail.

      PRINT and always carry the insurance card. 

      Insurance Holds and Refunds

      Step 1:

      Follow the steps above to purchase your insurance plan.

      Step 2:

      Email proof of insurance purchase, full name, and SF State student ID number to f1@sfsu.edu to clear the hold.

      Step 3:

      The processing time to clear the hold is FIVE (5) business days. 

      A screenshot example of the international insurance hold

      F-1 International Students

      Students should finalize their study plans for the semester before requesting a refund. The 3% administration fee for credit cards is non-refundable. 

      Students who have filed a claim with their insurance or who submit a refund request after the refund deadline are not eligible for a refund.

      Continuing students

      If enrolling full-time in online courses outside of the U.S.

      Students must:

      1. Sign the insurance waiver to verify their location.
      2. Drop any in-person/hybrid courses if enrolled.
      3. Pay off all the outstanding balances showing at the SF State Gateway/online student center.
      4. Email f1@sfsu.edu with the following information: 
        1. Full Name
        2. SF State ID number
        3. Confirmation that they have signed the insurance waiver and finalized their enrollment.

      If choosing to not enroll in courses:

      Students must: 

      1. Drop all courses if enrolled.
      2. Pay off all the outstanding balances showing at the SF State Gateway/online student center.
      3. Submit a signed Time Off Request Form (TORF).
      4. Email f1@sfsu.edu the following information:
        1. Full name, 
        2. SF State ID number
        3. Confirmation that they understand the information above.

      New students

      If enrolling full-time in online courses outside of the U.S.

      Students must:

      1. Sign the insurance waiver to verify their location.
      2. Drop any in-person/hybrid courses if enrolled.
      3. Pay off all the outstanding balances showing at the SF State Gateway/online student center.
      4. Email f1@sfsu.edu the following information:
        1. Full name
        2. SF State ID number
        3. Confirmation that they have signed the insurance waiver and finalized their enrollment.

      If choosing not to enroll in courses

      Students must:

      1. Drop all courses if enrolled.
      2. Pay off all the outstanding balances showing at the SF State Gateway/online student center.
      3. Understand they will be categorized as a "non-start" student and must re-apply for admissions.
      4. Email f1@sfsu.edu the following information:
        1. Full name
        2. SF State ID number
        3. Confirmation that they understand the information above.

      J-1 Exchange Students

      Students in the following situations may request a full refund for the insurance fees before the refund deadline. Students should finalize their study plans for the semester before requesting a refund.The 3% administration fee for credit cards is non-refundable.

      Request a refund from outside the U.S.

      If withdrawing before the exchange program begins

      Students must:

      1. Notify their home university of their intention to withdraw.
      2. Drop all courses, if enrolled.
      3. Email exchange@sfsu.edu the following information:
        1. Full name
        2. SF State ID number
        3. Confirmation that they have dropped all courses and wish to withdraw from the exchange program.

      If switching from in-person to virtual exchange

      Students must:

      1. Drop any in-person/hybrid courses, if enrolled.
      2. Email exchange@sfsu.edu the following information:
        1. Full name
        2. SF State ID number
        3. Confirmation that they have dropped all in-person/hybrid courses and have received permission from their home university to participate in virtual exchange from outside the U.S.

      Request a refund after entering the U.S. 

      If withdrawing from the exchange program

      Students must: 

      1. Notify their home university of their intention to withdraw.
      2. Drop all courses.
      3. Email exchange@sfsu.edu the following information: 
        1. Full name
        2. SF State ID number
        3. Confirmation that they plan to withdraw from the exchange program and leave the U.S.

      2024

      Spring 2024 refund deadline: Friday, February 16, 2024

      Seeking Medical Care

      Student Health Services

      Student Health Services (SHS) provides basic medical care to students who are enrolled at SF State.

      Most SHS services are covered by the Student Health Fee is included in SF State tuition and fees. *For J-1 exchange students it is the tuition paid to a student’s home universities.

      SHS services include:

      • Care for sore throats, stomachaches, and coughs
      • Care for back and neck pain
      • Care for mental health concerns
      • Blood tests (e.g. to clear immunization holds)
      • General health and medical advice

      Not all SHS services are covered by the Student Health Fee. Certain services are provided "at cost" which means that students must pay but at a lower-than-average price. 

      Important: SHS is NOT a walk-in clinic. Before accessing SHS services, students must first make an appointment. Students can schedule an appointment by following instructions on the SHS website.

      Students will have to pay no-show fees if they do not come to the appointment.

      Using Student Health Insurance at SHS

      SHS does not contact GeoBlue for payment. Students are required to pay for SHS services first at the Student Center, then file a claim with GeoBlue to be reimbursed (paid back).

      • To pay for the medical services received at SHS: Log on to the Student Center and make payment, just like how they pay for tuition and fees every semester.
         
      • To receive reimbursement from GeoBlue: Follow the claims instructions at AHP's website: https://sfsu.mycare26.com/

      Many off-campus healthcare options are available. Students must understand what each type of healthcare facility offers and when to use them.

      Off-Campus Clinics

      Students who wish to receive a general medical check-up or non-urgent medical care that is not available at SHS may make a doctor’s appointment at an off-campus clinic that offers general or specialized medical care for a specific health concern.  

      Find an off-campus doctors (aka "providers") at the following links: https://sfsu.mycare26.com/

      IMPORTANT: Students should NOT go to the Emergency Room unless they have a life-threatening illness or injury.

      Urgent Care

      Urgent Care is a type of walk-in clinic that treats injuries or illnesses that are non-life-threatening but still require immediate attention (e.g. flu, cold, sprained ankle). Students do not need an appointment to visit an Urgent Care clinic.  

      Students should visit Urgent Care in the following situations:

      • They cannot get an appointment with SHS but feel that they must see a doctor immediately.  
      • An Urgent Care clinic is more conveniently located than SHS.  
      • The student wishes to receive medical care that is not listed on the SHS website.  

      See the below for more details about how to find an Urgent Care clinic.

      Emergency Room

      The emergency room should ONLY be used for life-threatening situations (such as those that require an ambulance). Students who need to go to the emergency room due to life-threatening injury or illness should call campus police at 415.338.2222 (if on campus) or 911 for help.  

      Students should NOT visit the emergency room for non-life-threatening situations. If students use the emergency room in a non-emergency situation, their health insurance may not cover the cost of the healthcare that they receive.  

      For mild to moderate illnesses and injuries, SF state recommends that students visit Urgent Care or make an appointment with an in-network doctor. Use the Help! I Need Medical Care chart below to learn when to visit the emergency room.  

      When making an appointment with an off-campus doctor, students should be aware of the difference between “in-network” and “out-of-network” healthcare providers. 

      An in-network provider is a provider that will accept students’ insurance, while an "out-of-network" provider will not. For this reason, in-network providers are more affordable.

      Understanding Health Insurance

      To use their insurance properly, students should:

      1. Get familiar with insurance benefits posted at https://sfsu.mycare26.com/.
         
      2. Try to find an off-campus doctor (aka healthcare provider) and an urgent care clinic. Get an idea of where the healthcare facilities are around you.  To do so, visit https://sfsu.mycare26.com/. go to "Find a Provider".
         
      3. Carry the health insurance ID card with them all the time, especially when attending an appointment or visiting a walk-in clinic.
         
      4. If applicable, pay the “co-pay” at the beginning of the appointment. When checking in, students should ask if the healthcare provider will bill the insurance company directly for the remaining cost OR if the student must "file a claim".
         
      5. File a claim (if needed).

      For questions regarding enrollment or eligibility, contact Academic Health Plans (AHP) at ceduclientservices@ahpcare.com or call 1-800-537-1777.

      For questions regarding claims or benefits, contact GeoBlue at 1-844-268-2686 or visit www.geobluestudents.com

      What is a “co-pay”?

      A "co-pay" is a fixed fee that the student must pay for certain services at the beginning of an in-network medical appointment. Insurance will cover the remaining cost. Review the plan summary to learn which medical services have a co-pay.

      What is a "deductible"?

      A "deductible" is the set amount of money a student must spend on certain medical services before insurance will begin to cover the cost. Once the deductible is met, insurance will cover a percentage of the cost through a process called "coinsurance". Review the plan summary to learn which medical services have a deductible.

      What is “coinsurance”?

      If a student reaches the deductible limit for a deductible-eligible service, insurance will begin to pay for a percentage of the cost, while the student is responsible for the rest of the cost. This process is referred to as "coinsurance."

      While a "co-pay" is a fixed rate for service with no deductible, "coinsurance" is a percentage of the total bill that the students pays after reaching their deductible. 

      What does it mean to “file a claim”?

      Normally, when students use their health insurance to receive medical care, the medical provider will send the bill directly to the insurance company. However, at some locations (for example, Student Health Services at SF State), the medical clinic will bill the patient. The patient must pay the bill and then "file a claim" with the insurance company to receive a reimbursement, if eligible. 

      For more details about how to file a claim, visit the “Claims” section under “Use Your Insurance" on the https://sfsu.mycare26.com/

      Will my health insurance cover a flu shot?

      GeoBlue's ACA-compliant plan offers preventative care, including flu shots for in-network providers. Additionally, SF State’s Student Health Services offers affordable flu shots periodically during the semester.

      What do I say when a healthcare provider asks what kind of insurance I have?

      Your insurance company is GeoBlue (PPO).

      Who do I contact if I have a question about my coverage or a bill I have received?

      For specific questions about medical benefits and claims or support finding an in-network provider, contact GeoBlue at 844-268-2686 or  www.geobluestudents.com.

      Will my insurance cover “___”?

      If a student is not sure what is covered by their health insurance plan, they may do the following:

      Will my insurance cover the care I receive at Student Health Services (SHS)?

      Students who receive bills from SHS should pay the bill and then file a claim to receive reimbursement, if eligible.

      The U.S. health insurance industry uses a lot of confusing vocabulary. Where can I look up terms that I don’t understand?

      Contact Academic Health Plans (AHP) at ceduclientservices@ahpcare.com or call 1-800-537-1777.

       

      Last updated: February 2024

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