Health Insurance Requirement & U.S. Health Care

F-1 and J-1 exchange students, as well as research scholars, are subject to federal and state health insurance requirements. See the information below to learn more about these requirements, as well as how to purchase and maintain SF State approved health insurance.

What Students Need to Know

F-1 International Students

The Board of Trustees of the California State University (CSU) requires all matriculated, degree-seeking F-1 international students to have health insurance as a condition of registration and continued enrollment in the California State University system. 

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. They must purchase health insurance prior to entering the United States. 

In the United States, healthcare is not a public service. Therefore, the cost of healthcare is generally much higher and can vary more than in countries that have a national healthcare system. 

International students’ health insurance is intended to protect them financially within this expensive system, particularly when it comes to unexpected illnesses and injuries that lead to expensive medical bills. 

Relation Insurance logo

Relation is a broker that connects SF State with insurance companies that offer comprehensive, affordable health insurance plans.  Students can view the SF State international student insurance plan on Relation's website: http://www.4studenthealth.com/isfsu

The 2021-2022 Academic Year student health insurance provider is GeoBlue (no longer Aetna). To view resulting changes to benefits, visit the Relation website, choose “2021-2022” under “Currently displaying”, and read the “Important Message” section. 

In some cases, students may be required to pay a “co-pay” to receive a service (please see the Health Insurance Terms section for definitions of this and other terms). Additionally, some non-essential services, such as cosmetic surgery, may not be covered.

Students should visit the Relation Insurance page for a full summary of health insurance benefits. The summary is available under "Use Your Insurance" in the "Plan Materials" section. For a brief overview of the plan, please view the plan snapshot

F-1 international students, J-1 exchange students, and J-1 research scholars must purchase and maintain the SF State-approved health insurance offered by Relation Insurance. No other self-purchased insurance policies will be accepted. (F-1 students see Insurance Exceptions below)

To purchase SF State-approved health insurance, visit either the international/exchange student or research scholar links as appropriate:

TYPE OF PLAN

START DATE

END DATE

Academic Year

August 10, 2021

May 31, 2022

Fall

August 10, 2021

December 31, 2021

Early Fall

*For new Fall students who are arriving the U.S. early

August 1, 2021

December 31, 2021

Spring

January 1, 2022

May 31, 2022

Summer

June 1, 2022

August 15, 2022

After purchasing health insurance, students will receive an email with their Member ID Number, as well as instructions for activating their account and accessing their health insurance ID card.

Students should keep their insurance ID card with them at all times in their bag or wallet (or digitally, if available via smartphone app). This card contains important information regarding their health insurance plan and should be provided when seeking medical care.

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

  • F-1 international students on government-sponsored scholarships that provide compatible insurance coverage as a part of the sponsorship. Such students should contact OIP at f1@sfsu.edu for guidance.
     
  • 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). Such students should contact the Enterprise Risk Management office at riskmgmt@sfsu.edu for guidance. Students should include their full name and student ID number in the email.

F-1 International Students

F-1 international students who will remain in the United States during the Summer term but will not enroll in classes are not required to purchase SF State student health insurance or clear the Summer International Health Insurance Hold during the Summer term. A Summer Insurance Hold will not prevent F-1 international students from registering for classes in Fall, as long as  they purchase Fall insurance.

Students may purchase the Summer plan even if they are not taking Summer classes as long as they are registered for the following Fall semester. 

For F-1 international students who choose not to purchase SF State-approved health insurance for the Summer term, OIP recommends that they purchase some other form of health insurance in order 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.

Insurance Holds and Refunds

If an F-1 student is planning to enroll in Spring 2022 courses (in or outside of the U.S.), they must address the insurance requirement.

  • If an F-1 student intends to remain in/enter the U.S. for Spring 2022, they must purchase insurance. If they do not enter the U.S. or leave the U.S. before the Spring 2022 semester, they will be eligible for a full refund before the add drop deadline.
  • If an F-1 student has intentions of staying outside of the U.S. for Spring 2022, they must sign the insurance waiver. If they change their mind and decide to enter the U.S., they must purchase insurance.

There are two ways to clear "international health insurance hold":

  1. Students who plan to study in the U.S. for Spring 2022:  Must purchase the Spring 2022 plan (Cover from 1/1/2022 to 5/31/2022) at http://www.4studenthealth.com/isfsu.  
Students who received insurance hold MUST email proof of insurance purchase to f1@sfsu.edu to clear hold. The process time to clear the hold is FIVE (5) business days - please plan accordingly.
  1. Students who plan to study outside the U.S. for Spring 2022: Sign the insurance waiver.
    *For international students who are enrolled online during the COVID-19 pandemic and are verifiably out of the U.S., this waiver fulfills the requirement. 

F-1 International 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.

Request a refund as a continuing F-1 student:

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. 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. Submit a signed Time Off Request Form (TORF).
  3. Email f1@sfsu.edu the following information:
    1. Full name, 
    2. SF State ID number
    3. Confirmation that they understand the information above.

Request a refund as a new F-1 student:

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. 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. Understand they will be categorized as a "non-start" student and must re-apply for admissions.
  3. Email f1@sfsu.edu the following information:
    1. Full name
    2. SF State ID number
    3. Confirmation that they understand the information above.
Important: Students who have filed a claim with their insurance or who submit a refund request after the refund deadline are not eligible for reimbursement.

The Spring 2022 refund request deadline is February 11, 2022.

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.

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

The Spring 2022 refund request deadline is February 11, 2022.

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, which is included in SF State tuition (or the tuition paid to a student’s home university in the case of J-1 exchange students).

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." "At cost" means that students must pay for some forms of medical care, but at a lower than average price. 

Using Student Health Insurance at SHS

Unlike most clinics, SHS will not send students’ bill directly to the insurance company. Instead, the SHS bill will appear in the "Finances" section of the student’s Student Center. Students should pay this bill. After paying, they may contact their insurance provider to “file a claim” (see FAQ below). The insurance company will review the claim and reimburse the cost of the fee, if applicable.

 

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.

Many off-campus healthcare options 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.  

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

The "Finding a Doctor ("In-Network)" section provides instructions for finding off-campus healthcare services.

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.

Follow these steps to find a list of “in-network” healthcare providers: 

GeoBlue (Fall 2021, Spring 2022, Academic Year 2021-2022):

  1. To find a Blue Card PPO provider, call (844) 268-2686 or visit the GeoBlue website.
  2. Under “Find a Provider” select “U.S. Providers.”
  3. Click Choose a location and plan.
  4. Enter your address and city, or Zip code, click on address to confirm, then click Yes, this is correct.
  5. Type in the code “QHS,” then click Continue.
  6. Click on Doctors by nameDoctors by specialtyPlaces by name, or Places by type.
  7. Enter your search criteria, then click search.
  8. Make your selection from the list, and call to make an appointment.

Understanding Health Insurance

In order to use their insurance properly, students should:

  1. Understand what services are covered under the international student health insurance plan.

  2. Understand the difference between in-network and out-of-network medical care providers and know how to find an in-network provider. 

  3. Have their health insurance ID (and other requested documents) available 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).

Students unfamiliar with the terms "co-pay" and "file a claim" should refer to the "Frequently Used Insurance Terms" section.

For questions regarding enrollment or eligibility, contact Relation insurance services at clientservices@relationinsurance.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 Relation Insurance website.

Will my health insurance cover COVID-19 testing?

Health insurance will cover COVID-19 testing if the test is ordered by a doctor. 

If students would like a COVID-19 test for a different reason (e.g. they need one in order to travel), they must pay for the test "out-of-pocket" (using their own money). See here for a list of free and affordable COVID-19 testing facilities.

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.

Will my health insurance cover dental and vision?

Routine (i.e. non-emergency) dental and vision care are not covered by the International Student Health 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. Unlike purchasing health insurance, purchasing dental and/or vision insurance is not required by SF State.

Supplemental dental and vision plans can be found at the following link (students may use other dental and vision insurance services, if they wish): 

https://4studenthealth.relationinsurance.com/supplemental-plans/

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

The 2021-2022 international student health insurance plan 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 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?

Relation Insurance offers a helpful glossary (in both English and Spanish) explaining different health insurance terms. Visit Relation Insurance's Information & Resources page for more information.

Where can I find more information about how to use my health insurance?

Students can review Relation Insurance’s “How To” guide (PDF, 1.95MB), contact Relation Insurance at https://4studenthealth.relationinsurance.com/contact-us/, or call Relation Insurance customer services at (800) 483-6192 for support.

Last updated: December 2021

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