Health Insurance Requirement & U.S. Health Care

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.

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.

Risk Strategies 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 (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 can view the SF State pre-approved international student insurance plan at http://www.4studenthealth.com/isfsu

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

To purchase insurance, visit the following links as appropriate:

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

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

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 instruction.
   
• 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).
   

Follow the steps below:

• Step 1: Obtain an electronic copy of your Summary of Benefits and Proof of Insurance (that includes you name on policy and eligibility dates).
   
• Step 2: Purchase Evacuation & Repatriation insurance.  All F-1 students must purchase this plan.
   
• Step 3: Complete the Health Insurance Waiver Application (Link to DocuSign). Students will need to upload item 1 and 2 above while signing the application.

F-1 International Students

• F-1 international students are not required to maintain full-time enrollment in the Summer session or Winter break. 
• F-1 international students MUST maintain insurance coverage during Summer session and Winter break if they plan to physically remain in the U.S. (with or without class enrollment).
• Students may purchase the SF State pre-approved insurance plan through Relation Insurance Services in summer as long as they will 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 from Relation Insurance Services f
  • OIP recommends students to purchase some other form of short-term 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.

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. 

Supplemental dental and vision plans can be found at https://4studenthealth.relationinsurance.com/supplemental-plans/

Affordable dental clinics near SF State

• Potrero Hill Health Center 
  1050 Wisconsin Street 
  San Francisco, CA 94107
  415-648-3022
  Web: https://sfhealthnetwork.org/about-sfhn/do-you-need-a-dentist/ 

   

• UCSF General Dentistry Student Clinic 
  707 Parnassus Avenue Suite D-4000
  San Fransico, CA 94143
  415-476-1891
  Web: https://www.ucsfdentalcenter.org/clinics/student-general-dentistry-clinic-parnassus

Taking Online Classes Outside the U.S. in Summer 2023 or Fall 2023

Students must sign insurance waiver to clear hold. International health insurance waiver only applies to international students who will be outside the U.S. for the ENTIRE Summer 2023 session or Fall 2023 semester.

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.

New Students may request full refund if they are not able to obtain F-1 visa to enter the U.S.

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. 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.

New 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.

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.

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. 

Using Student Health Insurance at SHS

SHS do not contact GeoBlue for payment. Students are required to pay for SHS services first at 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 Student Center and make payment, just like how they pay for tuition and fees every semester.
   
• To receive reimbursement from GeoBlue: Follow "Claims" instructions at http://www.4studenthealth.com/isfsu

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.  

Find an off-campus doctors (aka "providers") at http://www.4studenthealth.com/isfsu.  Go to "Use Your Insurance" and click "PPO Network".  Follow instructions.

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 2022 - Spring 2023, Academic Year 2022-2023):

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 name, Doctors by specialty, Places 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.

In order to use their insurance properly, students should:

1. Get familiar with their health insurance at  http://www.4studenthealth.com/isfsu. Read “Snapshot (Plan Overview)” and “How to Use Your Plan”.  
2. Try to find an off-campus doctor (aka healthcare provider) and an urgent care clinic. Get an idea of where are the health care facilities are around you.  To do so, visit http://www.4studenthealth.com/isfsu, go to "Use Your Insurance", and click "PPO Network".  Follow instructions.
3. Cary 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 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.

What do I say when 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:

• Review the plan summary posted at http://www.4studenthealth.com/isfsu.
• 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 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.