Campus Health: Eligibility for Care Policy

Unit Policy

Title

Campus Health: Eligibility for Care

RI-12

Introduction

Purpose

This policy defines who is eligible to receive services at UNC Chapel Hill Campus Health, under what conditions, and for how long. It covers eligibility rules for a wide range of student categories — including degree-seeking students, part-time students, graduates, athletes, exchange students, and those on medical or administrative withdrawal — as well as specific guidance on insurance requirements and health fee payment.

Scope

This policy applies broadly to UNC Chapel Hill students, as well as postdocs, RAs/TAs, spouses of fee-paying students, exchange students, graduates, and in some cases faculty, staff, and community members seeking services at Campus Health.

Policy

The University of North Carolina at Chapel Hill Campus Health is committed to providing quality medical and wellness services and to promote health and wellbeing to all persons eligible to receive healthcare to the Carolina student community.

Campus Health offers the following services and clinics:

  • Primary Care services
  • Routine gynecologic services
  • Sports medicine and orthopedic services, including physical therapy
  • Laboratory services
  • Pharmacy
  • X-ray services
  • Immunization/International Travel clinic
  • Allergy clinic
  • Same Day Care and Mini Clinic
  • Limited acute care services
  • Academic Intervention for Medical Withdrawals

The scope of services for Counseling and Psychological Services (CAPS) is addressed in a separate document, PC-01, Institutional Plan of Care.

If, in the opinion of treating Campus Health physician or other health care provider, a patient's condition requires a level of care beyond that which can be offered safely and effectively through Campus Health, the physician or health care provider will refer the patient/client to a community provider for diagnosis, treatment, and/or medication maintenance. Campus Health reserves the right to make the final determination as to whether a patient can be effectively and safely treated at Campus Health.

In all cases, at the patient's request, Campus Health will provide a reasonable level of assistance to the patient/client to find appropriate medical services within the community.

General Information:

All degree seeking students at UNC Chapel Hill pay the (Campus Health) fee as part of tuition and fees. This Campus Health Fee is placed on all students' accounts by the UNC Cashier's Office making them eligible for services at Campus Heath during a specific defined academic period.

If a patient presents to Campus Health After Hours (fall/spring semesters) and is eligible for student status but has not paid the health fee, he/she will not be turned away. Medical/Nursing care will be rendered and the patient will be instructed the health fee will be added to their account. Nursing Services will contact Patient Accounts the next business day in order for the health fee to be added to the student's account.

Part-time and Distance Education students do not pay the health fee through tuition and fees. These students may opt to pay the health fee in order to have access to services provided at Campus Health. These students are directed to patient accounts to pay the fee and update their eligibility status in eCW. Students will need to show proof of insurance. Payment of the health fee does not qualify the student to enroll in the student insurance plan.

Not Eligible for Services at Campus Health:

  • Continuing Studies students (college of CS). Continuing Studies students can pay the Campus Health fee for the summer session(s) only and are then eligible for services at Campus Health during that defined period of time.
  • Visiting students (College of VS) except for visiting medical students
  • A student that is a full-time permanent employee of UNC or UNC Health Care that has completed a request for waiver of student fees.
    • The health fee & mandatory insurance fee are removed from their student account
  • A spouse of a full–time permanent employee of UNC or UNC Health Care that has completed a request for waiver of student fees.
    • The health fee is removed from their student account however the mandatory health insurance will remain on their account and they are required to waive
    • If enrolled in the RA/TA plan effective Fall 2012, can be enrolled in the plan without being required to pay the health fee.

Exceptions

  • Off Campus students (college of OS) or Distance Education students do not pay the health fee in their tuition and fees. Must pay health fee directly to Campus Health and show proof of active insurance.
  • In special circumstances per request from UNC system office UNC system school students can be eligible for services without paying the fee. Must provide proof of student ID and proof of active insurance coverage.
  • The Campus Health and Student Stores Pharmacies will fill prescriptions and administer certain vaccines for all students, faculty and staff as well as for community members as appropriate.

Eligibility Period:

  • An eligibility period begins when the academic semester/session officially opens and continues to the day before the next academic semester/session begins.
  • Students who have paid for care during a given enrollment period are eligible for care until the beginning of the next enrollment session.
  • Students enrolled for spring semester are eligible for care until the first day of the first summer session.
  • Students enrolled for the first summer session are eligible for care until the first day of the second summer session.
  • Students enrolled for the second summer session are eligible for care until the opening day of the fall semester.
  • Students enrolled for the fall semester are eligible for care until the opening day of spring semester.
  • Students coming to Chapel Hill early before an enrollment period begins, can be seen for state and department required immunization(s) and titer(s) only without paying the health fee. They will be charged for the immunizations. If a student would like to be seen for any other medical service prior to the opening date of the semester, they must pay the summer health fee.
  • Maymester – students enrolled in Maymester are charged tuition and fees on their student account.

Eligibility Status:

Spouse

The spouse of a fee-paying student is eligible to be seen if the health fee has been paid based on plans below. see below for specifics Note: if not enrolled in one of the plans below must show proof of active insurance coverage and pay the health fee directly to Campus Health..

  • If enrolled in the Student Plan, dependent coverage is not included therefore must show proof of active coverage and pay health fee directly to Campus Health.
  • If enrolled in RA/TA Plan, a Spouse enrolls directly with BCBS for medical coverage, The per semester Health Fee is added to the bank draft along with the health insurance premium. Spouse must pay Summer health fee direct to Campus Heath. .
  • If enrolled in Post Doc Plan, Effective 7-1-24 Spouse enrolls directly with BCBS health fee is paid directly to BCBS by bank draft each month for the entire FY which includes the summer.

Campus Health will receive checks per semester from BCBS for RA/TA and Postdoc spouse health fees.

RA's/TA's

The student must be registered (for a minimum of 1 credit hour) and have paid the health fee at the Cashier's office. Once the Verification of Student Eligibility form is completed by the student the department completes the on-line Graduate Student Health Insurance Program enrollment process in GradStar. Accounting sends monthly file to BCBS with student's names which is the current active enrollment file. BCBS then sends invoice back to UNC for monthly premium. If Dept decides to continue RA/TA enrollment due to medical withdrawal, no action needed in GradStar, they will remain on the plan. If Dept. does not want to continue paying RA/TA premium if a student withdraws, student can enroll in Student Blue, but they must do this prior to withdrawal and cancellation of classes because fees will be removed. Premium is paid directly to BCBS. Student calls 1-888-351-8283 to enroll as qualifying event.

Dental insurance is part of medical insurance plan. ID Card will be updated with filing information for Dental benefits. Vision benefits are also included in the medical insurance plan.

PostDocs

The Postdoc completes enrollment forms and returns the BCBSNC forms to the department manager or HR facilitator in their department. The Postdoc insurance premium and health fee are payroll deducted. All charges are paid one month in advance. Payroll deductions for family (spouse and/or children) health coverage will no longer be possible after 6-30-24. Postdocs may continue covering their dependents, but they will need to enroll the spouse & pay the premium directly to BCBS. The health fee for spouses will be collected by BCBS each month . . If a Postdoc is not on the payroll report:

  1. Call BCBS to verify if application for enrollment has been received. If so, Postdoc would be eligible to be seen.
  2. If BCBS has not received the application, contact his/her department to verify Postdoc status. If department confirms appointment, note contact person's name and effective date of appointment in the system and allow Postdoc to be seen. Tell Postdoc upon receipt of insurance card, to call Patient Accounts to request any outstanding claims to be electronically filed.

Dental Blue is a separate insurance plan for dental benefits. Exam Plus Plan is a separate plan for vision benefits. Both are paid by Postdocs department.

A postdoc's coverage should end the last day of the month following the month their position ends. For example, if their position ends on 3/15, then their coverage should extend through 4/30.

In-Coming International Student

The University of North Carolina at Chapel Hill requires all international students (F1 Visa, J1 and JO students) to maintain adequate medical insurance coverage at all times. This requirement does not apply if you have US permanent residence (Green Card) or US citizenship.

  • A list is provided from the International Student Program each semester
  • A student coming into the University who is not part of an exchange program and is paying all the fees and tuition.
  • Projected academic level, tuition group and academic plan are all as if this student were enrolled in the University as a domestic grad or undergrad student.
  • This student is eligible for the Hard Waiver plan.
  • The premium is applied to their University student account.
  • Can waive out of the Hard Waiver plan with their own international insurance.
  • They are not required to purchase HTH insurance. HTH is not on their student account
  • Waive requirements are:
    1. Medical benefits of at least $100,000 per accident or illness;
    2. Repatriation of remains in the amount of $25,000;
    3. Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $50,000; and
    4. A deductible not to exceed $500 per accident or illness
  • If an international student is enrolled in the BCBS Premium plan, their policy meets the requirements of the Insurance verification.

If a parent is currently living in the US and is pending permanent residence, the UNC legal counsel has approved the following modifications to this policy stating when the student does not have to pay for Repatriation and Medical Evacuation insurance benefits:

The parents of the student must send a letter stating the following:

  • They are currently living in the US,
  • They have no plans to return to their home country (other than brief temporary trips) while their child is in school here and,
  • If their permanent US residency application is denied and they are required to leave the US while their child is in school here, they agree that at that time they would purchase the Repatriation and Medical Evacuation insurance benefits for their child.

In-Coming Exchange Students

  • Patient accounts maintain a current list of exchange students from the Study Abroad office.
  • They are listed as a visiting student in connect Carolina and are exchanging fees with the outgoing exchange student.
  • eCW eligibility status is FEE Paid & Eligibility details - EXCHANGE Sem/Yr.
  • Contact from Study Abroad office is N. Nicole Cobb 966-2423 nncobb@unc.edu
  • MSHI fee is on the student's account. They are required to participate in waive/enroll process
  • Connect Carolina stream – Student Financials, View Customer Accounts, Academic Information Student Services Ctr(Student) Academic tab shows both plan names for incoming exchange (NDGRADFX/NDUGRDFX and VISGR/VISUG) as graduate and/or undergraduate students
  • Term must be defined as the current term example (2129)
  • The Academic Level – Projected = 'FX' and Academic plan = VISUG, VISGR, VISDENT, VISLAW, VISMED, or VISPHCY is used to add the MSHI premium. The Academic plan must also be added by the Registrar's office to have MSHI included: ASFXU, ASFXG

Out-Going Exchange Student

  • Students who are enrolled in the exchange program pay tuition and fees at UNC prior to international travel.
  • The student is enrolled in course number 'ISP' that allows them to pay UNC fees and their tuition group is defined as UGRCAS
  • *Note: There is a subject 'ISP' that is used for UNC students who are going on exchange abroad. These students will remain in their 'normal' tuition groups (like UG resident Arts & Sciences) and will be charged normal tuition fees. 'ISP' is not considered Study Abroad and pay tuition. These students may have a Study Abroad fee because they are administered through the Study Abroad office and are paying the price of going on that program.
  • Health fee is on their student account
  • MSHI fee on student account; required to participate in waive/enroll process
  • HTH insurance fee is on their student account

Out-Going Study Abroad Student

(are eligible for services in the summer if they pay the Campus Health summer fee).

During the fall or spring semester--

  • A UNC student traveling abroad does not pay the Campus Health fee.
  • Their eligibility in eCW will be NFP.
  • The study abroad office advises students to get the travel vaccines during the semester prior to travel because they are paying the health fee at that time.
  • They cannot be seen during the semester that they are coded as a study abroad student because they are not paying the HF. Exception - they must pay the HF directly to Campus Health and show proof of active domestic health insurance.
  • MSHI fee is not on their student account; they are not required participate in waive/enroll process
  • HTH insurance fee is on their student account
  • Pay study abroad fee to cover fees at the school they will be attending.
  • Study abroad office manually adds the appropriate study abroad fee depending on where they are going.
  • Tuition group is X_STUDYABR
  • Connect Carolina route is – Student Financials, View Customer Accounts
  • Students enrolled in one of the subjects below will be placed in the Study Abroad tuition group: X_STUDYABR
  • These students are not charged anything by our office (no MSHI fee or any tuition/ fees). Examples of abbreviated course subjects in Connect Carolina: YAP, BFRS, LSA, LVE, RLGE, BUSA, and SSAP
  • Connect Carolina stream – Campus Community, Student Services, Academics or Records & Enrollment, Enroll Students, Enrollment
  • Note: There is a subject 'ISP' that is used for UNC students who are going on exchange abroad. These students will remain in their 'normal' tuition groups (like UG resident Arts & Sciences) and will be charged normal tuition fees. 'ISP' is not considered Study Abroad and pay tuition. These students may have a Study Abroad fee because they are administered through the Study Abroad office and are paying the price of going on that program.

Graduated Student

For an individual who graduates from the University, eligibility for services at Campus Health end thirty (30) days post commencement (December/May). EXCEPTION: Pharmacy will fill prescriptions thirty (30) days post commencement or program completion other than December/May. Health Science students with blood borne pathogen (BBP) exposure that occurred prior to graduation, may elect to continue care at Campus Health beyond the 30 day period, for concerns related specifically to the BBP exposure. With loss of eligibility, a Campus Health provider may refill medications for up to three months. A graduated student is not required to pay an additional health fee in order to be seen for the thirty (30) day period.

To determine if a student has graduated, the Campus Health Patient Accounts individual will access Connect Carolina through the following computer screens:

  1. Click on Records and Enrollment
  2. Select Career and Program Information
  3. Click Student Program/Plan
  4. Enter student personal identification number (PID)
  5. Select at bottom of screen the degree on the top of list if multiple degrees are listed
  6. Click Student Degree tab
  7. Review Degree Checkout status:
    • Approved – student will be graduating but all grades may not be posted
    • Awarded – all grades and degree posted
    • Blank – student has not graduated

Exceptions for Graduated Student

Include Blood Borne Pathogen, Abnormal Pap smear management, string check post IUD insertion, scheduled for colposcopy, Japanese Encephalitis, completion of rabies and Human Papillomavirus (HPV) vaccine series. Other routine or elected vaccines should be directed to community resources. Eligible for International Travel Clinic (change status to private patient -- does not need to pay health fee).

Student Not Enrolled in the Summer or Current Semester

To provide maximal continuity of medical care, the UNC-Chapel Hill student who is not enrolled in summer school but remains in the Chapel Hill community during the summer months will be allowed and encouraged to receive pre-paid summer care at Campus Health. To be eligible for pre-paid summer care, a student must have paid a health fee for the previous spring semester and has not graduated from the University. In eCW, the eligibility Status will be Fee Paid and eligibility Details will include the summer session and end date. Exception: Students enrolled for the fall semester do not have to be enrolled in summer school nor do they have to have paid a health fee in order to use one of the Campus Health pharmacies during the summer.

Athletes

There are some spring sport programs that continue through June and these students would be eligible for care without paying the summer health fee. These spring sports include baseball, Men's and Women's Lacrosse, Men's and Women's track and field, Men's and Women's golf, Men's and Women's tennis, and softball.

Summer Orientation

For a parent, sibling (greater than 16 years of age), or student who is not entered into eCW who is attending Orientation and becomes ill can be seen for services at Campus Health without being charged the Campus Health summer health fee. Proof of insurance is required.

Orientation Leaders and Resident Advisors are eligible for services without paying summer health.

International Travel Clinic

Is available to faculty, staff, and private patients without paying the health fee.

Academic Intervention:

Medical Withdrawal – Individuals who are withdrawing from the University for a medical reason are eligible for services at Campus Health at thirty (30) days after the effective medical withdrawal. With loss of eligibility, a Campus Health provider may refill medications for up to three months. See Attached Termination of Services letter. Effective date 1/2/2013.

Psychological Withdrawal – Individuals who are withdrawing from the University for a psychological reason are eligible for services at Campus Health thirty (30) days after the effective psychological withdrawal date. Campus Health Therapist will immediately initiate transition for continuation of services with another outside provider. With loss of eligibility, a Campus Health provider may refill medications for up to three months. See Attached Termination of Services letter. Effective date 1/2/2013.

Administrative Withdrawal – Individuals who are withdrawn from the University for reasons related to Administrative, Honor Court and Emergency Evaluation are eligible for services at Campus Health thirty (30) days after resolution of the appeal. Since tuition and fees are refunded, individuals must pay the total current semester health fee in order to be seen for those 30 days. This eligibility status is documented in a letter sent to the individual by the Dean of Students office. Effective date 1/2/2013.

Based upon Medical, Psychological, or Administrative Withdrawal, the Business Services Coordinator will notify Patient Accounts of effective dates. Patient Accounts will change eligibility status to Fee Paid with an effective date until 30 days after the medical/psychological/ administrative withdrawal.

Medical Health Insurance

Since Fall Semester 2010, all students entering the University of North Carolina at Chapel Hill will have to show proof of insurance. Students can go to www.studentinsurance.com in order to waive out or enroll into the student insurance plan. If a student fails to waive, they will automatically be charged and enrolled in the Student Health Insurance Value plan. J1 Visa students will default to the Premium plan. There are three BCBS plans - Student Blue, RA/TA plan (grad students) and the Postdoc plan.

RA/TAs that are enrolled in the plan by their department are not required to participate in the per semester waiver process. BCBS will submit an administrative waiver when they process the GSHIP enrollment file.

COBRA

  • Enrolled students in the BCBS Student plan are not eligible for COBRA.
  • Postdocs are eligible for COBRA Campus Health must collect the health fee. The COBRA plan is the same postdoc plan. The only difference is that postdocs pay for their full subscriber premium as well, and the premium payments all go to the COBRA vendor (ACS Benefits) instead of BCBS.
  • The RA/TA Plan will not include COBRA. An employment change is considered a qualifying event and the individual can then apply for insurance through the Exchange.

Health Care Management:

Blood Borne Pathogen Exposure/Needlestick

Any student (including visiting health science students), or graduate that had a BBP exposure while a student, will be seen during the summer without paying the summer access charge.

Nursing Injections (Medroxyprogesterone, Testosterone, Vitamin B12, Estradiol)

During the summer months if the patient was enrolled during the spring semester, currently has a written order on file for these injections, the Summer Access Charge is not required. Proof of insurance will be required. If the provider order or a medical evaluation is needed to continue this injection, the patient must pay the Summer Access Charge and show proof of insurance..

Yellow Fever

Campus Health is a yellow fever international site for adults only (18 years of age and older). Non-Students are eligible to receive this vaccination. Payment of the health fee is not required but payment of the vaccine is required at the time of service.

Allergy Injections

Visits require payment of the campus Health fee and proof of insurance. Exceptions: patients who received allergy injections at Campus Health during the Spring semester can continue to receive allergy injections during the summer without having to pay the summer access charge.

Immunizations/Titers/TB Testing

Students may be seen for only immunization(s)/titer(s)/tb testing without paying the Campus Health fee but need to show proof of insurance. TB screening for International students, U.S. citizens and U.S. permanent residents living abroad who are enrolled at UNC Chapel Hill is required for those individuals coming from a country where tuberculosis is endemic. See the Campus Health website for list of high TB incidence countries. If the TB test is positive, students will not be charged the health fee for the associated provider visit. The Orange County Health Department (OCHD) offers some immunizations at no charge and students are informed of this option. The phone number for OCHD is 919-968-2022. Private patients must pay the health fee. Required immunizations for matriculating students are listed on the Campus Health Immunizations webpage.

See also MM-02, Vaccines and Titers, for additional information on vaccination eligibility.

Accutane Treatment

If a student needs follow-up visits or lab work related to ongoing Accutane therapy prescribed by a Campus Health provider, the patient may be seen without paying the Campus Health fee but will need to show proof of insurance.

Nursing Students

Eligible for Physical Exams and immunizations prior to semester open date without paying the health fee.

CAPS Summer Care

Summer Access fee is not required for group session visits. Couples Therapy would require payment of the fee by both partners. If not married or a domestic partner, the non-student is not eligible.

Follow-Up Visits

Non-graduating students may receive one follow-up visit connected to a previous visit, including labs if indicated, without paying the Summer Access Charge. Following this one visit, and if ongoing labs are needed, the summer access charge will apply. Note that this follow-up visit is typically within 1-2 weeks of the initial visit. Exceptions to the summer access charge for ongoing or continuation of initiated services include:

  • Accutane treatments
  • BBP management
  • injection series
  • IUD string checks
  • Wound checks

Please see the Campus Health Summer Care webpage for more details.

Contact Patient Accounts prior to scheduling the appointment to ensure appropriate documentation in eCW.

Please contact Patient Accounts or the Director of Business Services to discuss unique patient situations and exceptions to the above.

Reference

  • PC-01 Institutional Plan of Care

Attachments

  • Attachment 1: Termination of Services letters
  • Attachment 2: Medical and Counseling Community Services
  • Attachment 3: Medical and Mental Health Community List

Contact Information

Primary Contact

Name: Melody Gibson, Health Information Manager

Telephone: 919-966-6557

Email: mgibson@email.unc.edu

Publication Details

Issuing Officer: Ken Pittman, Executive Director of Campus Health

Effective Date: January 2003

Last Review Date: June 2025

Next Review Date: June 2028

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