William and Mary

Student Insurance Basic Coverage

Outside the Student Health Center

The basic coverage of the Student Insurance Plan features a $200 deductible per policy year and an additional $250 in-patient deductible. The basic plan provides coverage at 100% for Preferred Provider Physician's Visit (70% for Out-of-Network) with a $30 copay/deductible per visit (in lieu of the policy deductible) and 100% for Emergency Room Visits with a $75 copay/deductible per visit (in addition to the policy deductible). After the policy deductible(s) has been met, other inpatient and outpatient benefits are typically covered at 80% for Preferred Providers and 50% for Out-of-Network Providers. Benefits will be paid the same as any other sickness for inpatient, outpatient and partial hospitalization for mental illness and substance abuse services. Finally, benefits are available for outpatient prescription drugs on our Prescription Drug List (PDL) when dispensed by a UnitedHealthcare Network Pharmacy (Medco/Express Scripts network). Benefits will be subject to varying copayments of $15 for each generic, $30 for each formulary and $50 for each brand name prescription (up to a 31 day supply).

At the Student Health Center

Covered medical expenses, including prescriptions drugs, will be paid at 100% at the Student Health Center (SHC) after applicable copayments.  There is a College-required office visit charge of $5-$15 that must be paid by all students regardless of insurance coverage.  There is a $5 copay per prescription for generic and $15 copay per prescription for brand, up to a 31-day supply per perscription filled at the Student Health Center. The SHC is authorized to dispense 90-day supplies of your prescription drugs. Benefits for laboratory services performed at the Student Health Center will be payable after a $10 copay. Laboratory services that are referred outside the SHC for processing will be billed to your insurance and subject to the policy deductible and coinsurance. See the Plan Brochure and other policy documents on the W&M's UHCSR page for complete details. Once you have reviewed the plan brochure, you can use the provider search to locate a UHC Options PPO network provider in your area.