Health Care Assistance Fund

Background

Starting in the Fall 2021 semester, the university has changed the default insurance option for benefits-eligible academic graduate student (AGS) employees from UT Select to AcademicBlue (UT SHIP). AcademicBlue SHIP provides affordable, quality coverage that meets or exceeds a gold-level of coverage according to the Affordable Care Act (the same rating as UT Select). The university expects that the majority of students will have lower out-of-pocket costs under AcademicBlue SHIP. Nevertheless, a small percentage of the overall benefits-eligible graduate student population may experience increases in out-of-pocket costs due to plan differences. The impact of this insurance change will vary based upon utilization and students’ specific healthcare needs. The Health Care Assistance Fund is intended to help students who encounter higher costs through block grants awarded by the Graduate School. Efficiency of the application and award processes and the protection of student privacy are high priorities. It is expected that the fund will adapt to best suit student needs as we learn more about the impacts of the change.

Eligibility

The Health Care Assistance Fund is intended to help benefits-eligible academic graduate student (AGS) employees who encounter higher costs because of the change in their default health care plan. Graduate students enrolled in 2021-2022 are eligible to apply. All of the following eligibility criteria must be met:

  • Enrolled in a graduate program in the 2021-2022 academic year.
  • Benefits-eligible academic graduate student employee at the time when expenses were incurred.
  • Receiving health insurance coverage through AcademicBlue SHIP at the time when expenses were incurred.

Eligible Expenses

The Health Care Assistance Fund is intended to help benefits-eligible AGS employees with unexpected expenses due to the change in default health insurance plans. Therefore, the fund will help students with the difference in out-of-pocket costs for care between the two plans.

Students will be asked to estimate the difference between their out-of-pocket costs and what the costs would have been under UT Select. The comparison chart between the two plans (2021-2022 comparison chart or 2022-2023 comparison chart) is a useful tool for estimating these costs differences.

Types of health care expenses that are eligible for support from the Health Care Assistance Fund are:

  • Expenses resulting from services that are charged through a deductible and co-insurance under AcademicBlue SHIP but are charged by co-payments under UT Select. The difference between the AcademicBlue SHIP deductible plus co-insurance cost and the UT Select co-payment amount is eligible for assistance.
  • Expenses resulting from higher co-payments on AcademicBlue SHIP than on UT Select. The difference in co-payment amount is eligible for assistance.
  • Expenses resulting from services that are charged by deductibles plus co-insurance under both plans. AcademicBlue SHIP does not have a co-insurance maximum, which could result in higher out-of-pocket costs
    • For 2021-2022 expenses, the co-insurance amount exceeding $2,150 is eligible for support.
    • For 2022-2023 expenses, the co-insurance amount exceeding $3,500 is eligible for support.
  • Prescription drug costs exceeding the cost of that drug with UT Select.

Expenses incurred through the voluntary use of out-of-network providers are not eligible for assistance. The networks for UT Select and AcademicBlue SHIP are the same.

Additional Assistance

  • Students are encouraged to follow suggestions for managing out-of-pocket health care costs such as using in-network providers, using UHS, and taking advantage of manufacturer rebate programs for prescription medications.
  • Students should also be aware that area hospitals have financial assistance programs, including Seton and St. David’s.
  • Students with medical emergencies may also be eligible for assistance from the Student Emergency Fund.

Awards

  • The fund is not a direct reimbursement of expenses, and the value of the assistance provided will be discretized as block grants.
  • All funds remitted are considered taxable income, and the value of the award will be about 10% greater than the eligible expenses to approximately compensate for taxes.
  • For students receiving federal financial aid through the Office of Scholarships and Financial Aid, awards will be reviewed by that office. If the award causes the student’s aid to exceed their cost of attendance, the student can request a cost of attendance re-evaluation.

Application

  • Students may apply once per semester or session, for a minimum award of $250 up to a maximum value of $8,700 per year per individual (student and/or covered dependent). The $8,700 maximum represents the total possible out-of-pocket cost per individual on AcademicBlue SHIP.
  • Students will provide documentation of health care costs, such as Explanation of Benefits (EOB) forms, and a description of how these costs exceed UT Select coverage. Students may also choose to submit receipts, invoices, or other documentation to support their application. EOB forms can be obtained by logging in to the BCBSTX website, clicking on “claims,” selecting the Explanation of Benefits (EOB) form for the claim of interest, then saving the PDF file that appears.
  • In cases where the services received are available at UHS at no cost and the student chose to receive care elsewhere, the student should explain the reason.
  • The application materials will be maintained in password-protected sites, only accessible by those authorized to review applications. Only the award amount will be viewed by the Office of Scholarships and Financial Aid and Student Accounts Receivable.

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