Health Insurance

Health insurance is REQUIRED for all international students for their entire stay at UNM. Students who are not covered by health insurance are in violation of UNM and US policy, could be subject to tax penalties, and are financially responsible for all medical charges incurred in the US. Since health care in the US is extremely expensive, international students need to take these requirements seriously, think carefully about the kind of health care coverage they need while in the US, and select the appropriate insurance for their situation. IT IS THE STUDENT'S RESPONSIBILITY TO CARRY INSURANCE THROUGHOUT THEIR STAY IN THE US! Students entering new UNM programs need to show insurance proof in English to GEO before the end of the first week of classes.

Requirements

 

US government requirements for health insurance:

  • $100,000 minimum per person per accident or illness
  • $25,000 for repatriation of remains
  • $50,000 for medical evacuation
  • No more than $500 deductible per accident or illness
  • Coinsurance must not exceed 25% payable by the exchange visitor or sponsor

Short-term Insurance

Short-term Travel Medical Plans

Many students need to buy a short-term travel medical plan to cover them until the US insurance policy starts. You can research plans on the Internet or try one these:

Undergraduates and Graduates without assistantships

You will need to do research on the long term health insurance plan you will choose. You MUST show insurance proof in English to GEO. In general, you will be choosing between 2 types of insurance coverage:

1)    An “emergency-only” plan which normally does not cover preventative care, excludes pre-existing conditions, and has many other exclusions (the only advantages are: that it is easy to buy on the internet, it meets all J1 visa requirements, and it includes medical evacuation home in an emergency).

OR:

2)    A more comprehensive plan that you purchase from the US government health insurance “Marketplace” at www.healthcare.gov (this insurance will not meet all J1 visa requirements, so J visa holders who choose this also need to buy medivac and repatriation insurance).

If you are unsure which to choose, GEO highly encourages you to purchase an "emergency only" plan until September 30th for fall semester and February 28th for spring semester and then attend our health insurance information sessions offered at the beginning of each semester.

 

“EMERGENCY-ONLY” OR “SHORT-TERM” PLANS:

If you are going to choose this option, you can buy one of the 4 policies on the International Student Insurance (ISI) website.

Make sure to read through the plan descriptions carefully to find out what things the insurance does and does NOT cover and choose the plan that is best for you!  This insurance does not cover preventative care.  Also, all the ISI plans have a waiting period of at least 6 months before they will cover you for a “pre-existing condition” and if you allow any gap in insurance dates for any reason, you are then buying a new insurance policy which will “reset” the 6-month waiting period as well as any “deductible” that you paid under the policy you bought before.  The UNM Student Health Center (SHAC) may not send a bill for these types of policies, and typically you will have to file a claim form with your insurance company every time you use the student health center if you want the insurance company to pay or to count the charges toward your “deductible” (the amount you have to pay for each illness before the insurance company pays).

 

The cost of the insurance plan can be found through the ISI monthly fee page

 

We do NOT recommend you have this type of insurance if you are 30 or older, have a pre-existing condition, anticipate that you will have high medical need, or have lived in the US for more than 5 calendar years. Instead, we strongly recommend that you sign up at www.healthcare.gov for the more robust US “Marketplace” insurance (students who live in the US for more than 5 years become “tax residents” and are technically required to have this type of “ACA compliant” insurance). See the "Marketplace Insurance" tab for more information. Married students and dependents may not be eligible for marketplace insurance subsidies, so may want this insurance option instead.

Exchange and Guest Students

If you are coming to UNM for one semester or one academic year as an Exchange or Guest student, you MUST buy a plan from International Student Insurance (ISI). There are 4 plans to choose from. Please make sure to read through the plan descriptions carefully to find out what the insurance does and does NOT cover and choose the plan that is best for you! Remember that all the plans on this site have a waiting period of at least 6 months before they will cover you for pre-existing conditions AND you will have to file your own claims to the insurance company if you want to be reimbursed for medical costs. If you have an existing illness you may need to purchase additional insurance to ensure your medical expenses are covered.

Athletic Scholarship Students

Students on an athletic scholarship are required to purchase the plan offered through the UNM Athletics office.

Sponsored Students

Students who are financed or on visa documents from a government sponsor or agency such as SACM, SABIC, AMIDEAST, LASPAU or Fulbright should check with their sponsor to see if the sponsor has bought them insurance. If so, you will need to present your insurance card and benefits information in English when you check in with GEO.

Graduate Assistantship Students

International graduate students who receive graduate assistantships for 10 or more hours per week are offered UNM health insurance paid by the assistantship department. Assistantship students do not need to take any further action unless they want to add dependents or dental or eye coverage to their plan (contact the Office of Graduate Studies for more information). The department offering the assistantship cannot charge students for this insurance or ask them to waive out/decline coverage.

Marketplace Insurance

If you want to buy a more comprehensive health insurance plan, if you are an older individual, or if you have a pre-existing condition that needs to be covered, we recommend you buy a health insurance plan through the government insurance “Marketplace” as an “International Student.” Single non-residents can receive subsidies known as premium tax credits (financial assistance) for this insurance, but you must agree to file tax forms at the end of the year, at which time you might need to pay back all or part of the cost of the insurance if you earned more during the year than expected (you have to complete form 8962 with your tax return). Married students may not be eligible for the subsidies, so will need to pay for the full amount of the Marketplace insurance and therefore may want to choose a different option.

To choose the Marketplace option, you must apply after you arrive and continue to provide documents during the application period until you receive confirmation that you have selected a policy and the insurance is approved – this might take more than 1 month.  So, even if you intend to enroll in Marketplace insurance you should buy a short-term emergency plan at sites like the International Student Insurance (ISI) website to cover you until the Marketplace insurance begins. J1 students who buy Marketplace insurance will ALSO need to buy additional Medical Evacuation and Repatriation coverage to meet US government requirements. One plan option to meet this requirement can be found at ISI.

To enroll in Marketplace insurance, you have to apply during the normal enrollment period for the calendar year (in November for insurance that begins in January) or you have to qualify for a “Special Enrollment Period (SEP)” exception. You only have 60 days from the date you moved to New Mexico or the date you lose your previous insurance to apply. Prepare the documents and follow the instructions below to enroll through the website: www.healthcare.gov. We HIGHLY recommend that you attend the GEO health insurance enrollment help sessions in the first week of classes to get help since this process is VERY confusing! Students under 18 cannot apply for this insurance on their own (a parent can apply only if they are living in the US!).

 

HOW TO BUY MARKETPLACE INSURANCE

  1. REQUIREMENTS FOR BUYING MARKETPLACE INSURANCE AT HEALTHCARE.GOV
If you want to buy outside of the normal enrollment period covering the calendar year - called the “Special Enrollment Period (SEP)”, you will first need to prove that the Special Enrollment Period (SEP) applies to your case and be “Verified” by the marketplace. You cannot start the actual application process until you are “Verified”. This means that you should apply to be “Verified” as soon as possible. Once you get verified you will be able to complete your application and have health insurance coverage. This is a long process and there are many questions on the application that are confusing.
 
ONE QUESTION YOU MUST ANSWER CORRECTLY IS : “Were you found ineligible for Medicaid Based on your Immigration Status?"  FOR INTERNATIONAL STUDENTS THE ANSWER IS “YES” !!! IF YOU DO NOT ANSWER THIS QUESTION CORRECTLY THE INSURANCE SIGN UP WILL NOT WORK!!!!!
 

Here is what you need to apply:

  1. Proof that the Special Enrollment Period applies to you (if you are NOT applying in November for the next calendar year):
  • If you are coming to the United States for the first time you can apply within 60 days of your arrival (buy short-term health insurance until the Marketplace insurance is approved!). You will need copies of your passport, I-20 or DS-2019, and a copy of your I-94 as proof that you moved from another country.
  • If you are moving from another State you can apply within 60 days of the move. You will need some proof of the move.
  • If you lost your current insurance you can apply within 60 days of losing the insurance.  You will need a letter from your old insurance company stating that you lost your insurance
  1. Documents to verify your Immigration status: (ALL are required)
  • Copy of your Passport
  • Copy of your I-20 or DS-2019
  • Copy of the I-94
  1. Documents to verify household income: (Provide any and all that show your funding situation)
  • If NO income: write a letter stating that you do not have income and that you are a full-time student – you will need to copy your student ID card onto this letter.

Image of a Sample Letter

  • If you have income: Letter from an employer, US Tax Return, W2 or pay information
  1. Documents to verify your current residency: (2 proofs needed)
  • School enrollment document (letter from GEO is ok)
  • Current utility bill (not a cell phone bill, but something with your address)
  • Lease agreement
  • Valid Unexpired Driving License / Driver Authorization Card or State ID with current address
  1. Documents to verify your Social Security Number: (If you have one)
  • Copy of Social Security Card
  • OR Copy of your last year’s tax form if you filed in the US (1040NR or 1040NREZ)
  1. Documents you need to verify your Identity: (1 proof needed)
  • Valid Unexpired Foreign Passport
  • Valid Unexpired Driving License (Real ID license)
  • Valid Unexpired State ID (Real ID)

 

  1. HEALTH INSURANCE COMPANIES AVAILABLE THROUGH THE MARKETPLACE:

For more details about the available plans and comparing coverages, you can check www.healthcare.gov or www.bewellnm.com

 

  1. GETTING HELP WITH MARKETPLACE INSURANCE:

If you do not attend the health insurance help sessions organized by GEO at the beginning of each semester and during the annual Marketplace Open Enrollment period in November, you will need to seek help from an authorized health care guide off campus. A list of current guides is below:

- Lauren Aragon
505-389-4305
lauren@fidelisins.com

- Peng Mak
505-440-3717
pmmarketplace@gmail.com

- James Tome
505-440-0317
myhixguy@gmail.com

Terminology

  1. Accidental Death and Dismemberment Benefit: The amount of money the insurance company will pay your family if you die or the amount they will pay you should you lose body parts in an accident.

  2. Congenital Defects: Medical problems you are born with.

  3. Co-payment: The percentage of costs for services, which you must pay (e.g., if the company pays 80%, your "co-payment" is 20%).

  4. Deductible: The amount you must pay for treatment of an injury or illness before the insurance company will begin to pay for you.

  5. Exclusions: Illnesses or services the insurance company will not pay for.

  6. Health Maintenance Organization (HMO): A type of Health Benefit Plan under which the Members receive all medical services through a specific group of Participating Providers.

  7. Inpatient Care: Services provided while staying for a period of time in a hospital.

  8. Limitations: Limits on the amount the company will pay or the services they will pay for.

  9. Medical Evacuation Benefits (Medevac): The amount the company will pay if you need to be transported long distance for health care.

  10. Medical Expense Benefit: Services and amounts the company will pay for your medical coverage. (Also called your "Payment Limit")

  11. Outpatient Care: Medical services provided while you are not staying in a hospital (e.g., at a doctor's office).

  12. Policy: Specific contract or agreement between you and the insurance company, in which you pay to receive certain benefits.

  13. Pre-existing Conditions: Illnesses or injuries you had before your policy began.

  14. Premium: Monthly or yearly fee or cost which you pay to the insurance company for medical coverage.

  15. Primary Care Physician (PCP): A doctor selected by the member to be the first physician contacted for any medical problem. The doctor acts as the member's regular physician and coordinates any other care the member needs, such as a visit to a specialist or hospitalization.

  16. Provider: A licensed health care facility, program, agency, physician or health professional that delivers health care services.

  17. Referral: A written recommendation by a physician for a Member to receive care from a specialty physician or facility.

  18. Repatriation Benefit: The amount the company will pay to transport your body back to your home country if you die.

  19. Right of Subrogation: The insurance company has the right to sue others for your injuries even if you don't agree