Human Resource Services
GatorGradCare
GatorGradCare is an injury and sickness insurance plan underwritten by the BlueCross BlueShield of Florida and created specifically for students on appointment as Graduate Assistants and Pre-Doctoral Fellows.
GatorGradCare resources for the 2011-2012 policy year will be posted as information becomes available.
Resources |
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Enrollment
Download the brochure:
2011-2012
Enroll in GatorGradCare for the following coverage terms for the 2011-2012 academic year:
Annual: August 16, 2011 – August 15, 2012
Fall/Spring: August 16, 2011 – May 15, 2012
Fall: August 16, 2011 – December 31, 2011
Note: All eligible graduate students who wish to enroll in GatorGradCare for the 2011-2012 Academic year must submit an enrollment for one of these plans.
The enrollment deadline for these plans is September 14, 2011.
Insurance ID cards for students confirmed eligible for Fall coverage should be received by mid to late October 2011.
>>>> GatorGradCare online enrollment<<<<
Log onto http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp to complete the enrollment process for coverage for the 2011-2012 Academic year.
If a Graduate Assistant or Pre-Doc Fellow is on his/her appointment for both the fall and spring terms, it is strongly recommended that an annual GatorGradCare enrollment be submitted. As long as the Graduate Assistant or Pre-Doc Fellow maintains the eligibility criteria for the fall and spring terms, he/she can continue coverage through the summer term regardless of student registration or appointment status. The premium for summer coverage will still be paid on the student’s behalf. This is only the case with the annual GatorGradCare enrollment. International students must submit an annual GatorGradCare enrollment.
International Graduate Assistants and Pre-doc Fellows needing to provide insurance verification to the International Center for registration purposes may submit the INSURANCE REQUEST CONFIRMATION e-mail to the International Center at insurance@ufic.ufl.edu.
Graduate students (GA, TA or RA) may choose to cover a spouse, domestic partner, or child(ren) for annual, fall/spring or fall only coverage for the 2011-2012 academic year. The dependent premium will be taken through payroll deduction, if the dependents’ information is included in the online GatorGradCare enrollment. Graduate students (GA, TA or RA) also have the option to pay the dependent premium in full by check. If the check payment option is preferred, contact the GA and Post Doc Associate Benefits Office at 352-392-0003 for the Health Enrollment Application.
Graduate students on a Pre-doc Fellowship may choose to cover a spouse, domestic partner, or child(ren) for annual, fall/spring or fall only coverage for the 2011-2012 academic year. There is no payroll deduction option for graduate students on a Pre-doc Fellowship appointment as has been the current practice. The dependent premium must be paid by check. The Health Enrollment Application is linked to the INSURANCE REQUEST CONFIRMATION email.
Changes to coverage must be made prior to the enrollment period deadline. This includes adding/removing dependents and/or changing coverage terms. Refunds are only granted if eligibility is not met or upon entry into the armed forces.
Required Supporting Documentation for Dependent Coverage
Supporting documentation, including a marriage certificate for spouse coverage and/or birth certificates for child(ren) coverage, will need to be submitted within 60 days of the coverage effective date. This documentation can be sent to the GA and Post Doc Associate Benefits Office via fax to 352-846-1854. The Graduate Assistant’s or Pre-doctoral Fellow’s name and UFID should be included on any documentation submitted.
Supporting documentation for a domestic partnership includes an Affidavit of Domestic Partnership, which can be obtained through the GA and Post Doc Associate Benefits Office at 352-392-0003, and any three of the following:
- A joint mortgage or lease;
- Designation of the domestic partner as beneficiary for life insurance;
- Designation of the domestic partner as primary beneficiary in the Named Insured’s will;
- Domestic partnership agreement;
- Power of attorney granted by either party to the other for property and/or health care;
- Joint ownership of either a motor vehicle, checking account or credit account.
Eligibility
University of Florida graduate students on an appointment as a graduate assistant, teaching assistant, or research assistant may participate in the GatorGradCare Health Plan. To be eligible, University of Florida graduate students must be enrolled in a graduate degree program, on an appointment through University of Florida, appropriately registered and appointed 0.25 FTE (full-time equivalent) or greater for a particular semester.
University of Florida graduate students on a Pre-doc Fellowship appointment and appropriately registered are also eligible to participate. There is no FTE requirement for graduate students on a Pre-doc Fellowship appointment. Criteria for appropriate registration can be found in the Registration Requirements section of the Graduate Catalog.
In order to ensure that graduate assistants or pre-doc fellows meet the above eligibility criteria, departments must ensure the following:
a. The GA, TA, RA, or Pre-doc Fellow appointment must occur via the Letter of Appointment (LOA) process in PeopleSoft, and all Letter of Appointment criteria met.
b. The student receives a stipend as a bi-weekly paycheck from the appropriate UF account.
c. The student receives a tuition waiver from the appropriate UF account.
d. Health insurance premium is paid from the appropriate UF account.
GatorGradCare coverage is based on the eligibility status of a graduate student. The University of Florida or supporting Grant/Auxiliary funds will pay the student only premium for eligible students. Graduate students cannot pay the premium to continue participation in the GatorGradCare program if they lose their eligibility status.
Costs
Total cost of individual health insurance provided for eligible graduate students
Note: If the eligible graduate student is paid from grants and/or auxiliaries, funding for the individual plan cost will come from those resources.
These costs are for department and grant use. Coverage for eligible graduate students is free.
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Student Costs for Dependent Coverage for 2011-2012 academic year: (premiums for dependents are the student's responsibility)
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Annual |
Fall |
Fall/ |
Spring |
Spring/ |
Summer |
Spouse/ |
$2,627 |
$993 |
$1978 |
$986 |
$1642 |
$657 |
Each Child |
$1,181 |
$447 |
$890 |
$443 |
$739 |
$296 |
All Children (two or more) |
$2362 |
$893 |
$1779 |
$886 |
$1477 |
$591 |
Family (Spouse/ |
$3808 |
$1439 |
$2866 |
$1428 |
$2380 |
$952 |
Fall 2011 Deduction Schedule
Below is the Fall 201 deduction schedule for GatorGradCare premiums. The first column indicates the pay dates from which the deductions will be taken. There will be five total deductions for the fall. The deductions listed under the “Student” column are for UF Departmental/Grant purposes only. These deductions will not affect the Graduate Assistants’ net pay in their paychecks. The deductions listed under the “Spouse/Partner,” “Each Child,” and “All Children” columns are for informational purposes to those Graduate Assistants who enrolled their dependents through the online GatorGradCare enrollment. These deductions will affect the Graduate Assistants’ net pay in their paychecks. Only the fall deductions will be taken during the fall term, even if the Graduate Assistant submitted an annual or fall/spring GatorGradCare enrollment.
Paycheck |
Student |
Spouse/Partner ($993) |
Each Child |
All Children |
10/21/11 |
$89.80 |
$198.60 |
$89.40 |
$178.60 |
11/04/11 |
$89.80 |
$198.60 |
$89.40 |
$178.60 |
11/18/11 |
$89.80 |
$198.60 |
$89.40 |
$178.60 |
12/02/11 |
$89.80 |
$198.60 |
$89.40 |
$178.60 |
12/16/11 |
$89.80 |
$198.60 |
$89.40 |
$178.60 |
Spring and Spring/Summer 2012 Deduction Schedule
Below is the Spring and Spring/Summer 2012 deduction schedule for GatorGradCare premiums. The first column indicates the pay dates from which the deductions will be taken. There will be five total deductions for the spring and spring/summer premiums. The deductions listed under the "Student" column are for UF Departmental/Grant purposes only. These deductions will not affect the Graduate Assistants' net pay in their paychecks. The deductions listed under the "Spouse/Partner," "Each Child," and "All Children" columns are for informational purposes to those Graduate Assistants who enrolled their dependents through the online GatorGradCare enrollment. These deductions will affect the Graduate Assistants' net pay in their paychecks. The spring deductions apply to the Graduate Assistants who enrolled in Fall/Spring or Spring Only coverage, and the spring/summer deductions apply to the Graduate Assistants who enrolled in Annual or Spring/Summer coverage.
Spring Deduction Schedule |
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Paycheck Dates |
Student |
Spouse/Partner |
Each Child |
All Children |
3/09/12 |
$89.20 |
$197.20 |
$88.60 |
$177.20 |
3/23/12 |
$89.20 |
$197.20 |
$88.60 |
$177.20 |
4/06/12 |
$89.20 |
$197.20 |
$88.60 |
$177.20 |
4/20/12 |
$89.20 |
$197.20 |
$88.60 |
$177.20 |
5/04/12 |
$89.20 |
$197.20 |
$88.60 |
$177.20 |
Spring/Summer Deduction Schedule |
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Paycheck Dates |
Student |
Spouse/Partner |
Each Child |
All Children |
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3/09/12 |
$148.60 |
$328.40 |
$147.80 |
$295.40 |
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3/23/12 |
$148.60 |
$328.40 |
$147.80 |
$295.40 |
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4/06/12 |
$148.60 |
$328.40 |
$147.80 |
$295.40 |
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4/20/12 |
$148.60 |
$328.40 |
$147.80 |
$295.40 |
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5/04/12 |
$148.60 |
$328.40 |
$147.80 |
$295.40 |
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New features of the 2011-2012 GatorGradCare Policy
- No Referral Requirement
- Deductible Waived at Student Health Care Center and Shands
- Annual Deductible of $100 for BlueCross BlueShield Providers
- No Prescription Maximum
- No Wellness Benefit Maximum
Discount Programs through BlueCross BlueShield of Florida
Blue365 helps you find the health and wellness information, support and services you need 365 days a year – while at the same time enjoying special member savings.
As a member of BlueCross BlueShield of Florida, you automatically have access to the content, tools and discounted offers available through Blue365. Once your eligibility is confirmed for GatorGradCare, you may visit http://www3.bcbsfl.com/wps/portal/bcbsfl/disclaimer/blue365 and search for products and services available to you at discount rates.
Summary of Benefits
2011-2012 (PDF)
FAQs
Answers to frequently asked questions.
- Who is eligible for GatorGradCare?
- How can I get insurance if I am not eligible for GatorGradCare?
- Can I request an extension of benefits although I am no longer eligible for GatorGradCare?
- Can I continue my GatorGradCare coverage although I am no longer eligible for GatorGradCare?
- How do I withdraw my enrollment from the GatorGradCare program?
- How do I enroll in GatorGradCare?
- When can I enroll in GatorGradCare?
- Can I enroll in GatorGradCare after the enrollment period has ended?
- Can I enroll a dependent in the GatorGradCare program?
- What supporting documentation must be provided, if I enroll a dependent in the GatorGradCare program?
- I enrolled in GatorGradCare last year and was confirmed eligible. Will I be automatically re-enrolled this year?
- How can I enroll my newborn child into GatorGradCare after the enrollment period has passed?
- I am no longer at the address that I provided when I completed my application. What should I do?
- When will I get my Insurance Card?
- Where can I view Certificate of Coverage Receipts, request duplicate ID cards, and check up on my claims status?
- What should I do if I incur a medical emergency or schedule a doctor’s appointment after I submit my GatorGradCare enrollment, but before my eligibility is confirmed for GatorGradCare?
- Who pays the premium for the GatorGradCare program?
- Will the university pay for my spouse or child(ren)’s premium as well?
- What is the Group Number for GatorGradCare?
- How are benefits paid?
- What are the deductibles and copays/coinsurances under GatorGradCare?
- What is the out-of-pocket maximum under the GatorGradCare policy?
- What is a Pre-Existing Condition?
- What are the effective and termination dates for GatorGradCare for the 2011-2012 school year?
- When is my health insurance coverage effective?
- I am currently insured with GatorGradCare. Where can I go to obtain medical treatment?
- I am an International student. I have registered for GatorGradCare but still have an insurance hold on my record. What should I do?
- I am/my spouse is currently pregnant and conceived prior to enrolling in GatorGradCare. Will the pregnancy and delivery be covered?
- Does GatorGradCare offer coverage for students who are Studying Abroad?
- How do I know when my GatorGradCare coverage terminates?
Questions about Medical Services
- Where can I look up the Blue Cross Blue Shield Network Providers?
- How can I transfer a prescription from my current pharmacy to the Student Health Care Center Pharmacy?
- Who should I contact with questions about GatorGradCare?
- Who should I contact about eligibility and enrollment information?
- What is the Student Health Care Center phone number?
- What is the Student Health Care Center Pharmacy phone number?
Questions About Eligibility
Who is eligible for GatorGradCare?
University of Florida graduate students on an appointment as a graduate assistant, teaching assistant, or research assistant may participate in the GatorGradCare Health Plan. To be eligible, University of Florida graduate students must be enrolled in a graduate degree program, on an appointment through University of Florida, appropriately registered and appointed 0.25 FTE (full-time equivalent) or greater for a particular semester.
University of Florida graduate students on a Pre-doc Fellowship appointment and appropriately registered are also eligible to participate. There is no FTE requirement for graduate students on a Pre-doc Fellowship appointment. Criteria for appropriate registration can be found in the Registration Requirements section of the Graduate Catalog.
In order to ensure that graduate assistants or pre-doc fellows meet the above eligibility criteria, departments must ensure the following:
a. The GA, TA, RA, or Pre-doc Fellow appointment must occur via the Letter of Appointment (LOA) process in PeopleSoft, and all Letter of Appointment criteria met.
b. The student receives a stipend as a bi-weekly paycheck from the appropriate UF account.
c. The student receives a tuition waiver from the appropriate UF account.
d. Health insurance premium is paid from the appropriate UF account.
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How can I get insurance if I am not eligible for GatorGradCare?
Students who are not eligible for GatorGradCare may obtain student insurance through UnitedHealthcare StudentResources at www.uhcsr.com. If you have questions about the benefit details, you may contact the local servicing agent, Scarborough Company Insurance at (352) 377-2002.
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Can I request an extension of benefits although I am no longer eligible for GatorGradCare?
Extension of Benefits - In the event the School Master Policy is terminated, Blue Cross Blue Shield will not provide coverage for any Service rendered on or after the termination date. The extension of benefits provisions described below only applies when the entire School Master Policy is terminated. The extension of benefits described in this section does not apply when your coverage terminates if the School Master Policy remains in effect. The extension of benefits provisions are subject to all of the other provisions, including the limitations and exclusions.
Note: It is your sole responsibility to provide acceptable documentation to Blue Cross Blue Shield showing that you are entitled to an extension of benefits.
- In the event you are totally disabled on the termination date of the School Master Policy as a result of a specific Accident or Illness incurred while you were covered under this Booklet, as determined by Blue Cross Blue Shield, Blue Cross Blue Shield will provide a limited extension of benefits for the disabled individual only. This extension of benefits is for Covered Services necessary to treat the disabling Condition only.
- In the event you are receiving covered dental treatment as of the termination date of the School Master Policy, Blue Cross Blue Shield will provide a limited extension of such covered dental treatment provided the criteria listed in the benefit booklet are met.
- In the event you are pregnant as of the termination date of the School Master Policy, Blue Cross Blue Shield will provide a limited extension of the maternity expense benefits provided by this Booklet, provided the pregnancy commenced while the pregnant individual was covered under the School Master Policy, as determined by Blue Cross Blue Shield. This extension of benefits is for Covered Services necessary to treat the pregnancy only. This extension of benefits will automatically terminate on the date of the birth of the child. You are not required to be totally disabled in order to be eligible for this extension of benefits.
Can I continue my GatorGradCare coverage although I am no longer eligible for GatorGradCare?
Continuation of GatorGradCare is not an option. However, individual products or conversion policies are available through Blue Cross Blue Shield. A conversion policy is a plan that does not apply pre-existing condition limitations. Please call (800) 766-3737 to enroll in an individual or purchase a conversion policy.
Students enrolled in GatorGradCare have 63 days from the termination of their prior coverage to apply and obtain new coverage. Students who wish to enroll in a conversion policy through Blue Cross Blue Shield must have at least 90 days or greater of coverage on the GatorGradCare policy and must have no other means of insurance. The cost for the conversion policies varies depending upon the student’s demographics and the plan selected. The cost depends on product choices such as deductible amount and other variables. It also takes into consideration the student’s sex, age and dependent coverage.
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How do I withdraw my enrollment from the GatorGradCare program?
Please contact the GA and Post Doc Associate Benefits Office at (352) 392-0003 or via e-mail at gabenefits@admin.ufl.edu to receive assistance on withdrawing your enrollment from GatorGradCare.
Enrollments can be withdrawn during the designated enrollment periods or based on a Qualifying Event.
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Questions About Enrollment
How do I enroll in GatorGradCare?
All GA, TA, RA, and Pre-Doctoral Fellows must enroll online at http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp during the specified enrollment period and prior to the enrollment period deadline. Eligible participants who do enroll may also insure their spouse or registered domestic partner and/or children. Dependent coverage must be purchased at the time the student enrolls. Criteria for eligibility can be found on page 1 of the GatorGradCare brochure, under the caption “Participant Eligibility Requirements for Coverage.”
Insurance premiums for dependents of eligible GA’s, TA’s and RA’s will be paid for through a payroll deduction process by the University of Florida. GA, TA, and RA Dependent (spouse, Domestic Partner and/or children) coverage must cover the same period as the student’s coverage.
However, if the GA, TA, or RA chooses the category of Summer only, then the Dependent will have to fill out an enrollment application and submit the completed enrollment application and premium payment by mail to the GA and Post Doc Associate Benefits Office at P.O. Box 115007, Gainesville, FL 32611. There is a link posted at http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp which will direct the student to the Health Enrollment Application.
Dependents of Pre-Doctoral Fellows can only enroll in GatorGradCare by filling out an enrollment application and submitting the premium payment and completed application to the GA and Post Doc Associate Benefits Office at P.O. Box 115007, Gainesville, FL 32611. There is a link posted at http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp which will direct the student to the Health Enrollment Application. Payroll deduction of premiums for dependent coverage of Pre-Doctoral Fellows is not available.
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When can I enroll in GatorGradCare?
Eligible graduate students must enroll in GatorGradCare during the designated enrollment periods. The enrollment period for fall, fall/spring, and annual coverage is March through September 14. The enrollment period for spring and spring/summer coverage is October through January 30. The enrollment period for summer only coverage is March through May 16.
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Can I enroll in GatorGradCare after the enrollment period has ended?
Students will not be able to enroll in GatorGradCare after the enrollment period has passed. Students who miss the enrollment deadline for GatorGradCare can purchase the UF Student Insurance Plan available through UnitedHealthcare StudentResources at www.uhcsr.com or by calling the local servicing agent, Scarborough Company Insurance, at 352-377-2002.
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Can I enroll a dependent in the GatorGradCare program?
Dependents can be enrolled in GatorGradCare as long as the Insured Student is enrolled. Eligible dependents are the spouse or domestic partner and their children up to 26 years of age. Supporting documentation must be provided to prove the dependent relationship. Dependent coverage must be purchased at the time the student enrolls. Criteria for eligibility can be found on page 1 of the GatorGradCare brochure, under the caption “Participant Eligibility Requirements for Coverage.”
Insurance premiums for dependents of eligible GA’s, TA’s and RA’s will be paid for through a payroll deduction process by the University of Florida. GA, TA, and RA Dependent (spouse, Domestic Partner and/or children) coverage must cover the same period as the student’s coverage.
However, if the GA, TA, or RA chooses the category of Summer only, then the Dependent will have to fill out the Health Enrollment Application and submit the completed enrollment application and premium payment by mail to the GA and Post Doc Associate Benefits Office at P.O. Box 115007, Gainesville, FL 32611. There is a link posted at http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp which will direct the student to the Health Enrollment Application.
Dependents of Pre-Doctoral Fellows can only enroll in GatorGradCare by filling out a Health Enrollment Application and submitting the premium payment and completed application to the GA and Post Doc Associate Benefits Office at P.O. Box 115007, Gainesville, FL 32611. There is a link posted at http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp which will direct the student to the Health Enrollment Application. Payroll deduction of premiums for dependent coverage of Pre-Doctoral Fellows is not available.
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What supporting documentation must be provided, if I enroll a dependent in the GatorGradCare program?
Supporting documentation, including a marriage certificate for spouse coverage and/or birth certificates for child(ren) coverage, will need to be submitted within 60 days of the coverage effective date. This documentation can be sent to the GA and Post Doc Associate Benefits Office via fax to 352-846-1854. The Graduate Assistant’s or Pre-doctoral Fellow’s name and UFID should be included on any documentation submitted.
Supporting documentation for a domestic partnership includes an Affidavit of Domestic Partnership, which can be obtained through the GA and Post Doc Associate Benefits Office at 352-392-0003, and any three of the following:
- A joint mortgage or lease;
- Designation of the domestic partner as beneficiary for life insurance;
- Designation of the domestic partner as primary beneficiary in the Named Insured’s will;
- Domestic partnership agreement;
- Power of attorney granted by either party to the other for property and/or health care;
- Joint ownership of either a motor vehicle, checking account or credit account.
I enrolled in GatorGradCare last year and was confirmed eligible. Will I be automatically re-enrolled this year?
Students are not automatically re-enrolled in GatorGradCare after their coverage term has ended. If you are in need of GatorGradCare for an additional semester or year, you must go to http://hr.ufl.edu/benefits/gatorgradcare/enroll.asp and re-enroll online during the enrollment period.
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How can I enroll my newborn child into GatorGradCare after the enrollment period has passed?
A newborn child can be added to an existing plan by contacting the GA and Post Doc Associate Benefits Office at (352) 392-0003 or gabenefits@admin.ufl.edu and submitting a Health Change Application within 31 days of the birth. The premium will be prorated based on the child’s date of birth. The full prorated premium will need to be paid by check.
If notice is not given within 60 days of the birth of the child, coverage may be denied for the child due to the failure of the insured to make timely notification to Blue Cross and Blue Shield of Florida for the birth of the child. Coverage may then be purchased for the child during the next open enrollment period.
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I am no longer at the address that I provided when I completed my application. What should I do?
If you change your mailing address, contact the GA and Post Doc Associate Benefits Office at (352) 392-0003 or at gabenefits@admin.ufl.edu to ensure future mailings are delivered.
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When will I get my Insurance Card?
Insurance Cards will be sent to students after their eligibility has been confirmed (at some point after Drop/Add).
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Where can I view Certificate of Coverage Receipts, request duplicate ID cards, and check up on my claims status?
Please visit www.bcbsfl.com and login to MyBlueService.
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What should I do if I incur a medical emergency or schedule a doctor’s appointment after I submit my GatorGradCare enrollment, but before my eligibility is confirmed for GatorGradCare?
Contact the GA and Post Doc Associate Benefits Office at (352) 392-0003 or gabenefits@admin.ufl.edu.
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Questions about Benefits
Who pays the premium for the GatorGradCare program?
The premium of all eligible students will be paid by the University of Florida or supporting grant/auxiliary funds. The premium for any dependent coverage is the student’s responsibility.
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Will the university pay for my spouse or child(ren)’s premium as well?
The premium for the dependent will not be paid by the University of Florida. Students who desire coverage for their spouse or domestic partner and/or child(ren) are responsible for the dependent’s premium. The premiums for dependents of Graduate Assistants will be taken through payroll deduction, if the dependent information is included on the online GatorGradCare enrollment form. Pre-Doctoral Fellows who wish to cover their dependents must pay the premium in full by check, since payroll deduction is not available. Graduate Assistants who wish to cover their dependents may also choose to pay the premium in full by check. Please see the “Student Costs for Dependent Coverage” section for the dependent premium information.
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What is the Group Number for GatorGradCare?
The Group Number for the GatorGradCare policy through Blue Cross Blue Shield of Florida is 78358.
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How are benefits paid?
- At Student Health Care Center: GatorGradCare pays 90% of allowed amount; insured pays 10%. Deductible waived.
- At UF&Shands hospitals/physicians: GatorGradCare pays 90% of allowed amount; insured pays 10%. Deductible waived.
- Blue Cross Blue Shield providers: GatorGradCare pays 80% of allowed amount after insured meets deductible; insured pays 20%.
- Out-of-network: GatorGradCare pays 70% of allowed amount after insured meets deductible; insured pays 30%.
- Preventive and Wellness Care: Adult wellness applies to age 17 and up. Preventive care includes covered services billed with a routine diagnosis, such as a physical or well woman exam; immunizations; screening lab tests; and bone density screening. Blue Cross Blue Shield of Florida has adopted the recommendations of the U.S. Preventive Services Task Force (USPSTF) A and B level recommendations for age-appropriate clinical preventive services. For Preventive and Wellness Care at the Student Health Care Center, UF&Shands, and at Blue Cross Blue Shield providers, no out-of-pocket is applied to the insured. At out-of-network providers, insured pays 30%.
What are the deductibles and copays/coinsurances under GatorGradCare?
The deductibles are as follows:
- Deductible waived at the Student Health Care Center and UF&Shands.
- $100 per policy year at Blue Cross Blue Shield in-network providers.
- $300 per policy year at out-of-network providers.
The copays/coinsurances are as follows (Note: copays are listed as dollar amounts/coinsurances are listed as percentages):
- $15 – physician visits at the Student Health Care Center (copay will be applied to the student’s health fee) and UF&Shands
- 20% after in-network deductible – physician visits at in-network providers
- 30% after out-of-network deductible – physician visits at out-of-network providers
- $25 – specialist visits at the Student Health Care Center and UF&Shands
- 20% after in-network deductible – specialist visits at in-network providers
- 30% after out-of-network deductible – specialist visits at out-of-network providers
- $200 – in-network and out-of-network emergency room (waived if admitted)
The Prescription Drug Copays (Dispensed at the Student Health Care Center and UF&Shands) are as follows:
- $10 – for generic
- $25 – for brand name
- $40 – for non-preferred
The Prescription Drug Copays (In-network Retail) are as follows:
- $20 – for generic
- $30 – for brand name
- $50 – for non-preferred
- Mail Order – 90 day supply with a 2 ½ month copay
No Prescription Drug Maximum
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What is the out-of-pocket maximum under the GatorGradCare policy?
The maximum out-of-pocket is $3000 for in-network providers. This is per insured per policy year. The out-of-pocket maximum includes the deductible, insured coinsurance, and copays for medical services. Prescription copays do not apply to the out-of-pocket maximum.
What is a Pre-Existing Condition?
Generally, there is no coverage under this Booklet for Health Care Services to treat a Pre-existing Condition, or Conditions arising from a Pre-existing Condition, until you have been continuously covered under this Booklet for a 6-month period. This 6-month Pre-existing Condition exclusionary period begins on your Effective Date of coverage under this Booklet. This exclusionary period also applies to any prescription drug that is prescribed in connection with a Pre-existing Condition. A Pre-existing Condition means any Condition related to a physical or mental Condition, regardless of the cause of the Condition, for which medical advice, diagnosis, care, or treatment was recommended or received during the 6-month period immediately preceding your Effective Date of coverage under the School Master Policy.
This Pre-existing Condition exclusionary period does not apply to:
1. the Covered Student and each Covered Dependent who was covered under the School’s prior medical plan on the date immediately preceding the Effective Date of coverage under this Booklet;
2. pregnancy;
3. Genetic Information in the absence of a diagnosis of the Condition;
4. Routine follow-up care of breast cancer after the person was determined to be free of breast cancer;
5. Conditions arising from domestic violence; or
6. Inherited diseases of amino acid, organic acid, carbohydrate or fat metabolism as well as malabsorption originating from congenital defects present at birth or acquired during the neonatal period;
7. You when the School has elected to waive, in writing, at the time of School Application the Pre-existing Conditions exclusionary period for all subsequent Eligible Students and/or Eligible Dependents;
8. A newborn child or an adopted newborn child properly enrolled under this Booklet; or
9. An adopted child that has Creditable Coverage.
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Questions About Coverage
What are the effective and termination dates for GatorGradCare
for the 2011-2012 school year?
2011-2012 coverage dates are as follows:
- Fall: 8/16/2011-12/31/2011
- Fall/Spring: 8/16/2011-5/15/2012
- Annual: 8/16/2011 - 8/15/2012
- Spring: 01/01/2012-05/15/2012
- Spring/Summer: 01/01/2012-08/15/2012
- Summer: 05/16/2012-8/15/2012
When is my health insurance coverage effective?
As long as you enrolled during the enrollment period, your coverage is effective on the first date of the coverage period as long as you meet the eligibility requirements.
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I am currently insured with GatorGradCare. Where can I go to obtain medical treatment? There is no referral requirement in the GatorGradCare Health Plan. However, Graduate Assistants and Pre-doc Fellows participating in GatorGradCare are encouraged to use the Student Health Care Center for medical and prescription services. To make an appointment for medical services at the Student Health Care Center, call (352) 392-1161.
Note: Spouse, domestic partner and dependent children who are covered under GatorGradCare can utilize the Student Health Care Center if proper fee is paid. No dependents will be seen under the age of 16.
Participating providers outside of the Student Health Care Center are UF&Shands and providers in the Blue Cross Blue Shield of Florida network. Please go to www.shands.org to find a Shands network provider or www.bcbsfl.com to access the Blue Cross Blue Shield provider directory for network providers in the state of Florida. For network providers outside the state of Florida, call BlueCard Access at 1-800-810-BLUE (2583) or visit the BlueCard Doctor and Hospital Finder at www.bcbs.com.
Please review the Schedule of Benefits in the brochure to determine the payment rules for services you receive from the participating providers.
I am an International student. I have registered for GatorGradCare but still have an insurance hold on my record. What should I do?
International Graduate Assistants and Pre-doc Fellows needing to provide insurance verification to the International Center for registration purposes may submit the INSURANCE REQUEST CONFIRMATION e-mail to the International Center at insurance@ufic.ufl.edu.
If you are unable to locate this email, please contact the GA and Post Doc Associate Benefits Office at (352) 392-0003 or gabenefits@admin.ufl.edu and we will have another confirmation email sent to you.
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I am/my spouse is currently pregnant and conceived prior to enrolling in GatorGradCare. Will the pregnancy and delivery be covered?
Students or dependent spouses who need services for pregnancy while enrolled in GatorGradCare are covered by the program.
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Does GatorGradCare offer coverage for students who are Studying Abroad?
If you are a student insured with GatorGradCare, you and your insured spouse and/or minor child(ren) are covered while traveling abroad. For more information please contact customer service or visit BCBS.com and use the search term BlueCard Worldwide.
In addition, your policy includes Emergency Medical Evacuation and Return of Mortal Remains that meet the U.S. State Department requirements. The Emergency Medical Evacuation services are not meant to be used in lieu of or replace local emergency services such as an ambulance requested through emergency 911 telephone assistance.
To access either of these services, place a collect call to 804-673-1177.
*This information can be found on pages 9-10 in the GatorGradCare Brochure.
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How do I know when my GatorGradCare coverage terminates?
Students can access their online accounts through Blue Cross Blue Shield of Florida. Through their online account, students can review their coverage effective and termination dates, print id cards, and access claim information.
Students can also maintain for their records the INSURANCE REQUEST CONFIRMATION that is received after successfully completing the online GatorGradCare enrollment, in order to keep track of their GatorGradCare enrollment submissions.
Coverage will automatically terminate after a Graduate Assistant or Pre-Doc Fellow loses his/her eligibility status. The termination date of coverage will depend on when the Graduate Assistant or Pre-Doc Fellow loses his/her eligibility status. Contact the GA and Post Doc Associate Benefits Office if you are unsure when your GatorGradCare coverage will terminate.
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Questions about Medical Services
Where can I look up the Blue Cross Blue Shield Network Providers?
You can find a UF&Shands network provider within the state of Florida at www.shands.org. You can find a Blue Cross Blue Shield network provider at www.bcbsfl.com. If possible, students are advised to go to the Student Health Care Center or a UF&Shands network provider, since these providers offer the best benefit under the GatorGradCare policy. For network providers outside the state of Florida, call BlueCard Access at 1-800-810-BLUE (2583) or visit the BlueCard Doctor and Hospital Finder at www.bcbs.com.
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How can I transfer a prescription from my current pharmacy to the Student Health Care Center Pharmacy?
Advise a Student Health Care Center pharmacist where your prescription is currently being filled. The Student Health Care Center pharmacist will then call your previous pharmacy and get the prescription transferred.
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Contact Information
Who should I contact with questions about GatorGradCare?
Prior to receiving your BCBSF ID card please call 800-967-8938.
Once you have received your BCBSF ID card please call 800-664-5295.
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Who should I contact about eligibility and enrollment information?
For questions about eligibility and enrollment into GatorGradCare contact the GA and Post Doc Associate Benefits Office at 352-392-0003 or gabenefits@admin.ufl.edu.
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What is the Student Health Care Center phone number?
The Student Health Care Center phone number is 352-392-1161. It is recommended that students covered by the GatorGradCare Health Plan contact the Student Health Care Center first for medical services.
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What is the Student Health Care Center Pharmacy phone number?
The Student Health Care Center Pharmacy phone number is 352-392-1760.
Contact Information
For benefits questions prior to receiving your BlueCross BlueShield of Florida ID card please call 800-967-8938.
For benefits questions after you have received your BlueCross BlueShield of Florida ID card please call 800-664-5295.
If you update your mailing address at any time with BlueCross BlueShield of Florida, please inform the GA and Post Doc Associate Benefits Office at (352) 392-0003.
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HRS Building , 903 W. University Avenue |