Navigating Healthcare at BYU: A Comprehensive Guide to Student Health Services

Maintaining good health is crucial for academic success. Brigham Young University (BYU) understands this and provides a variety of health services to support its students. This article offers a detailed overview of the BYU Student Health Services, including coverage requirements, available resources, and how to access care.

Health Coverage Requirements for BYU Students

BYU mandates that all students enrolled for at least 3/4 time (nine credit hours per semester or 4.5 credit hours per term) have adequate medical coverage. This requirement ensures that students have access to healthcare and can avoid significant financial burdens due to unexpected medical expenses. Your good health is essential to achieving your educational goals, and access to adequate healthcare and medical coverage is essential to your good health. Without adequate coverage, unexpected medical expenses could alter your future dramatically.

Satisfying the Coverage Mandate

Students can meet this requirement in several ways:

BYU Student Health Plan: Enrollment in the Student Health Plan automatically satisfies the coverage requirement.
Alternative Medical Plans: Students can also use a group medical plan provided by their employer, their spouse’s employer, or their parents' employer.

If a student chooses a medical plan other than the Student Health Plan, they must provide verification of adequate coverage at the beginning of every academic year (each fall semester). The Student Health Plan office (located at the BYU Student Health Center) makes all determinations about health coverage waivers, and these decisions are final. Carefully review any medical plan you’re considering, making sure it will provide you with sufficient coverage for your current and future healthcare needs. Coverage must be effective by the first day of the semester/term.

International Student Requirements

BYU requires all ELC students and F-1 and J-1 visa students to be enrolled in the BYU Student Health Plan or an ACA-compliant plan offered by a United States-based insurance company. This plan must provide comprehensive medical coverage for you while you are on campus. Insurance plans from companies outside of the United States will not be accepted.

Read also: Comprehensive Health Overview

Automatic Enrollment

All students enrolled at least 3/4 time (nine credit hours per semester or 4.5 credit hours per term) and all F-1 and J-1 visa students who don’t submit proof of other coverage before the deadline each year will be enrolled automatically for individual coverage and assessed the appropriate premium (single or married rate) for the Student Health Plan. Students who are actively working toward a degree and have at least 0.5 on-campus credits are eligible to enroll in the Student Health Plan. Graduate students who have a least nine credits during fall semester and were enrolled in the Student Health Plan for the previous summer term will automatically be enrolled for fall semester in the same plan they had during summer term.

Enrollment for Spouses and Dependents

Spouses and dependents won’t be enrolled automatically the first semester or term you’re on the plan. The Student Health Plan has an annual enrollment requirement. This means when you enroll, you enroll for the entire academic year. If you gain new health coverage, you may waive the Student Health Plan.

Accessing Your Health Plan ID Card

You can access your Student Health Plan ID card online at www.dmba.com. On the homepage, select View ID Card and follow the instructions.

Understanding the BYU Student Health Plan

The BYU Student Health Plan offers comprehensive medical coverage. Medical care covered by this plan is provided by or coordinated through the health centers. If you need eligible services the health centers can’t provide, you’ll be referred to providers in the community who are part of DMBA’s preferred provider network. These providers have contracted with DMBA to offer care at a reduced cost to participants. The discounts will be reflected in the portion of charges you’re responsible to pay. If you live in Utah County, you must use the BYU Student Health Center for your initial care. The BYU Student Health Center is your primary care provider.

Key Features of the Plan

Primary Care Provider: If you live in Utah County, the BYU Student Health Center serves as your primary care provider.
Referrals: The health centers will refer you to specialists or other providers if you need additional care.
Preferred Provider Network: The plan utilizes DMBA’s preferred provider network, offering discounted rates for services received from in-network providers.

Costs and Coverage Details

Copayments at Health Centers: \$10 for regular visits and \$15 for urgent care visits.
Deductibles: \$300 per person; \$600 per family; \$3,000 maternity deductible* for eligible spouse/dependent(s) plus all applicable copayments.
Maximum Benefit: \$20,000 per person per academic year for services received outside of the health centers.
Maternity coverage is included for all student contract holders with no additional deductible. An eligible spouse or dependent must meet an additional $3,000 deductible before the plan pays for maternity care. This summary of benefits provides a brief review of plan benefits. For complete details of coverage, including limitations and exclusions, please read this entire handbook.**

Receiving Services Outside of Health Centers

If you receive authorized services outside of the health centers, you pay an up-front copayment to the provider. A copayment is a fixed dollar amount (usually $25) that you owe at the time services are received.

Plan benefits will not be paid for services received outside of the health centers until you meet your annual deductible of $300 per person, up to $600 per family. Also, eligible spouse/dependent(s) must meet an additional $3,000 deductible for maternity expenses. This means if a spouse is not the contract holder, she is responsible for the first $3,000 of the cost for prenatal care and baby delivery. Regular plan benefits apply to eligible expenses over $3,000.

Claim Submission and Payment

After you pay your copayment, the amount covered by the plan is your plan benefit (for example, 80%). The remaining 20% is your responsibility.

If you receive services outside of the health centers, you or your provider must submit an itemized bill to DMBA. DMBA will process your claim, send a check for the plan benefit to the provider, and send you an Explanation of Benefits statement. This statement will itemize the charges, your deductible (if applicable), your copayment, the plan benefit, and your responsibility. You must pay your copayment (if you haven’t already done so) and the remaining charges to the provider.

In some cases, the provider will bill more than DMBA’s allowable limit for the services you received. If you receive services from in-network providers, you don’t have to pay any amount over the allowable limit. You are also responsible to pay your provider for any services that aren’t covered by the plan. For services received outside of the health centers, you may need to obtain preauthorization from DMBA before you receive the services. If you appeal a claim for benefits that was denied for failure to preauthorize, the denied claim may be approved by DMBA on post-service review. Not all denied claims are eligible for post-service review.

Even though your physician provides much of the needed information, you’re responsible to make sure services are preauthorized by your provider.

Read also: U of U Student Health Plan

If your provider recommends care that is not specified in the initial preauthorization (such as a test at another facility or consultation with another healthcare provider), your provider must contact DMBA for preauthorization before you receive the additional care. Remember, care beyond the scope of the original preauthorization must also be authorized in advance by DMBA.

Even if you have preauthorization from DMBA, that does not guarantee payment for any treatment you may receive. The health centers send nearly all lab tests to an outside provider. Until you meet your deductible, you are billed 100% for these services. Remember, benefits for services received outside of the health centers are based on the lesser of billed charges, contracted rates, or allowable limits for the services received, as determined by DMBA. For all services, the guidelines, benefits, and exclusions of the plan will determine claims payment.

The maximum benefit for all services received outside of the health centers is $20,000 per person per academic year. There is a $300 annual deductible per person (up to $600 per family) for services received outside of the health centers.

Eligibility for the Student Health Plan

The following individuals are eligible to enroll in the Student Health Plan, but must be enrolled the first semester of the academic year you attend or when you have a qualifying event:

Students who are actively working toward a degree and have at least 0.5 on-campus credits are eligible to enroll in the Student Health Plan.
Your spouse.
Your eligible children. Natural children (including infants from the date of birth), legally adopted children, and children appointed by a court of law to your custody or your spouse’s custody. A child placed with you under the direction of a licensed child placement agency and for whom you’re the legal guardian. If you add a newly adopted baby to your plan, the baby will be covered from the date you sign the adoption papers.
Your stepchild (child of your spouse) younger than 26.

You may enroll in the Student Health Plan, either for individual or family coverage, at the beginning of your first semester or term as a continuing student. When you enroll in the Student Health Plan, you enroll for the entire academic year.

Enrollment Periods

Open Enrollment: Your enrollment is due on or before the add/drop deadline for the first semester or term you enroll in classes at least 3/4 time. Your enrollment will remain in effect until the end of the academic year.
Automatic Enrollment: At the beginning of each academic year (fall semester) you’ll be enrolled automatically in the same coverage option you had the previous year if you’re enrolled for at least 3/4 time. If you wish to make any changes (add or remove dependents) to this coverage option, you must make them within the first week of fall semester. If you aren’t enrolled for at least 3/4 time in the fall semester and you want Student Health Plan coverage, you must contact the appropriate office by the last day to add or drop classes (Student Health Plan office at BYU or cashier’s office at Ensign College).
Late Enrollment: If you don’t enroll before the first day of classes, you have a late enrollment “grace period.” This will end one week after classes begin for a semester or term.

Adding Dependents and Changing Marital Status

When you get married, you are required to change your marital status from single to married. You can do this by logging in to MyBYU, clicking on the Communications tab, and then clicking on the Personal Information tab. Or you can change your status at the appropriate office (ASB records office or registration office at Ensign College). If you want to cover your eligible dependents, you may change your enrollment from individual coverage to family coverage at the beginning of your first semester or term, or at the beginning of each academic year (fall semester) thereafter. This must be done by the add/drop deadline.

If you enroll your family, their enrollment will generally remain in effect until the end of your enrollment in school. Spouses and dependents won’t be enrolled automatically the first semester or term you’re on the plan. However, we’ll renew enrollment for your family at the beginning of each subsequent academic year, based on their enrollment for the previous term and your current status as a 3/4-time student. Remember to notify the health center if you need to change your family’s enrollment.

Remember, if you don’t enroll your dependents at the beginning of your first semester or term or at the beginning of the academic year (fall semester), you can’t add them to your coverage midyear. If you acquire a new dependent because of marriage or the birth or adoption of a child, you may change your enrollment to include coverage for your new spouse and/or the new dependent as long as you apply within 60 days of this event. If this…

Accessing Healthcare Services

BYU Student Health Center

The BYU Student Health Center is located at 1750 N. Ensign College 95 N. BYU Student Health Center 1750 N. Suite 170, P.O.

If you're sick, call for an appointment at 801-422-5156. If you need to be treated immediately but the health center isn't open, go to the nearest urgent care facility or emergency room. Call before you receive any follow-up care outside of the health centers.

For your primary care provider, you and your covered dependents must use the BYU Student Health Center in Provo or the Madsen or Sugar House health centers in Salt Lake. Covered services are paid at 100% after your copayment.** If necessary, the health center will refer you to a provider to receive additional care.

Preauthorization for Services

To maximize benefits, call DMBA at 800‑777‑3622 to ask about preauthorization requirements for services received outside of health centers. Office visits generally do not require preauthorization. Services performed during an office visit (tests, labs, surgery, etc.) may require preauthorization.

Pharmacies

All employees and students can fill their prescriptions at the BYU-Idaho Student Health Center. If you are an employee of BYUI, you and your spouse can schedule a Know Your Numbers assessment for DMBA’s Living Healthy program. Fasting is preferred. Bring your insurance card.

Additional Healthcare Resources in the Area

BYU students have access to numerous healthcare facilities in the surrounding areas. Here's a list of urgent care centers and hospitals:

Urgent Care Centers

American Fork InstaCare: 801-492-2550, 98 N. 1100 E., Suite 101, American Fork
Lehi InstaCare: 801-753-4310, 3429 N. 1200 W., Lehi
Intermountain North Orem InstaCare: 801-714-5500, 1975 N. State St., Orem
Intermountain Saratoga Springs InstaCare: 801-714-5585, 354 W. Crossroads Blvd., Saratoga Springs
Intermountain Spanish Fork InstaCare: 385-344-6600, 819 E. Market Place Dr., Spanish Fork
Intermountain Utah Valley InstaCare: 801-357-1770, 395 W. Cougar Blvd., Suite 205, Provo
Parkway Urgent Care: 801-234-8600, 145 W.
Intermountain Alta View InstaCare: 801-501-2110, 9450 S. 1300 E., Sandy
Intermountain Cottonwood InstaCare: 801-314-7700, 181 E. Medical Tower Drive, Murray
Intermountain Draper InstaCare: 801-495-7970, 12473 S. Minuteman Dr., Draper
Intermountain Holladay InstaCare: 801-871-6400, 6272 S. Highland Drive, Suite 103, Murray
Intermountain Southridge InstaCare: 801-285-4560, 3723 W. 12600 S., Suite 150, Riverton
Intermountain Taylorsville InstaCare: 801-840-2020, 3845 W. 4700 S., Taylorsville
Intermountain West Jordan InstaCare: 801-256-6399, 2655 W. Holy Cross Hospital Mountain Point 385-345-30003000 N. Triumph Blvd., Lehi

Medical Clinics

Blue Rock Medical: 801-375-2177, 3152 N. University Ave., Suite 120, Provo
Intermountain Highland Clinic: 801-763-2900, 10968 N. Alpine Highway, Highland
Intermountain Health American Fork: 801-357-8310, 170 N. 1100 East, American Fork
Intermountain Health Orem Community: 801-224-4080, 331 N. 400 West, Orem
Intermountain Health Spanish Fork: 385-344-5000, 765 E. Market Place Dr., Spanish Fork
Intermountain Health Utah Valley: 801-357-7850, 1034 N. 500 West, Provo
Intermountain Health Alta View: 801-501-2600, 9660 S. 1300 East, Sandy
Intermountain Health Medical Center: 801-507-7000, 5121 S. Cottonwood St., Murray
Intermountain Health Riverton: 801-285-4000, 3741 W. State St., Draper

Hospitals

Mountain View Hospital: 801-465-7104, 1000 E. Miller Campus Dr., Lehi
Timpanogos Regional Hospital: 801-797-5337, 750 W. Holy Cross Hospital Jordan Valley 801-561-88883580 W. 9000 South, West Jordan
Holy Cross Hospital Salt Lake: 801-350-4111, 1050 E. South Temple, Salt Lake City
Holy Cross Hospital West Valley: 801-964-3100, 3460 S. Pioneer Parkway, West Valley City
Primary Children’s Hospital: 801-432-2600, 100 N. Mario Capecchi Drive, Salt Lake City
St. Mark’s Hospital: 801-268-7111, 1200 E. 3900 South, Salt Lake City
University of Utah Hospital: 801-581-2121, 50 N.

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