Navigating the UVA Student Health Plan: A Comprehensive Guide to Benefits and Coverage

The University of Virginia (UVA) prioritizes the health and well-being of its students by providing access to comprehensive health and dental insurance plans. This article provides a detailed overview of the UVA Student Health Plan, including medical and pharmacy benefits, dental plan options, eligibility requirements, enrollment procedures, and important deadlines. It also addresses frequently asked questions and clarifies student responsibilities regarding health insurance coverage.

Health Insurance Plans: Medical and Pharmacy Benefits

UVA offers two medical plans through Ameriben/Anthem, each with low-cost pharmacy benefits, allowing students to select the coverage that best suits their individual needs. These plans aim to provide peace of mind, ensuring that students and their families have access to quality healthcare services.

UVA Community Health PPO and HDHP

UVA offers two distinct health plan options: the UVA Community Health PPO 2026 and the UVA Community Health HDHP 2026. Detailed summaries of benefits and coverage for both the PPO and HDHP medical plans are available for review. These summaries provide a comprehensive understanding of each plan's features, including covered services, cost-sharing arrangements, and limitations.

Ameriben and Anthem: Your Insurance Providers

Ameriben and Anthem are the insurance providers for the UVA Student Health Plan. Students can access claims online and find in-network providers through Anthem's Provider Finder.

LiveHealth Online: Virtual Healthcare Access

LiveHealth Online offers a convenient way to connect with board-certified doctors or licensed therapists via video visits on smartphones, tablets, or computers with webcams. This service provides easy access to care from home or while on the go.

Read also: Understanding SHP

Ameriben's Disease Management Program

Ameriben’s Disease Management Program primarily targets chronic conditions. A registered nurse health coach facilitates the process by providing personalized support to discuss conditions, medications, and management plans through various communication channels.

Pharmacy Benefits

An overview of pharmacy plan details for 2026 is available, providing information on prescription coverage, formularies, and cost-sharing. CarelonRx is involved in managing pharmacy benefits.

TruHearing

TruHearing is the preferred care provider for traditional and over-the counter hearing aids.

Dental Plans: Investing in Your Smile

Recognizing the importance of quality dental care, UVA offers an insured dental program to students charged full comprehensive fees with tuition.

Dental Plan Coverage and Enrollment

The annual maximum benefit is $750 per insured, with coverage effective from August 1st to July 31st. Enrollment opportunities are available during the Fall and Spring insurance verification timeframes. These are the only times students may enroll in the optional annual dental plan, with payment processed within the portal during the specified timeframe.

Dental Plan Costs

The following are the costs for the dental plan:

Student: \$311.40 (Annual), \$180.87 (Spring)
Student & Spouse: \$619.71 (Annual), \$359.94 (Spring)
Student & Child(ren): \$858.55 (Annual), \$498.67 (Spring)
Student & Family: \$1,067.91 (Annual), \$620.27 (Spring)

Deductibles, Coinsurance, and Exclusions

The annual deductible is $50 per enrollee. Students should carefully review the plan details for information on coinsurance and exclusions.

Health Insurance Requirement and Subsidies

UVA mandates that all students have health insurance. Graduate students may be eligible for a Health Insurance Subsidy to cover the cost of the UVA Student Health Plan.

Qualified Health Insurance Subsidy

A Qualified Health Insurance Subsidy is a mandated subsidy provided on behalf of a graduate student who earns at least $5,000 in wages as a GTA or GRA over the course of the fiscal year.

Departmental Health Insurance Subsidy

Students who do not meet the above qualification may still receive a health insurance subsidy from their school or department at their respective department’s discretion. Students receiving a Health Insurance Subsidy must enroll in the University’s student health insurance plan each year.

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Insurance Verification Program

Graduate students who do not receive the Health Insurance Subsidy are required to have health insurance and can satisfy this requirement through the Insurance Verification Program. Students may waive the UVA Student Health Plan by providing proof of other health insurance coverage that meets the University’s specific requirements.

Waiver Process

Graduate students request an insurance waiver through the online waiver process. Failure to complete this process by August 31, 2025, will result in automatic enrollment in the UVA plan and billing for its annual cost.

Cost of Attendance Increase

Students can request an increase to their cost of attendance by completing the Health Insurance Expense Request Form and submitting it to Student Financial Services.

Enrollment in the UVA Student Health Plan

Students who do not have health insurance or whose current plan does not meet UVA requirements can enroll in the UVA Student Health Plan through August 31, 2025.

Special Enrollment Period

Students who lose qualifying health coverage may be eligible for a Special Enrollment Period. Events like having a baby, adopting a child, getting married, or adding a dependent may also qualify students for special enrollment in the Student Health plan for the rest of the plan year. A student must first be enrolled in the UVA student health plan before adding dependents to the plan. Please allow for processing time of 5-7 days.

Eligibility for Enrollment

Only students charged the comprehensive fees that include the Student Health Fee are eligible to enroll in the UVA Student Health Plan. Failure to pay the full cost of the UVa Student Health Plan premium will result in a registration block, preventing registration for the next semester of classes.

Cancelling Enrollment

If a student withdraws from school within the first 31 days of a coverage period, they will not be covered under the Policy and the full premium will be refunded, less any claims paid. If a student withdraws from school for any reason other than joining the armed forces, they won't be refunded their premium. Instead, they’ll continue to be insured until their coverage period runs out for which premium has been paid.

Substance Use Disorder and Behavioral Health Treatments

If medically necessary, substance use disorder and behavioral health treatments will be covered. Generally, the extent of coverage may depend on what type of treatment is provided on an inpatient or outpatient basis. Students can refer to their insurance brochure or call the customer service number on their ID card. They may also call Counseling and Psychological Services (CAPS) at (434) 924-5556.

Using Insurance Outside of Student Health and Wellness

Students can consult a guide for information on using their insurance outside of Student Health and Wellness.

Pre-Determination (PRD)

PRD is a voluntary medical review process.

Important Dates

January 1, 2026: UVA student health plan effective date for incoming Spring students. Premium for 2025/2026 Spring semester (1/1/2026-7/31/2026) is $2,317
January 30, 2026: Deadline to submit insurance information for review or enroll in the UVA student health plan.
February 6, 2026: Appeal deadline.
February 27, 2026: UVA student health plan premium is added to student accounts for students that actively enroll, are denied a waiver as insurance does not meet set criteria shown below, or do not submit insurance to be reviewed.
March 31, 2026: Due date for premium set by Student Financial Services (SFS) unless payment plan option is taken or Health Insurance Expense Request Form is submitted to SFS.
July 31, 2026: End of UVA student health plan year. If you are a returning student for 26/27 plan year, you will need to re-enroll for the UVA student health plan to continue beyond this date. You will be assigned a to-do in SIS when portal is available for re-enrollment.

Comparable Coverage Criteria to WAIVE

In order to be considered comparable coverage, both domestic and international student’s health plan must meet the following specific requirements for 2025-2026:

The plan provides in-patient care and outpatient care coverage (including visits for behavioral health) within a 75-mile radius of the Charlottesville area. Coverage for emergency-only care (out of state medicaid) does NOT satisfy this requirement.
The plan provides unlimited medical benefits per sickness or injury.
The plan provides practical and timely access to care in the local Charlottesville area which includes but is not limited to: (a) a local primary care physician, (b) a local referral process and phone number, (c) plan literature available in English, and (d) benefits provided in accordance with the Affordable Care Act (ACA).

The following programs do NOT qualify as comparable coverage: Travel insurance & Reimbursement programs of any kind.

Students must also acknowledge that their coverage will remain in effect for all semesters in which they are enrolled for the 2025-2026 academic year. If coverage is lost at any point during the academic year, students will request to be enrolled in the UVA student health plan at a prorated rate or provide their new health insurance information for review.

Students are held financially responsible for payment of all charges not covered by their health insurance plan.

Why UVA Requires Health Insurance

UVA implemented the health insurance verification program to reduce the health risk of its student population by ensuring reliable access to healthcare services.

Student Health and Wellness (SHW) Coverage

SHW professional services are included with tuition as part of the comprehensive fee, meaning there is no charge for the evaluation and management services provided by the clinician during your visit (e.g. physician, nurse practitioner, mental health clinician, or health educator.) However, there are charges for medications, lab tests, supplies for certain treatments, immunizations and injections. In addition, there are charges associated with referrals that occur outside of SHW.

Student Responsibility

As a patient, it is your responsibility to know and understand your insurance plan benefits and to inform your provider if you have specific concerns related to your plan of care prior to the receipt of services in question. You are responsible for payment of any out-of-pocket costs associated with your plan of care.

Billing

For services billed by SHW, charges will be placed on your UVA SIS account unless you have the UVA Student Health Plan. If you have the school’s sponsored Student Health insurance plan, SHW will submit a claim directly on your behalf. SHW does not submit claim information to any other insurance companies or Medicaid. In fact, Medicaid claims can only be submitted by a Medicaid provider and SHW is not a Medicaid provider.

For services billed by UVA Health (including the satellite lab and pharmacy located in the SHW building), charges will be filed to most insurance companies. You will receive a bill from UVA Health for any portion of the cost not covered by your insurance. . Students may be referred for services outside of UVA Health (ex. private practice providers in the area).

Additional Benefits for Employees

UVA offers a range of benefits to support employee well-being, including:

Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA): Depending on employee type and health plan enrollment, employees may have the option to enroll in a Flexible Spending Account, limited Flexible Spending Account, or Health Savings Account.
Basic Life Insurance: If you are enrolled in a UVA retirement plan (VRS, ORP, or MCRP), if you are Housestaff, or a Postdoctoral Fellow, you already have basic life insurance coverage at no cost to you.
Employee Community Resource Service: The Employee Community Resource Service helps members of the UVA community connect with local organizations who can assist with basic needs such as housing, clothing, utilities, and food, as well as assistance with personal budgeting and finance strategies.
Commonwealth of Virginia (COV) Voluntary Group Long Term Care Insurance Program: The Commonwealth of Virginia (COV) Voluntary Group Long Term Care Insurance Program, administered by VRS and underwritten by Genworth Life Insurance Co., provides a maximum monthly benefit for covered long-term care expenses.

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