The Ohio State University Student Health Plan

The Ohio State University
Student Health Insurance Benefits Plan

2022-2023 Plan Year


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Prior Year

General Information

Medical benefits information

Domestic Plan Brochure 
PDF Download
View, download and print the Certificate of Coverage from UHC

International Plan Brochure PDF Download
View, download and print the Certificate of Coverage from UHC

Summary of Benefits and Coverage (SBC) PDF Download
What this Plan Covers & What You Pay For Covered Services-- Domestic Plan 

Summary of Benefits and Coverage (SBC) PDF Download
What this Plan Covers & What You Pay For Covered Services--International Plan    

UHC Health Plan Privacy Notice 

Medical ID Card 

www.uhcsr.com/myaccount

 


Claims Information

Medical claims are administered by
HealthSmart


View Your Claims 
Log in to MyHealth from HealthSmart to view the status of your claims

Medical Claim Form 
PDF Download
Download this form to file medical claims
How to Read Your Explanation of Benefits PDF Download
If you have received an Explanation of Benefits (EOB), this will help you understand how to read it.

Response Form - Other Insurance
Use this online form if you received an Explanation of Benefits requesting additional information about other insurance finalize your claim.

Response Form - Accident Details
If you have been in an accident, you may be asked to complete this online form. 

For questions about your claim
s processing, email: OSUSHIPclaims@HealthSmart.com 
or call 844.206.0374.


Click here to download Adobe Reader

 

Your Provider Networks

On-Campus and In Franklin County

Wilce Student Health Center, Student Life Student Health Services (SLSHS) 

OSU Providers - OSU Health Plan Network

Counseling and Consultation Service

Ohio State Dental Clinics

Ohio State Optometry Services

Outside of Franklin County

UHC Options PPO Network

United Behavioral Health


Prescription & Pharmacy Information

Pharmacy benefits are administered by
HealthSmartRx Solutions

‚Äč2022 Formulary Preferred Drug List 
PDF Download
Approved medications for most treatments

Approved Specialty Drug List PDF Download
High-cost medications used to treat complex chronic conditions

Pharmacy Network
The HSRx Network is powered by Express Scripts. Log in here to find a pharamacy near you. 


Pharmacy Claim Form PDF Download
Download this form to complete and submit pharmacy claims to HSRx.