AHP (24) BCBSSC-USC
This document contains a summary of your school’s student health insurance policy benets and restrictions as of the date of its publication; the summary document may differ from the
benets in the approved policy of insurance. The nal policy may be pending approval by applicable federal and state regulatory authorities. The nal approved policy of insurance is
accessible upon approval at sc.myahpcare.com.
University of South Carolina
Student Health Insurance Plan
2024-2025
Eligibility
All students who meet the following criteria are considered eligible and are
required to provide proof of health insurance:
• all undergraduate students enrolled in six (6) or more credit hours;
• all graduate students enrolled in six (6) or more credit hours;
• all graduate students with assistantships regardless of credit hours;
• USC School of Medicine students enrolled in one (1) or more credit hours;
and
• all International students enrolled in one (1) or more credit hours.
Students are automatically enrolled in the Student Health Insurance Plan, unless
proof of other comparable coverage is provided.
OPT-OUT / WAIVER
To waive out of the Student Health Insurance Plan go to
sc.myahpcare.com/waiver and enter your health insurance information. Students
that are not required to show proof of health insurance and are enrolled in six
(6) or more hours and in a degree seeking program are eligible to purchase the
student health insurance plan. Eligible students can voluntary enroll by visiting
sc.myahpcare.com/enrollment and selecting the voluntary student option.
What’s Included?
• Access to After Hours Nurse Line & Telehealth Services
• Urgent Care Benefits
• Coverage when Traveling
• Emergency Medical and Travel Assistance*
More Information
For full details of participation
in the plan, enrollment, & coverage periods,
please view the complete brochure online at:
sc.myahpcare.com
Questions
To view Frequently Asked Questions or
submit a request, please visit:
help.ahpcare.com
Insurance ID Card
To access your ID card, please click here.
This is for informational purposes only and is
neither an offer of coverage nor medical advice. It
contains only a partial, general description of plan
benets and programs and does not constitute a
contract. Covered Expenses are subject to plan
maximums, limitations, and exclusions as
described in the Policy. The PPO network is
Preferred Blue PPO Network.
Rates & Coverage Periods
FALL
08/01/2024 - 12/31/2024
SPRING/SUMMER
01/01/2025 - 07/31/2025
Enrollment Periods
06/03/2024 - 09/09/2024 11/04/2024 - 02/03/2025
Student $1,355.29 $1,849.71
Spouse $1,355.29 $1,849.71
Each Child $1,355.29 $1,849.71
Three or More Children $4,065.87 $5,549.13
*Academic Emergency Services and AD&D coverage are underwritten by 4 Ever Life International Limited and administered by Worldwide Insurance Services, LLC, separate and independent companies
from Academic HealthPlans, Inc. (AHP), a Risk Strategies Company.
Academic HealthPlans, Inc. (AHP), a Risk Strategies Company is an independent company that provides program management and administrative services for the student health plans of
BCBSSC.
University of South Carolina 2024-2025
BENEFITS PARTICIPATING PROVIDER NON-PARTICIPATING PROVIDER
Benet Maximum
per Insured Person, per Policy Year
Unlimited
Individual Deductible
per Insured Person, per Policy Year
$500 $3,000
Family Deductible
for all Insureds in a Family, per Policy Year
$1,000 $6,000
PARTICIPATING PROVIDER &
STUDENT HEALTH SERVICES
NON-PARTICIPATING PROVIDER
Individual Out-of-Pocket Maximum
per Insured Person, per Policy Year
$9,450 $15,000
Family Out-of-Pocket Maximum
for all Insureds in a Family, per Policy Year
$15,000 $30,000
**STUDENT HEALTH SERVICES
Payments are based on the
Allowable Charge
PARTICIPATING PROVIDER
Payments are based on the
Allowable Charge
NON-PARTICIPATING PROVIDER
Payments are based on the
Allowable Charge
In Ofce Physician’s Visits
Primary Care and Specialist
100%, $20 Copayment (if applicable) $25 Copayment, then Deductible, 80% $40 Copayment, then Deductible, 70%
Physician Services in the Ofce
Includes Lab, X-Ray, Ofce Surgery, Allergy Injections,
Treatment Modalities, IV’s, Breathing Treatments and
Other Diagnostic Services.
100% $25 Copayment, then Deductible, 80% $40 Copayment, then Deductible, 70%
Emergency Room Facility Charges
Copayment waived if admitted
N/A
$200 Copayment, then Deductible, 80% $450 Copayment, then Deductible, 80%
Diagnostic Imaging Services & Outpatient
Lab Services
100% Deductible, 80% Deductible, 70%
Durable Medical Equipment
$20 Copayment, 100% $25 Copayment, then Deductible, 80% $40 Copayment, then Deductible, 70%
Mental Health & Substance Use
Inpatient/Outpatient Facility Charges
Mental Health & Substance Abuse Ofce Visits
N/A
$20 Copayment, 100%
Deductible, 80%
$40 Copayment, 100%
Deductible, 70%
$40 Copayment, then Deductible, 70%
Prescriptions Drug Benet
Includes diabetic supplies - no charge for
contraceptives at SHC and In-Network
Prescription Deductible: $100
Retail 31-day supply
1
Prescription deductible does not apply
1
Prescriptions lled at the
on-campus pharmacy
100% after a:
Generic: $10 Copayment
Preferred: $20 Copayment
Non-Preferred: $20 Copayment
Specialty: $20 Copayment
Prescriptions should be lled at an
OptumRx participating Pharmacy
100% after a:
Generic: $20 Copayment
Preferred: $40 Copayment
Non-Preferred: $100 Copayment
Specialty: $100 Copayment
100% after a:
Generic: $20 Copayment
Preferred: $40 Copayment
Non-Preferred: $100 Copayment
Pediatric Dental Care Benet
Under age 18
(Limited to one dental exam every six months)
N/A
Preventive: 100%
Basic & Major Services: 50%
Preventive: 100%
Basic & Major Services: 50%
Adult Dental Care
Age 19 and older
(Limited to one dental exam every six months)
N/A
Preventive: 100%
Basic Services: 80%
Preventive: 100%
Basic Services: 80%
Children’s Eye Exam & Glasses
Under age 18
(Limit one Visit & one Pair of Prescribed Lenses &
Frames per Policy Year)
N/A 100%
100%
Adult Eye Exam
Age 19 and older
(Limit one Routine Eye Exam per Policy Year)
N/A $20 Copayment, 100%
Deductible, 100%
Up to $75
(balance billing may apply)
Adult Glasses
Age 19 and older
(Limit one Pair of prescribed lenses & frames or
contact lenses in lieu of frames & lenses per
Policy Year)
N/A
100% after a:
Lenses: $20 Copayment, Up to Single -
$50; Bifocal - $70; Trifocal - $400
Frames: $20 Copayment, Up to $150
Contact Lenses: $20 Copayment, Up to
$100
100% after Deductible
(balance billing may apply)
Lenses: Up to: Single - $50;
Bifocal - $70; Trifocal - $400
Frames: Up to $150
Contact Lenses: Up to $100
Wellness/Preventive Benets
For more information, please visit
healthcare.gov/coverage/preventive-care-benets/
100% 100% 100%
**Plan Deductible Waived