| Claim form* |
Standard form to provide notice of medical/prescription and/or provide details on requests for additional information.
|
| Authorization to use or disclose health information |
This form allows an insured to provide specific instructions to UnitedHealthcare Student Resources International for use or disclosure of protected health information for a particular purpose.
|
| Personal Representative Appointment* |
This document allows an insured to appoint a personal representative to act on their behalf in the matters of health insurance with UnitedHealthcare Student Resources International. |
*You can submit the form online by signing in to My Account.
For questions on how to access your benefit plan call 1-888-251-6253.
If you have any questions on how to participate in the health plan or on a Qualifying Life Event, please go to Contact and submit the form.
Global Emergency Services (GES)
Have some peace of mind while traveling. We’ve heard great stories about GES saving the day for students who are studying or traveling in other states or other countries. When you’re at least 100 miles from home and you’re sick or hurt, GES steps in with immediate assistance and evacuation benefits. They can even help you get home if you need to be medically evacuated.
Some benefits of this service include:
- Emergency Medical Evacuation
- Dispatch of Doctors/Specialists
- Medical Repatriation
- Transportation after Stabilization
- Transportation to Join a Hospital Insured Person
- Return of Minor Children
- Repatriation of Remains
- May also include additional assistance services to support your medical needs, including worldwide medical referrals and medication/vaccine transfers.
- Contact information is on the back of your SR ID card or in My Account
For more information on Global Emergency Services, please review the Assistance and Evacuation Benefits section in your Brochure-Certificate.
| Claim form* |
Standard form to provide notice of medical/prescription and/or provide details on requests for additional information.
|
| Authorization to use or disclose health information |
This form allows an insured to provide specific instructions to UnitedHealthcare Student Resources International for use or disclosure of protected health information for a particular purpose.
|
| Personal Representative Appointment* |
This document allows an insured to appoint a personal representative to act on their behalf in the matters of health insurance with UnitedHealthcare Student Resources International. |
*You can submit the form online by signing in to My Account.
Please use this link below to search for preferred doctor, medical specialist, hospital or lab or receive cost estimates for you or any member covered under this plan.
Find preferred providers*
* Your actual costs could vary. Check with your provider to confirm the cost and your health plan for benefits. You are responsible for costs that are not covered and for getting any referrals if required by your health plan. Neither payments nor benefits are guaranteed.
Note: Provider networks change periodically. To ensure that a provider is participating in the network, please confirm with your provider before making an appointment.
Behavioral health
Please use the link below to search for behavioral health provider or facility.
Find behavioral health providers
Virtual Services
Your plan gives you free access to virtual Medical and Mental Health care.
Sign in to your My Account to learn more.
For questions on how to access your benefit plan call 1-888-251-6253.
If you have any questions on how to participate in the health plan or on a Qualifying Life Event, please go to Contact and submit the form.
