Student Health Costs 

To enroll for health insurance go to http://www.umaryland.benelogic.com

Table I: Student Health and CareFirst Options and Associated Out-of-Pocket Costs
Table II: Student Health, CareFirst, and Dental Plan Coverage Costs
Table III: Student Dental Discount Plan Services and Associated Out-of-Pocket Costs
Table IV: Student Vision Plan

Table I: Student Health Care Options and Associated Out-Of-Pocket Costs*

Service

Student Health (Services available to all registered students except evening law; fee included in tuition.)

CareFirst Plan
Preferred Provider Option

CareFirst Plan 
Out-of-Network Provider

Annual deductible

$0

Individual=$0
Family=$0

Individual=$250
Family=$500

Annual out-of pocket maximum

None

Individual=$2,500
Family=$5,000

Individual=$5,000
Family=$10,000

Lifetime maximum benefits paid

No limit

No limit

No limit

What's Covered?

Routine exams and office visits

Free (visit only)

$20 copay, one per year

40% of allowed costs after deductible; one per year

Physician sick visit

Free

$20 copay

40% of allowed costs after deductible

Allergy shots

Free

$20 per injection

As above

Routine blood pressure screening

Free

One per year

One per year

Routine gynecological exam

Free (visit only; lab work billed to insurance)

$20 copay, one per year

40% of allowed costs after deductible, one per year

Family planning

Free

Not covered

Not covered

Prescription drugs

Not covered

$15 generic, $35 formulary, $60 brand, nonformulary
 (self injectable medication, 50% up to max $100  benefit)

$15 generic, $35 formulary, $60 brand, nonformulary
(self injectable medication, 50% up to max $100  benefit)

Birth control pills
Nuvaring

Discounted with gynecological exam

$15 generic, $35 formulary, $60 brand, nonformulary

$15 generic, $35 formulary, $60 brand, nonformulary

Immunizations

Administered at cost

20% of allowed costs

40% of allowed costs

Mental Health

Free short-term counseling at the

Counseling Center

only for registered students

20% of allowed costs

40% of allowed costs

Accidental injury: outpatient care

Free

$0 if care is received within 72 hours

$0 if care is received within 72 hours

Emergency room visits

Not covered**

$0 if for a CareFirst recognized emergency

$0 if for a CareFirst recognized emergency

Outpatient surgery

Not covered**

20% of allowed costs

40% of allowed costs after deductible

Maternity care

Not covered**

20% of allowed costs

40% of allowed costs after deductible

Anesthesia

Not covered**

20% of allowed costs

20% of allowed costs after deductible

Diagnostic testing: X-rays, lab and blood tests, machine tests

Not covered**

20% of allowed costs

40% of allowed costs after deductible

Hospitalization, including semi-private room, supplies, and care

Not covered**

20% of allowed costs; precertification required

40% of allowed costs after deductible; precertification required

Physical, speech, and occupational therapy

Not covered**

$35, precertification required

40% of allowed costs after deductible; precertification required

*This is not a complete listing of services. Call CareFirst or Student Accounting to inquire about other services. In the event that the costs or services listed here differ from information in official publications, the latter shall take precedence.

**Family Medicine physicians at Student Health can perform these services and will bill your insurance company (CareFirst or the equivalent plan you used to waive CareFirst coverage). If you are covered by an alternate plan, you must follow plan guidelines. Family Medicine physicians participate in many plans and can be selected as your primary care provider if they participate in your plan.

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Table II: Student Health, CareFirst, and Dental Plan Coverage Costs*

Participants

Student Health Plan

CareFirst Health Plan**

Dental Plan***
(Dental Discount Plan)

Student

Included in tuition

$1,174.50 per semester

$188.97 per semester

Student and Child

Coverage for student only

$2,641.50 per semester

N/A

Student and Spouse

Coverage for student only

$3,522.00 per semester

N/A

Student and Family

Coverage for student only

$4,519.50 per semester

N/A

*Premiums are not refundable.

**Fall coverage begins Aug. 1 and runs through Jan. 31. Spring coverage begins Feb. 1 and runs through July. 31.

***Students can enroll in a dental plan at the beginning of any month during the semester; rates will not be prorated, but the participant will be eligible for a full six months of benefits. Policy dates are Aug 1 - Jan 31 and Feb 1 - July 31. 

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Table III: Student Dental Plan Services and Associated Out-Of-Pocket Costs

Service

Dental Discount Plan

Class I: preventive (e.g., cleaning, X-rays)

No charge

Class II: basic restorative (e.g., fillings)

20% of the fee schedule

Class III: periodontal and oral surgery (e.g. extractions)

50% of the fee schedule

Class IV: prosthetic and endodontic (e.g., dentures, crowns)

50% of the fee schedule

Class V: orthodontics

Available at a discounted fee, but not covered

Annual maximum benefit per participant*

$1,250.00

*Benefits used in the first six months cannot exceed one-half of the annual benefit. Any unused benefit will carry forward from the fall to the spring semester.

Vision:

ParticipantsAnnual Rate
Student$54.20
Student and Child$103.00
Student and Spouse$123.25
Student and Family$150.25


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