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International Student Health Forms

 

Our staff at Health Services is committed to maintaining a safe and healthy campus for our entire Niagara community.  Enclosed in this letter, please find the necessary requirements pertinent to your insurance requirements for attendance to Niagara University.

It is University policy that:

 

“International students are required to submit proof of health insurance effective for one year, as well as the required Medical History & Immunization forms.  In addition to basic coverage, the student’s insurance must provide repatriation and medical evacuation expenses.  No international student shall be permitted to check into the residence halls or to register for classes until all the specified information is part of the student's permanent record.  If the insurance policy lapses, the student will be subject to suspension from NU until such time as health coverage is renewed."

Please use the following guidelines for completing the required forms:

    ONTARIO STUDENTS:  Ontario students need only to fill out the:

Request for Waiver of Health Insurance  (Form 1) and provide a photocopy of their health insurance card.  Further documentation of health insurance coverage is not required.  Mail or fax to Niagara University.

   ALL OTHER INTERNATIONAL AND PROVINCIAL STUDENTS:  Identify which subgroup you belong to, and then follow the directions.

  1. If you DO NOT HAVE health insurance that provides comparable coverage as outlined and you choose to purchase the Niagara National Accident and Health Plan fill out the application and mail to Niagara National with payment.
  2. If you DO HAVE comparable private or national health insurance or choose to purchase an alternate plan and request to apply for a waiver:

     3.  IF YOU DO HAVE comparable private or national health insurance but DO NOT HAVE REPATRIATION & MEDICAL EVACUATION BENEFITS, you MUST purchase these additional benefits:

IMPORTANT - PLEASE REVIEW

All international students will automatically be enrolled into the 2008-2009 Student Accident and Health Insurance Program if the necessary paperwork is not received by the deadline.  Students who prove adequate coverage through private insurance polices, OR choose to purchase alternate medical insurance OR have national health insurance MAY APPLY FOR A WAIVER.

The deadline for requesting a waiver is January 9, 2008.  If you have not submitted this information by the above deadline, $515.00 will be directly forwarded to Niagara National (plan administrator) on you behalf for payment of the health insurance premium.  At this time your student account will be billed.  This fee will be non-refundable.  This will ensure that all international students will have appropriate medical coverage on the first day of classes.

Mail the completed for #1 and #2 to the Student Health Services, P.O. Box 1923, Niagara University, NY 14109 or fax them to 716-286-8391.  Do not hesitate to call us for assistance at 716-286-8390.  Our office is open from Monday-Friday 9 am to 5 pm.

 

 

 

Mandatory Health Insurance Requirements for Attending Niagara University:

 

While Niagara University does not require that an individual’s private plan identically match the Student Accident & Health Insurance Program (pamphlet enclosed), students must provide documentation of comparable basic Accident & Sickness benefit health insurance.  To ensure that you have adequate and minimum basic health insurance to cover the potential cost of health services in the United States, following is a list of benefits that your medical insurance plan should provide:

 

     BENEFIT

   U.S. DOLLAR EQUIVALENT

Accidental injury Expenses

$2000.00 minimum

Hospital Room & Board

$350.00 per day

Surgical Benefits

$2000.00 minimum

In-Hospital Physician’s Fees

$50.00 per visit

Out-Patient Physician’s Fees

$50.00

Diagnostic & Laboratory Fees

$200.00 per visit

Emergency Room visits

$150.00 minimum

Consultant Expense

$75.00 per sickness

Prescription Medications

$50.00 per sickness

Ambulance

$250.00

Maternity

As above

Annual Pap/Pelvic

One visit per year

Expenses associated with pre-existing conditions

Covered

 

 

 

 

Supplemental Expenses:   When expenses exceed the basic accidental and sickness benefit, 80% of the expenses are paid up to a maximum of $50,000

 

Medical Evacuation

$10,000

Repatriation

$10,000

 

                  MEDICAL EVACUATION:  $10,000 coverage for evacuation to your natural country or approved facility for the care of the injured or ill person when the insured student is hospitalized for 5 consecutive days or more.

 

                  REPATRIATION:  In the event of death, the insurance company will pay $10,000 for the preparation and transportation of the remains of the deceased body to the country of origin.

 

Wishing you success and a healthy stay at Niagara University.

 

 

 

 

 

Niagara University
Niagara University, NY 14109
716-285-1212 or 1-800-778-3450
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