This information has been compiled to give you a better understanding of your son/daughter’s coverage while participating in intercollegiate athletics at The University of Texas-Rio Grande Valley. It also contains helpful information regarding your family's primary HMO or PPO policy while your son/daughter is away at school. In the event that your son/daughter suffers an injury as a direct result of his/her participation in an official team athletic activity (practice, game, or travel), coverage of medical expenses incurred will be processed in the following order:
- Student-Athlete's primary insurance policy (parents’ policy)
- Athletic Department's secondary/excess insurance policy
- NCAA's catastrophic insurance plan (after $90,000)
- Student-Athlete's Primary Insurance Policy: *In accordance with the U.S. Affordable Care Act, all U.S. citizens are now required to carry a qualified primary health insurance policy or receive an exemption from the federal requirement. (*see links to additional information below) For insurance coverage purposes, UTRGV Athletic Department will require all student-athletes to provide proof of their primary coverage or proof of the federal exemption prior to participation in intercollegiate athletics. Student-athletes will be asked to submit a copy of both sides of their insurance card.
In the event that the student-athlete suffers an athletic injury during participation, medical expenses incurred will be processed
first through the student-athlete's primary insurance policy. If your primary policy is an HMO or PPO, it is imperative that you
check with your insurance company regarding out of area/network coverage for your son/daughter while he/she is away at school. Many companies can set your son/daughter up on a “student status”, thereby extending their coverage from your home area to cover them while they are away at school. If not, there may be an additional rider available for purchase that will extend your son/daughter’s coverage out of area. For HMO policies, check with your company regarding changing your son/daughter’s Primary Care Physician (PCP) from a physician at home to one in the area where he/she will be attending school. If needed, the UTRGV Sports Medicine Staff can help with this selection. Both of these steps will prove invaluable when seeking care in the event of an illness or accident involving your son/daughter.
International Students: It is a University of Texas System requirement that each international student purchase the Student Health Insurance Policy offered by the Office of International Admissions and Services (
or comparable US health care plan that meet the required criteria). This policy must be in place prior to their athletic participation. International student-athletes will be asked to submit a copy of both sides of this policy’s card as well.
https://utrgv.myahpcare.com/
- UTRGV Athletic Department's Secondary/Excess Insurance Policy: Once expenses have been filed with the student-athlete's primary policy, remaining expenses are filed with the athletic department's secondary policy. Should the student-athlete not have insurance coverage by virtue federal exemption, the athletic policy then becomes the primary policy. (proof of exemption must be on file) An Explanation of Benefits (EOB) or denial letter from the primary policy is required before a claim can be processed through the secondary athletic policy. The Sports Medicine Staff will help coordinate the processing of claims between the two (or more) policies, the doctor's office, and the parents. It is therefore very important to bring any documentation received (EOB's, denial letters, medical bills, etc.) to the attention of the Sports Medicine Staff as soon as they are received.
The Athletic Department's Secondary Excess Policy has a maximum benefit of $90,000 per claim. The NCAA Catastrophic Insurance Plan picks up after this amount.
The Athletic Department's Athletic Injury (Excess) Policy does
not cover: illness of any sort, injuries that occur outside of official athletic participation, eye exams, glasses, or contacts, or dental work (unless as a direct result of an athletic injury to a sound and natural tooth).
Therefore, having a primary insurance policy for major medical coverage on your son or daughter is imperative.
- NCAA's Catastrophic Insurance Plan: This plan, sponsored by the NCAA, is in place to provide benefits to those student-athletes who sustain injuries in competition, practice, or team travel that results in irrecoverable loss of physical or mental capacity. This coverage is in excess to the athletic department policy's $90,000 maximum benefit.
As much as athletic participation is a shared responsibility, so is the responsibility for providing adequate insurance coverage for your son or daughter. NCAA policies and Federal mandates require that your son/daughter be adequately covered. If you do not currently carry a primary policy to cover your son or daughter that meets the minimal federal requirements, you should consider adding them to your policy or purchasing a short term policy which provides minimal essential coverage as per the Affordable Care Act while they are attending college. One such policy is available through the University. The cost of this type of coverage is not covered under athletic scholarship. The student-athlete is still ultimately responsible for charges incurred on his/her name and due to privacy laws, it is therefore extremely important to communicate closely with the Sports Medicine Staff to coordinate coverage and documentation. Please call us if you have any questions regarding the insurance coverage for your son/daughter.
We hope this information has been helpful as your son or daughter prepares for the upcoming season. If you have any questions at all regarding insurance coverage, please feel free to contact us in the Athletic Training Room at (956) 665-2233 or by email:
alfred.castillo@utrgv.edu.
Sincerely,
Alfred Castillo, MS, ATC, LAT, USAW
Head Athletic Trainer
*For more information regarding the Affordable Care Act and exemptions:
http://obamacarefacts.com/affordablecareact-summary/
https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/
