Lehigh Student Health Insurance Form

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Lehigh student health insurance form. The forms must be completed and signed in order to be considered. Health insurance for undergraduate students. J 1 visiting scholars are required by federal law to carry medical insurance that meets the j 1 visa requirements above. Please send the completed forms to.

The following tables summarize which students are eligible and or required to have health insurance. If you meet eligibility requirements and have comparable coverage from a domestic insurance company with claims paid in the united states. Students must fill out a claim form for each injury or sickness and submit it to wellfleet at the address on the form. Services include but are not limited to treatment of routine illnesses and injuries gynecological care and immunizations.

To request this optional payroll deduction complete the graduate student health insurance payroll deduction form which can be found at http financeadmin lehigh edu content payroll forms. Authorization for disclosure use of personal health information gynecological history form. The student or the medical provider must also submit the bills for the services. Below is a list of important forms for leigh students immunization and physical exam forms lehigh university student health insurance plan insurance claim form.

New or readmitted students who enter lehigh university in the spring term are not automatically enrolled in the lehigh student health insurance plan but are still required to have health insurance. As part of its efforts to keep the lehigh community safe students will no longer be able to come directly to the health wellness center lobby. Lehigh universitystudent health insurance policy guidelines all students required to have health insurance will need to either waive or confirm enrollment in the lehigh student health insurance program. The lehigh student health insurance plan meets these requirements.

The lehigh university student health wellness center provides primary medical care for students. Office of the bursar lehigh university 27 memorial drive west bethlehem pa 18015 3093. To be seen by a health professional they must first either log onto the patient portal found on our web page or call 610 758 3870 to schedule an initial phone assessment appointment. Students on an f 1 or j 1 visa please see international student section confirm enrollment if you need to purchase the lehigh student annual insurance plan and expedite activation of your coverage using the link to the right.

Bills for medical services should be submitted to cigna po box 188061 chattanooga tn 37422 8061. If you choose to fill in the form online you must print and sign the form before returning it to the bursar s office. Or fax it to.