Health Insurance

Using Your Insurance 

Medical visits and emergencies can be very costly in the U.S.  San Jose City College requires all international students to purchase and subscribe to the health insurance plan selected by the San Jose/Evergreen Community College District.  SJCC does not accept any other U.S. or foreign-based insurance plans. Only students who meet certain eligibility criteria may request a waiver by completing a health insurance waiver form and providing the required proof by the first day of each semester. 


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Your Insurance ID Card 

Visit www.4studenthealth.com/sjcc and click on the Insurance ID Card icon to download your insurance ID card. Fill in the information on the LewerMark Student Login page to access your account. 

Your username is your nine (9) digit Student ID number. If your Student ID number is less than 9 characters, add zero(s) at the beginning. 

Keep your ID card with you at all times! You will need your card when you visit the campus health center, doctor’s office, urgent care, or hospital.


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What You Will Pay 

• The cost of the insurance charge
• A $20 copay when you go to an in-network doctor’s office, or $35 copay at an out-of-network doctor’s office (waived at the campus health center) 
• No copay when you go to an in-network urgent care center when the campus health center or doctor’s office is closed 
• A $50 copay when you visit an in-network hospital, or a $70 copay when you visit an out-of-network hospital 
• A $100 copay if you go to an in-network emergency room, or $200 copay at an out-of-network emergency room (waived if you are admitted to hospital)
 • 50% of the cost of prescription medication up to a maximum benefit of $2,500
 • Out-of-network coinsurance if you don’t use an in-network provider 
• Full amount for any services not covered by insurance (see exclusions and limitations in the Plan Brochure)


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What Does “In-Network” Mean and Why Does It Matter?

In-network means providers such as doctors, specialists, and hospitals that accept this insurance plan. Note: Sometimes it is also called “PPO” or “Preferred” network. The network for this plan is First Health Network

If you use an in-network provider, covered medical services are paid by the insurance company at 100%. If you use an out-of-network provider, meaning a provider who is not in-network, covered medical expenses are paid at 80% of reasonable and customary charges.
To find an in-network provider: 
2. From the “Locate a Provider” screen, select “Start Now.”
 3. Select the type of provider, such as physician or Urgent Care. 
4. Select Search by ZIP code and enter your ZIP code. 
5. Select the distance you are willing to travel to the provider (minimum of five [5] miles). 
6. Click “Search Now.”
 Always check with the doctor or medical facility directly to confirm that they accept First Health Network before you receive treatment. 
It is best to locate an in-network doctor, urgent care center, and an emergency room near you before you get sick.


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What Is Covered? 

• $250,000 benefit year maximum for all eligible medical expenses
• Most doctor visits and hospital charges, paid at 100% (after copay) when you use an in-network provider; or 80% when you use an out-of-network provider
• Emergency expenses
• Surgery, in- and out-patient 
• Physical therapy, chiropractic care, acupuncture
• Wellness benefit 
• Tests, procedures, and laboratory services, such as X-rays and blood draws 
• Pregnancy and maternity
• Prescriptions are covered at 50% of charges (100% at the campus health center) up to a maximum benefit of $2,500 
Limitations, copays, and coinsurance may apply.  Please see the Plan Brochure for full benefit details. 

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Urgent Care 

Do not go to the hospital for minor illnesses or injuries! If you need to see a doctor immediately and cannot wait for a scheduled appointment, please go to an urgent care center. Hospital emergency rooms typically charge 2-3 times more than a doctor’s office or urgent care center. Use an urgent care center instead of an emergency room to save time and money.

Here are some in-network urgent care centers close to campus: 

Verity Medical Foundation 
625 Lincoln Avenue
San Jose, CA 95126 
(408) 278-3620

Beacon Urgent Care 
4949 Stevens Creek Boulevard 
Santa Clara, CA 95051 
(408) 260-2273

 Santa Clara Urgent Care
 1825 Civic Center Drive, Suite 7 
Santa Clara, CA 95050 

(408) 985-2401


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Claims 

After your visit, the doctor or provider will send a bill to the insurance company for the charges. The insurance company will review the doctor’s statement and determine the payment for each itemized procedure. The insurance company will then send you an Explanation of Benefits. This is not a bill. It is a notification of what the insurance company will pay your doctor. 

The doctor will receive payment from the insurance company and then bill you for any amount not covered by the insurance. You must pay for any amount the insurance company doesn’t cover. If you don’t pay, it will affect your credit and possibly your visa status. Note: Most charges are covered at 100% if you use an in-network provider. 

In most cases, the provider will submit the claim for you.

If you are required to pay for services up front, you will need to complete a claims questionnaire in order to be reimbursed (paid back) by the insurance company. 

Go to www.4studenthealth.com/sjcc and click on Claims under the USE YOUR INSURANCE section to download a Claims Questionnaire.

Send the claims questionnaire with bills and receipts for medical treatment to: 

The Lewer Agency, Inc.
P.O. Box 32247 

Kansas City, MO 64171 

Make sure you fill out the questionnaire completely so your claim will be processed promptly.

Keep copies of all the documents you submit for claims.

To check the status of a claim, email lewermarksupport@lewer.com or call (800) 821-7710 (Monday to Friday, 8:00 a.m. to 6:00 p.m., Central Time).

For questions about claims or benefits, please contact LewerMark at:

Phone: (800) 821-7710 

Website: lewermarksupport@lewer.com


For more information you please visit the official website 4studenthealth.relationinsurance.com

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