The UIGRADCare Plan is a comprehensive health care program that covers hospital, medical, surgical, outpatient, and other health care services such as physical therapy. Coverage is also provided for routine physicals, newborn care (including inoculations, scheduled visits, etc.), well-child checkups, and prescription drugs.
- 2015 UIGRADCare Summary of Benefits and Coverage (pdf)
- 2014 UIGRADCare Summary of Benefits and Coverage (pdf)
- UIGRADCare Coverage Manual (pdf)
- Wellmark/Blue Cross Patient Claim form #C-5321f (pdf)
- Prescription Reimbursement Claim form (pdf)
- International Claim Form (pdf)
How an Individual Uses the UIGRADCare Plan
Health care under this plan is provided by primary care physicians, physician assistants, advanced registered nurse practitioners, certified nurse midwives and the specialists at the University of Iowa Hospitals and Clinics.
The student must select a primary care clinic for all primary care services from the University of Iowa Student Health Service, Family Practice and Internal Medicine at the UIHC, or Community Medical Service Clinics. Spouses and children may select their provider from Family Practice, Internal Medicine, Pediatrics, or Community Medical Service Clinics. If a Graduate Student wishes to obtain OB/GYN care, either the Student Health Center or the OB/GYN department at the UIHC may be used. Female spouses and dependents who want an OB/GYN clinic that is separate from their Primary Care Clinic must select the UIHC OB/GYN department.
All specialist care must be obtained from a provider located at UIHC. No referrals are needed for this care.
Care by non-participating providers needed due to medical necessity (examples: referrals or ambulance transportation) may involve higher cost to you. Non-participating providers do not have contracts with Blue Cross and Blue Shield. They do not agree to accept payment arrangements and are not responsible for filing claims for you. Non-participating providers may charge more for health care than participating providers. Payment is made to you and you are responsible for paying the provider. Non-participating providers can bill you for the difference between what Blue Cross and Blue Shield will pay for a service and what they charge (balance billing).
Referrals are needed for:
- Out-of-network providers – Except for emergencies, benefits are only available from providers outside of the network for care that is beyond the scope of services available from UIGRADCare providers. Prior approvals are needed for all referrals outside the network.
Note: Care for an accident or an emergency will be covered while traveling as long as services are provided in a Hospital Emergency Room setting.