Plan Information
Health Benefits Overview
The Ohio State University Health Plan Inc. contracts with a network of doctors, hospitals and facilities to offer a full range of benefits at a reasonable cost. Learn more about your plan and your rights and responsibilities. [Health Plan Overview]
Enrollment/Family Status
You have the opportunity to change your medical, dental, and vision benefits and the flexible spending accounts program during open enrollment. [Enrollment/Family Status]
Pharmacy, Vision, & Dental
Looking for a dentist? Not sure if you need glasses? Want to review the preferred drug list? Access to the information you need. [Pharmacy] [Vision] [Dental]
Prior Authorization of Services
Prior authorization is notification to OSU Health Plan of a request for benefits before receipt of specific services or before elective admission to a hospital or facility. If prior authorization is not obtained from OSU Health Plan, a penalty will be assessed.
Services that need prior authorization include, but are not limited to, the following:
- Rental or purchase of medical equipment or supplies (over $2,000)
- Inpatient hospitalization
- Weight management programs and surgery
- Home health care services
- Admission to extended care facilities
- In-patient behavioral health services (psychiatric or substance abuse)
- Select prescription medications (view a listing)
- Hospice care
- Purchase of prosthetic or orthotic devices (over $2,000)
- Organ/Bone marrow transplant services
For a complete list of services requiring medical necessity review, click here or call OSU Health Plan at (614) 292-4700 or (800) 678-6269.
All network providers have been contracted to accept the responsibility to complete all prior authorization paperwork for covered members. Your responsibility is to show your medical plan insurance card to make sure the provider understands you are on an OSU medical plan and to make your copayment.
For providers who ask you, as a member, to obtain prior authorization or for non-network providers, call OSU Health Plan Customer Service at (614) 292-4700 or (800) 678-6269 to obtain the necessary forms.
Claims Processing
As a self-funded employer, The Ohio State University does not have the ability to process claims for payment. NGS American was selected to provide claims processing services for medical claims incurred by OSU faculty and staff. [Claims Processing]
Forms
Members may view or print out the following forms: