Medical Insurance Information for UW-Green Bay Student-Athletes
Understanding medical insurance is important. It's also important to understand Green Bay Athletics' insurance rules. Please review these rules carefully. If you have any questions, please contact Jeremy Cleven, Director of Sports Medicine / Head Athletic Trainer at 920.465.2138 or clevenj@uwgb.edu.
Mandatory Medical Insurance
All student-athletes are required to carry their own primary medical insurance as a condition of eligibility to participate with Green Bay Athletics. If your son or daughter does not have health insurance, a cost effective option is available through the university. Please contact Jeremy Cleven to discuss details of this policy.
For our international student-athletes, you will also be required to carry a primary medical insurance policy. We will not accept travel insurance as primary medical insurance. All polices from our international student-athletes must be provided in English. For more information on our international insurance requirements, please reference our International Student-Athlete Insurance Policy, available by contacting Green Bay Sports Medicine.
Green Bay Athletics' Excess Insurance Policy
Green Bay Athletics has purchased an Excess Insurance Policy (EIP) to cover expenses related to injuries directly related to intercollegiate athletic participation. This coverage will act secondary to the student-athlete's required primary medical insurance. Once the primary insurance has paid their portion, the EIP will be used to pay the remaining balance. At no time will the Department's Excess Insurance Policy act as a student-athlete's primary insurance.
Green Bay Athletics will be held to the terms and conditions of our insurance provider, as well as the following conditions:
1. Only injuries sustained during sanctioned intercollegiate practice or games will be covered. These sanctioned activities must be directly supervised by a coach or athletic trainer in order to be covered. Such activities include, but are not limited to: practice, games, strength & conditioning workouts, required individual workouts, or countable athletic related activity. See Table 1 for examples.
2. Injuries or illnesses resulting from non-athletically related activity cannot be covered as per NCAA rules. The following list includes specific and general activities, as well as issues or situations that will not be covered: personal illness, pre-existing injuries/issues, pickup games, intramurals, captain's practice, non-mandatory or volunteer activity, routine or non-traumatic dental, routine or non-traumatic vision, skin issues/diseases. See Table 1 for examples.
3. Overuse and reoccurring injuries may be covered under the EIP providing those injuries are a result of covered events approved by the Head Athletic Trainer.
4. Medical Services that are not initiated or authorized by Green Bay Sports Medicine will not be eligible for any EIP coverage, including but not limited to: injuries not first reported to an athletic trainer, unauthorized physician visits or other medical care, unauthorized second opinions, preparticipation exams, or diagnostic testing, lab work, or evaluations done as part of a preparticipation exam. Emergency room visits may be covered if approved by the Head Athletic Trainer.
5. Injuries, issues, or additional specific charges that result from student-athlete non-compliance, reckless behavior, or not following this policy or their established plan of care, will not be covered.
6. The Head Athletic Trainer must authorize all requests for outside physical therapy or other medical services to be covered.
7. Diagnostic testing will be covered until a diagnosis is determined. If the condition is deemed to be not related to covered athletic activity, no further coverage will be provided by our EIP.
8. The student-athlete or their primary insurance carrier will be responsible for any deductibles or co-pays.
9. Student-athletes must be members of a varsity sport in order to be covered under Green Bay Athletics' EIP. Practice players or tryouts will not be covered under this policy.
10. If a student-athlete's primary insurance changes during the course of the year, Green Bay Sports Medicine must be notified of that change immediately. Failure to notify Green Bay Sports Medicine of a primary insurance change may result in the student-athlete being held responsible for charges that is typically billed to the primary insurance.
Table 1 - Athletically vs. Non-Athletically Related Injury Examples
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Athletically Related Injury Examples
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Non-Athletically Related Injury Examples
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Knee injury during sanctioned off-season practice
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Knee injury while in an accident
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Ankle injury during intercollegiate competition
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Ankle injury during open gym or pickup game
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Broken tooth during in-season practice
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Broken tooth during an intramural game
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Back injury from team's strength training
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Chronic back pain from an injury suffered in high school
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Blood in your urine from a collision
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Blood in your urine from a kidney stone
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Shoulder tendonitis experienced caused by in-season practice
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Shoulder tendonitis from training at home over the summer
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Pre-existing Injuries and Illnesses
The student-athlete is financially responsible for medical expenses related to pre-existing injuries and illnesses. Every incoming athlete will have a health history and physical examination. Pre-existing illnesses or injuries will be identified at this time. Pre-existing conditions may also be identified during the history taken as part of an injury or illness evaluation by our athletic trainers or physicians. While Green Bay Sports Medicine may provide treatment for such conditions, the Athletic Department assumes no financial responsibility for their management. Pre-existing injuries or illnesses not disclosed during the health history, preparticipation exam, or later exacerbated by athletic participation will remain the financial responsibility of the student-athlete.
Authorization for Medical Care
Green Bay Athletics' financial responsibility is limited to those cases in which medical care is authorized by our athletic trainers or physicians. If a student-athlete seeks services from an outside provider, reports for medical care that was not part of the student-athlete's established plan of care, or pursues services recommended by a consultant without pre-authorization by Green Bay Sports Medicine, the student-athlete is financially responsible for these costs.
Financial Responsibility
The student-athlete is financially responsible for all medical expenses incurred during any lapses in insurance coverage, regardless of whether the injury is caused through participation in athletics or otherwise. Green Bay Athletics does not assume financial responsibility for student-athlete medical expenses when the student-athlete is uninsured. We strongly recommend that student-athletes maintain insurance coverage when participating in any sport-related activity or training when the student may not be enrolled in classes.
Prescription Medications
The student-athlete is responsible for the purchase of all prescription medication, regardless of their need.
Claims procedure
An athletic trainer with Green Bay Sports Medicine will provide a student-athlete with the EIP information for all covered medical services. Medical bills not covered by the student-athlete's primary insurance should be sent to the EIP by the provider. However, in the event the student-athlete receives bills, they should submit those bills to the Head Athletic Trainer along with the Explanation of Benefits (EOB) from their primary insurance.
The provider does not send medical bills to Green Bay Athletics. Therefore, we will be unable to submit a claim until the bills are provided to us by the student-athlete or their family. Green Bay Sports Medicine will be unable to submit a claim to the EIP without copies of the provider's itemized bills and EOB.
Appeal procedure
If a student-athlete or their family feels that a particular charge is the responsibility of the Athletic Department's EIP after initially being denied, they may appeal directly to the Head Athletic Trainer. The Head Athletic Trainer will hear the appeal and make a decision on whether to make a claim after consultation with the student-athlete's athletic trainer, Head Team Physician, and Associate Athletic Director for Program Operations.
