Health Insurance

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Basic Information







Academic Information







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Health Insurance Information



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Insurance Card Front & Back Upload

Accepted file types: DOC, DOCX, PDF, JPEG, JPG, PNG

Accepted file types: DOC, DOCX, PDF, JPEG, JPG, PNG

Documentation

Accepted file types: DOC, DOCX, PDF, JPEG, JPG, PNG
Major Medical Insurance Coverage Verification
Please be aware that your name provided on this form must be included the following must be included in your documentation
  • Name (must be the same as the name provided on this document)
  • Health Insurance Group/Policy #
  • Health Insurance Provider Contact Information. 
Health Plan not accepted

Medi-share, MAP basic, CommUnity Care, or Texas Women's Health and other similar plans will not be accepted. After careful review and further consultation with the clinical agencies, it has been determined those plans do not meet the criteria of the clinical agencies.


To meet the requirements of our clinical education partners, your health insurance plan should provide coverage for the following types of care:

  • Urgent Care:
    Medical care are for non-life-threatening illnesses or injuries that require prompt attention but are not emergencies.
  • Emergency Room Care:
    Treatment for serious or life-threatening medical emergencies, such as accidents or sudden illness.
  • Hospital Inpatient Services:
    Medical care provided when a patient is formally admitted to a hospital for treatment or monitoring.
  • Outpatient Services:
    Medical care received without being admitted to a hospital, such as outpatient procedures, diagnostic services, or same-day treatments.
Please refer to our website for more information on health insurance requirements for clinical placements: https://sites.austincc.edu/health/insurance/