Southern Wesleyan University Sports Medicine Insurance


 

Insurance Letter

TO: Southern Wesleyan University Student-Athletes and Their Parents/Guardians
SUBJECT: Athletic Physical and Insurance Requirements for the 2022-23 Academic Year


 

Athletic Physical Information

Each student-athlete is required to have a physical examination prior to any participation (conditioning/practice/games) in intercollegiate sports at SWU. Freshmen must have an athletic physical on file with the Sports Medicine staff IN ADDITION to any forms the Health Center requires. SWU will provide physicals for all freshman/transfer student athletes at the beginning of the school year. The final decision of physical disqualification(s) or reason for rejection is the responsibility of the team physician. Any condition found during physicals that requires further evaluation is considered pre-existing, and is the sole financial responsibility of the student-athlete and their family. Returning student-athletes will be required to complete an annual medical history questionnaire.  NO ATHLETE WILL BE ALLOWED TO PARTICIPATE UNTIL ALL FORMS ARE SIGNED AND SUBMITTED ON FRONT RUSH.

*Any student athlete not present at the annual group physicals at the beginning of the school year will be required to have a physical completed at their own expense with our team physician.


 

Athletics Insurance Coverage

All SWU student-athletes must provide evidence of primary insurance that includes coverage of athletic-related injuries. NO STUDENT ATHETE WILL BE ALLOWED TO PARTICIPATE UNTIL EVIDENCE (Insurance Card) OF CURRENT INSURANCE IS ON FILE WITH THE SWU SPORTS MEDICINE DEPARTMENT / FRONT RUSH FORMS. If a student athlete does not have any primary insurance, SWU will help direct the student-athlete where to purchase a qualified insurance plan.  Any changes to the status of the student-athlete’s primary insurance MUST be brought to the attention of the Head Athletic Trainer immediately. If a student-athlete does not maintain insurance coverage, or fails to notify the Head Athletic Trainer of any changes, SWU will not pay claims.  



 

Accepted Insurances

SWU Athletics does not accept Medicaid (commonly called Healthy Connections in SC), Christian Healthcare Ministries, Tricare, Medicare, Medishare (or any other medical cost sharing program) as acceptable coverage.  In these plans, the policies are all “payer of last resort” which are not considered primary insurance. SWU accepts all major medical plans (Aetna, Cigna, Blue Cross, etc.) provided they cover injuries in Upstate South Carolina. Some plans don’t cover injuries across state lines. It is your responsibility to confirm coverage with your insurance company.
 


 

SWU Athletics Secondary Insurance Policy

Southern Wesleyan University carries a secondary insurance policy that covers athletic injuries sustained by student-athletes.  Please be aware of the following limitations:

• This is a secondary policy and is only used after the student-athlete’s primary insurance company processes a claim.
• This policy only covers athletic related injuries, and will not cover illness, cardiac issues, injuries sustained outside of an activity sponsored by the Athletic Department, pre-existing conditions, including conditions found during SWU physicals, or injuries sustained over the summer.
• This policy does not cover anything COVID-19 related.  Any COVID related testing/work-ups will be the financial responsibility of the student-athlete.
• If the student-athlete fails to maintain insurance coverage and suffers an injury, the secondary policy will not cover the claim, and any cost is the sole responsibility of the student-athlete.
• As with any insurance policy, there may be exclusions and out-of-pocket or other non-covered charges that will be the responsibility of the student-athlete. However, we do not anticipate this to be the case for claims filed for legitimate athletic injuries.
• Southern Wesleyan University does not directly pay claims; all claims are submitted to the insurance carrier for payment.
• Functional/Return to Sport Braces: Most types of braces are not covered by secondary insurance.

 
Note: Any student-athlete who self-refers to an outside physician for any athletic-related injury risks not having their injury claim processed against the Southern Wesleyan University Secondary Athletic Insurance Plan.  It is imperative that all injuries incurred while participating in intercollegiate athletics be dealt with through the SWU Sports Medicine Staff. Failure to follow this procedure may result in unpaid insurance claims, which will then become the responsibility of the student-athlete. Accidents do occur and we attempt to provide our student athletes with the best possible care. Medical bills may be incurred when a student-athlete is treated for bodily injury due to an accident, whether it is locally, during a road trip, or by a medical vendor in his/her hometown.


 
****IT IS YOUR RESPONSIBILITY TO DETERMINE COVERAGE IN THE STATE OF SOUTH CAROLINA.
If your insurance only covers emergencies, it is important to recognize that this is not adequate insurance coverage for your student-athlete, and will result in your student-athlete being required to see an ER physician prior to visiting any of our team physicians. If the primary family coverage is through an HMO, or out-of-state PPO, you must provide the Sports Medicine Department with a list of local orthopedic physicians that accept your insurance. This is especially important if your plan requires pre-authorization to have your son/daughter treated out of your plan’s service area. If these procedures are not followed properly, it may result in delayed care, and denial of excess coverage. Please be informed about how your insurance works!      
       

   SWU Team Physician Info: 
Blue Ridge Orthopedics Easley
309 E 1st Ave
Easley, SC 29640
(864) 850-2663

Blue Ridge Orthopedics Seneca
10630 Clemson Blvd # 100
Seneca, SC 29678
(864) 482-6000



 

Student Athlete Medical Transport Policy

Student athletes are expected to arrange transportation to and from any visit related to doctor’s visits.  SWU will attempt to assist in providing transportation when needed, but the responsibility is ultimately up to the student athlete.


 

Catastrophic Injury Insurance

The NCAA’s Catastrophic Injury Insurance Program covers student-athletes who are catastrophically injured while participating in a covered intercollegiate athletic activity (subject to all policy terms and conditions). This policy has a $90,000 deductible. This coverage does not qualify as the basic coverage required for athletics participation at Southern Wesleyan University. It is supplemental coverage in the event of a catastrophic injury. More information on this program can be found on the NCAA’s website at www.ncaa.org.
 


 

Injury Claim Procedures

To avoid any issues with unpaid claims, it is important that student-athletes and their parents/guardians know the proper procedures for filing claims with SWU’s secondary insurance.  Many medical providers OUTSIDE of SWU’s team physicians often don’t have SWU’s secondary insurance information on file.  When student-athletes visit these providers, they will often receive claims/statements in the mail with a remaining balance due.  If the injury was sustained during an official athletic activity, SWU’s secondary insurance policy should cover these charges.  When a student-athlete receives a medical bill in the mail, the SWU Sports Medicine Staff can review the information and advise on what needs to be done, but it is the responsibility of the student-athlete to submit all claims to the secondary insurance company.    

 
Student-Athlete’s/Parents/Guardians You Should Do the Following:
                                   
 
ATHLETES WILL NOT BE ABLE TO PARTICIPATE UNTIL ALL FORMS ARE SIGNED AND COMPLETED IN FULL, INCLUDING UPLOADED INSURANCE CARDS.
 
Please complete the Insurance/Contact Info form with correct information.  This form is required in order for student athletes to be cleared for participation.  You must also include a copy of both the front and back of your insurance card.