Skip Navigation
 
 

Student Health Form Requirements


Health Services seeks to ensure a safe, healthy environment for the entire campus community. In order to do so, there are items that are required of every undergrad and seminarian. Please read everything carefully and submit the information by June 30.

Required Health Insurance: Due Aug. 15

Each student at the Mount is required to have health insurance coverage either through a qualified insurance plan or through the school sponsored insurance program (SHIP). If you do not enroll or waive the insurance coverage you will automatically be enrolled in the school sponsored insurance program (SHIP) at the cost of $1,678 for the 2018-19 academic year.

Do I Enroll or Waive the SHIP?

Enroll in the SHIP

  1. All full-time undergraduate students who do not have health insurance that meets MSMU’s criteria must enroll in the SHIP.

  2. The $1678 SHIP includes $99 in administrative fees and a $1579 premium for a one-year term of insurance, effective 8/1/2018 - 7/31/2019.

  3. The SHIP does not automatically renew and paying for it via your student account does not guarantee your enrollment. You must complete the enrollment process online before the beginning of every school year.

To enroll login to the Hulse/QM website using your ID (student's last name and first name initial, example for Pat Smith: smithp) and your password (student ID number). Select "Enroll" and continue. Please print out or take a screen shot of the confirmation page for your records.

Waive the SHIP

  1. To waive the SHIP, you are required to have comparable health insurance that covers you in the Emmitsburg area.

  2. To submit a waiver request, log on to the website and enter information from your current health insurance card.

  3. You must complete this waiver process before the beginning of every school year.

To waive login to the Hulse/QM website using your ID (student's last name and first name initial, example for Pat Smith: smithp) and your password (student ID number). Select "Waive" and continue. Please print out or take a screen shot of the confirmation page for your records.

Cost

$1,678 - is the cost of the school sponsored insurance (SHIP) with coverage from 8/1/18 to 7/31/19.

QM Services and Questions

Mount St. Mary’s University has hired QM Services to process our student insurance enrollments and waivers. If you have questions about the online process or SHIP, please contact QM Services at 1-800-273-1715 or visit the Hulse/QM Health website.

Required Health Forms - New Students: Due June 30

For new undergraduate students and seminarians entering the Mount in the fall, the following forms are due at Orientation or not later than June 30. If you are unable to schedule a physical before this due dates, please complete pages 1,3, 4 and 5 and attach a note stating date of physical. Once physical is complete, please submit page 2 to health services. Please call us with any questions.

Print and complete these required forms:

Cover Letter  (.pdf) Important to read first
Health History Form (.pdf page 1)
Physical Examination Form (.pdf page 2)
Immunization Form (.pdf page 3) or Waiver for Immunizations (.pdf)
Meningitis Information/Waiver *  (.pdf page 4)
Emergency Information (.pdf page 5)
► New NCAA student-athletes are also required to fill out additional athletics forms.

* Effective June 1, 2000 Maryland law requires that an individual enrolled in an institution of higher education in Maryland who resides in on-campus student housing must be vaccinated against meningococcal disease.

Please mail your forms to:

Mount St. Mary's University
Attention: Health Services
16300 Old Emmitsburg Road
Emmitsburg, MD 21727

Faxed forms will not be accepted


Returning Students and Seminarians

Returning students and seminarians must do the following:

  • Inform Health Services of any changes in your health insurance plan;
  • Inform Health Services of any changes in medications or diagnosis;
  • Update your Emergency Contact information.

Health Services seeks to insure a safe, healthy environment for the entire campus community, we cannot impress upon you enough the importance of getting this information to us in a timely manner.

If you have any questions about Health Services or what is required, please call 301-447-5288 or email healthservices@msmary.edu. The Health Services staff is looking forward to having you as a part of the Mount St. Mary’s University family again.

 
16300 Old Emmitsburg Road | Emmitsburg, MD 21727
Map & Directions | admissions@msmary.edu | 301-447-6122
Frederick Campus | 5350 Spectrum Drive | Frederick, MD 21703
Map & Directions | inquiry@msmary.edu | 301-682-8315