MGH INSTITUTE OF HEALTH PROFESSIONS
Student Health Insurance Plan
Frequently Asked Questions
GENERAL
Who is Wellfleet Student? Who is University Health Plans? What are their roles? How do I contact them?
Wellfleet Student is the claims administrator for the health insurance plan. Wellfleet Student is responsible for answering questions about insurance benefits, claims and providing replacement ID cards. If you have any questions for Wellfleet Student, please call 877-657-5030. University Health Plans (UHP) is the broker/plan manager who handles the enrollment process for the school health insurance plan. Please email UHP at info@univhealthplans.com or call 800-437-6448 if there are any questions about your enrollment or if there are customer service issues with Wellfleet Student.
Do I get an insurance card?
Yes. When your enrollment in the Student Health Insurance Plan is submitted to Wellfleet Student, you will receive an email with instructions on how to create an account and download your insurance ID Card.
What if I lost my insurance card?
You will have the ability to download as many copies of your ID card as is necessary. It is suggested that you save the image of your insurance ID card to your mobile or smart phone device.
How can I determine which providers I can see?
You can seek treatment from any provider. The insurance will pay a percentage of the Reasonable & Customary charges for services that are covered by the plan.
Your out-of-pocket costs may be lower when you utilize the Cigna PPO Network of Participating Providers. For a listing of Cigna PPO Network Participating Providers, go to https://hcpdirectory.cigna.com/web/public/providers or contact www.wellfleetstudent.com.
Who should I contact for updating my personal information such as a mailing address, name, etc.?
Please call UHP at 800-437-6448 to update your personal information.
CLAIMS
Once I receive treatment, is there anything that I need to do to have my claim processed?
Submit all medical claims to:
CIGNA
P.O. Box 188061
Chattanooga, TN 37422-8061
Electronic Payer ID: 62308
Note: Claims submitted directly to Wellfleet Student will be denied and you will be asked to resubmit them to CIGNA.
Although you are not required to submit a student claim form to Wellfleet Student each time, there may be situations where Wellfleet Student contacts you for additional information about your injury, other insurance plans that are possibly covering you, etc. If Wellfleet Student sends you a form to complete, the processing of your claim may stop until the form is properly completed and returned to the address indicated in the request.
How can I check the status of a claim I submitted?
You can check your claims status at www.wellfleetstudent.com. To view information unique to you, you must be registered online. For first time users, you may register at www.wellfleetstudent.com. For returning users, simply "Login" with your username and password.
You can also contact Wellfleet Student via phone at 877-657-5030.
What if I can't remember my password?
You can retrieve your password by providing answers to the security questions you established when you registered on www.wellfleetstudent.com.
What are some of the reasons Wellfleet Student might not reimburse my medical provider for a claim I submitted?
Wellfleet Student will send a letter when a claim is denied. The following are common reasons for denial:
- The claim was not submitted to Cigna. Claims submitted directly to Wellfleet Student will be denied and you will be asked to resubmit them to Cigna at the address shown on the back of your ID card.
- Other insurance may be responsible for paying the claim.
- The services may not be covered according to the exclusions listed in your Student Health Insurance Program brochure.
- The claim may not have occurred while you were covered.
- The charges may be over the Reasonable and Customary amount (any questions about the Reasonable and Customary policy please contact Wellfleet Student).
If I am in a car accident or sustain any other injury, what kind of documents will I need in order to submit a claim form for reimbursement?
You will be asked for a description of the accident, other coverage information and perhaps a police report. A letter from Wellfleet Student will be sent to you requesting the pertinent information.
I have exhausted my medical benefits, what are my options?
You should speak with your provider to see if they can set up a payment schedule with you that meets your financial needs. Depending on your circumstances you may qualify for some state aid.
BENEFITS/COVERAGE
If I have a benefit question about my policy, who should I ask?
We recommend that you familiarize yourself with your covered benefits located in the Student Health Insurance Program brochure. If you still need assistance, please email or call Wellfleet Student and a claims administrator can help you with your benefit questions.
Does MGHIHP's Insurance cover prescription drugs?
Yes. Your student insurance covers prescription drugs to the plan maximum, subject to copays per 30 day prescription. Please refer to the on-line plan brochure for details.
Which pharmacy can I go to get my prescription?
You can go to any participating pharmacy that is part of the Cigna PBM, such as CVS and Walgreens, etc. To find out more about participating pharmacies, you can look up participating pharmacies via this link: https://hcpdirectory.cigna.com/web/public/providers.
Prescription filled at an Out-of-Network Pharmacy are not covered by this Plan.
Does this plan cover dental?
The only dental coverage that you will have is when you need treatment for any injury to sound natural teeth or for the removal of impacted wisdom teeth ($300 maximum per tooth).
There are voluntary Delta Dental Plans that are available to you. The premium for the voluntary dental plan is not included with your Health plan premium. You may enroll in and pay for the Delta Dental Plans on the UHP website during open enrollment periods. Please see the UHP website for enrollment deadlines and more details. From the UHP home page, select your school and then click on "Voluntary Delta Dental Plans".
Does this plan offer any vision benefits?
This plan provides a vision discount plan. For details, go to https://consolidatedhealthplan.com/products/davisvision.
There is also a voluntary VSP Vision Care Plan that is available to you. The premium for the voluntary vision plan is not included with your Health plan premium. You may enroll in and pay for the VSP Vision Care plan on the UHP website during open enrollment periods. Please see the UHP website for enrollment deadlines and more details. From the UHP home page, select your school and then click on "Voluntary VSP Vision Care Plan".
What is a "pre-existing condition"? How does this affect me as a consumer of this health insurance?
A pre-existing condition is any condition which originates, is diagnosed, treated or recommended for treatment within six (6) months immediately prior to the Insured Person's Effective Date of coverage under this Policy (Diagnosis, care and treatment will not include any prior diagnosis of or treatment for infertility.)
What is the policy regarding pre-existing conditions?
Pre-existing conditions are not excluded, and will be covered the same as any other condition and are subject to the same limitations that all other conditions are subject to.
What is a reasonable and customary charge and how does that charge affect me as a consumer?
Reasonable and Customary (R&C) charge means the normal and customary charge of the provider, incurred by the Covered Person, in the absence of insurance for a service or supply, but not more than the prevailing charge in the area. If you are treated by an out-of-network provider, there may be a difference between what they are charging and what is considered Reasonable & Customary. You would be responsible for that difference.
