Student Health Insurance FAQs

For information about Berklee's Student Health Insurance Plan (Blue Cross Blue Shield PPO Student Health Plan), including what's covered, how to access benefits, enrollment concerns, waiving coverage, finding participating providers, or replacement ID cards, select an option from the links on the left, or visit gallagherstudent.com/Berklee. There, you can view personal and dependent coverage information, download a plan brochure, learn more about discounts and wellness services available to you, contact customer service with specific questions about your coverage, or engage in a live chat with a Gallagher Student representative.

For a detailed listing of plan benefits and out-of-pocket costs, click here to download the Berklee Student Health Plan: 2014-2015 Summary of Benefits.pdf.

 

We've also put together the following list of frequently asked questions about Berklee's student health insurance.

How do I enroll?

Who do I call if I have questions about the student health insurance plan?

When will I get my ID card?

How can I get my prescriptions if I don't get my card until after the start of the semester?

What do I do if I go to the pharmacy and they say that I don't have insurance coverage when I know that I do?

What are the costs of copayments for doctor visits?

What are the costs of copayments for prescriptions?

What do I do if I get a bill in the mail stating that I owe money for a recent medical service?

Is there dental coverage?

Will the student health insurance cover me even though I'm going to graduate this May?

Can I continue coverage after the policy terminates?

Will the student health insurance cover me if I decide to study abroad?

Can I add my spouse and/or child to the student health insurance plan?

Can I get insurance if I'm on Practical Training?

Where is the nearest health care facility?

Does the student health insurance cover immunizations?

What are the QSHIP laws and what does having comparable student health insurance coverage mean?

Where can I get a list of network providers in the area?

What is the difference between "in-network" and "out-of-network"?

If I'm terminated from my parent's insurance, can I opt in to Berklee's student health insurance?

 

Q: How do I enroll?

All registered students at Berklee College of Music taking credit hours who do not submit a Health Insurance Waiver Form by the posted deadline will be automatically enrolled in and billed for the Student Health Insurance Plan for the policy year. To waive the health insurance fee for fall 2014, you must submit an online waiver no later than August 1, 2014.

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Q: Who do I call if I have questions about the student health insurance plan?

For questions about what's covered, benefits, enrollment concerns, or replacement ID cards, call Gallagher Student at 800 391-8057; email them at Berkleestudent@gallagherstudent.com, or visit gallagherstudent.com/Berklee.

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Q: When will I get my ID card?

You will receive your insurance ID card from Blue Cross Blue Shield at the address the school has on file for you—either your on-campus address or your local address. Cards are usually sent 7 - 10 business days after Gallagher Student has received your enrollment confirmation.

Please call Blue Cross Blue Shield at 888 753-6615 or Gallagher Student at 800 391-8057 with any questions regarding the status of your ID card or to request a replacement.

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Q: How can I get my prescriptions if I don't get my card until after the start of the semester?

If you need to see a doctor or fill a prescription before you receive your ID card, tell the provider or pharmacy that you are covered under the Blue Cross Blue Shield PPO Student Health Plan. Providers can call either Blue Cross Blue Shield at 888 753-6615 or Gallagher Student at 800 391-8057 to confirm your eligibility. You do not need your card in order to be eligible to receive benefits.

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Q: What do I do if I go to the pharmacy and they say I don't have insurance coverage when I know that I do?

Show the pharmacy your ID card or tell them that you are covered by the Blue Cross Blue Shield PPO Student Health Plan. They can call either Blue Cross Blue Shield at 888 753-6615 or Gallagher Student at 800 391-8057 to confirm your eligibility. You can also call Express Scripts at 800 711-0917 to confirm that the pharmacy is in the Express Scripts network.

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Q: What are the costs of copayments for doctor visits?

The cost varies depending on whether you have received services from a preferred provider ("in-network") or a non-preferred provider ("out-of-network"). You receive the highest level of benefits and save money by staying "in-network." Generally, you receive full coverage for most hospitals, physicians, and other providers that participate in the Blue Cross Blue Shield Blue Care Elect Enhanced Value (PPO) Network, although for some outpatient services, you may pay a $20 copayment for each visit. You pay a $150 copayment per visit for in-network or out-of-network emergency room services.

Note: If a preferred provider refers you to another provider for covered services (such as a lab or specialist), make sure the referred provider participates in the BCBS Blue Care Elect Enhanced Value (PPO) Network in order to receive benefits at the in-network level. If the provider you use is not a preferred provider, you're still covered, but your benefits, in most situations, will be covered at the out-of-network level, even if you were referred by a network provider.

You can also obtain services from non-preferred providers, but your out-of-pocket costs will be higher and you must pay a policy-year deductible of $250 per person for most services received from an out-of-network provider.

To locate participating providers, go to gallagherstudent.com/Berklee and select "Find a Doctor" in the menu on the left. Or visit Blue National Doctor and Hospital Finder to locate healthcare providers within the U.S., Puerto Rico, and U.S. Virgin Islands, or to find a doctor or hospital worldwide.

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Q: What are the costs of copayments for prescriptions?

The pharmacy benefit program is managed by Express Scripts and includes retail chains as well as independent pharmacies. At participating Express Scripts pharmacies, you will pay a $15 copayment for a 30-day supply of a tier-1 drug; a $30 copayment for a 30-day supply of a tier-2 drug; and a $50 copayment for a 30-day supply of a tier-3 drug. To find a participating pharmacy, call Express Scripts at 800 711-0917 or go to gallagherstudent.com/Berklee and select "Pharmacy Program" from the links on the left.

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Q: What do I do if I get a bill in the mail stating I owe money for a recent medical service?

Blue Cross Blue Shield providers will bill Blue Cross Blue Shield directly. The billing information is on the back of your health insurance ID card. However, should you receive a bill or need to be reimbursed for services, please send your bill (and proof of payment if seeking reimbursement) to the claims administrator. You do not need an additional claim form. Make sure your name, health insurance ID number, and school name are on the bill, and make a copy for your records before sending to the claims administrator at Blue Cross Blue Shield, P.O. Box 986020, Boston, MA 02298.

Blue Cross Blue Shield will reimburse members directly for covered services rendered by providers who do not participate in certain Blue Cross Blue Shield products and services. It will be the responsibility of the student to reimburse the non-participating provider. The payment to the student will reflect the provider's billed charge, less any applicable copayments, co-insurance, or deductibles.

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Q: Is there dental coverage?

No, but students enrolled in Berklee's Student Health Insurance Plan have access to the Basix Dental Savings Program, a discount program available exclusively from Gallagher Student at no additional cost. It is important to understand that the Dental Savings Program is not dental insurance. Think of the program as pooling the purchasing power of thousands of students to obtain better rates for dental services. The Dental Savings Program allows students to pay reduced fees for services; the reduction can be as high as 50 percent of the dentist's billed charges. Payment for the services you receive is required at the time of your visit; however, you'll pay the dentist at the reduced rates. For more information and a list of contracted providers and the fees they accept, go to gallagherstudent.com/Berklee, select "Discounts and Wellness" in the menu on the left, then "Gallagher Student Complements," or visit basixstudent.com.

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Q: Will the student health insurance cover me even though I'm going to graduate this May?

Yes. You will be covered under the student health insurance plan until the policy year ends on August 14, 2015.

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Q: Can I continue coverage after the policy terminates?

Yes. To continue coverage on a direct-pay basis through Blue Cross Blue Shield after your policy terminates, visit bluecrossma.com and select "Vistor" and then "Plans & Products" to review and compare plans. You can also contact Gallagher Student at gallagherstudent.com/Berklee for other possible plan options.  

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Q: Will the student health insurance cover me if I decide to study abroad?

Yes, the Student Health Insurance Plan (Blue Cross Blue Shield PPO Student Health Plan) covers you during semester breaks, summer vacation, and even if you're traveling or studying abroad, providing the same benefits as if you were on campus for the period for which you paid the premium.

In addition to coverage for medical treatment and services, you will also be covered for Repatriation of Remains, Emergency Medical Evacuation, and Travel Assistance Services through On Call International, the 24-hour worldwide assistance service. All services must be arranged for in advance and provided by On Call International. For more information, go to gallagherstudent.com/Berklee, and select "My Benefits and Plan Information" in the menu on the left for details on the services offered by On Call International.

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Q: Can I add my spouse and/or child to the student health insurance plan?

Yes, insured students may also enroll their spouse, domestic partner, and/or children under the age of 26 who reside with the student. Dependent coverage must be purchased for the same time period as the student's period of coverage and cannot exceed coverage purchased by the student. The enrollment deadlines to add dependents are September 15 (fall), February 15 (spring), and June 15 (summer). Students may enroll their eligible dependents online for an additional premium by visiting gallagherstudent.com/Berklee, selecting "Dependent Enroll", and completing the form by the published deadline. For information on additional premium costs (above the student premium) and coverage dates, contact Gallagher Student at 800 391-8057 or email them at Berkleestudent@gallagherstudent.com.

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Q: Can I get insurance if I'm on practical training?

Yes. Students approved for practical training are eligible to enroll in the Student Health Insurance Plan (Blue Cross Blue Shield PPO Student Health Plan) on a voluntary basis. You must sign up for health insurance at the Office of the Registrar and show your Practical Training Card or I-20 form; then pay the health insurance fee to the Bursar's Office.

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Q: Where is the nearest health care facility?

View a list of the many local health care facilities here. More listings are available in the Counseling and Advising Center, the Student Activities Center, and your local/Boston-area phone book. Please note: A referral by a primary care physician may be required for off-campus specialist services. Contact your health insurance provider before your visit for coverage information. Berklee College of Music does not endorse any specific services.

For students who are new to the Boston area or who do not have an existing relationship with a doctor, there are a number of group practices in the Back Bay - Fenway - Downtown area that are close by and easy to get to. Here are three that are preferred providers in the Blue Cross Blue Shield PPO Student Health Plan.

Harvard Vanguard Medical Associates

133 Brookline Avenue, Boston, MA 02215
Phone: 617 421-1000
harvardvanguard.org

A multi-specialty group practice offering a wide range of medical and surgical specialties. Conveniently located in Kenmore Square, Harvard Vanguard also offers urgent care hours for sudden illnesses "after hours" and during evenings and weekends.

Hours of Operation
Monday through Friday, 8:00 a.m. to 5:00 p.m.
Urgent care hours: Monday through Friday, 8:00 a.m. to 8:00 p.m.; Saturday, 10:00 a.m.–5:00 p.m., and Sunday, 12:00 p.m.–5:00 p.m. Holiday: varied hours

Massachusetts General Hospital (MGH) - Back Bay

388 Commonwealth Avenue, Boston, MA  02215      
Phone: 617 267-7171
massgeneral.org/backbay

Conveniently located on Commonwealth Avenue, MGH Back Bay offers primary care services by appointment. A nurse is also available by telephone or email (Patient Gateway) to answer specific health questions. 

Hours of Operation
Monday through Friday, 8:30 a.m. – 5:00 p.m. by appointment

Massachusetts General Hospital - Medical Walk-In Unit

Wang Ambulatory Care Center, Suite 108
15 Parkman Street, Boston, MA 02114  
Phone: 617 726-2707
massgeneral.org/appointments/walkinunit/

An alternative to the emergency room, the Medical Walk-In Unit provides urgent care for adults (18 years and over). Patients are seen on a first-come, first-served basis, with extremely urgent cases receiving priority attention.

Hours of Operation
The Medical Walk-In Unit is open every day except for Thanksgiving and Christmas:
Monday through Friday, 8:30 a.m. to 8:00 p.m.
Weekends and holidays, 9:30 a.m. to 4:00 p.m.

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Q: Does the student health insurance cover immunizations?

Yes. Immunizations fall under Preventive Care Services and are covered at 100% (no co-payments or deductibles) when services are received by in-network providers. Other Preventive Health/Wellness Benefits include, but are not limited to, routine physical exams, routine GYN exams, and preventive screening and testing.

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Q: What is the SHP law, and what does having comparable student health insurance coverage mean?

Massachusetts law requires all students enrolled in colleges and universities located within the state to either participate in a school-sponsored Student Health Program (SHP, previously called QSHIP), or provide documentation of comparable coverage through their own or their family's insurance provider. To ensure compliance with the SHP law, Berklee College of Music students registered for credits who do not submit an insurance waiver by the deadline are automatically enrolled in and billed for the Student Health Insurance Plan (Blue Cross Blue Shield PPO Student Health Plan). Please note: International students cannot waive coverage unless they are currently enrolled in an insurance plan of comparable coverage through a U.S.-based insurance carrier. 

If you are under the age of 26, you MAY be eligible to enroll as a dependent under the employer health insurance plan held by your parent(s). However, before you do so, you should fully compare the employer plan against Berklee's Student Health Insurance Plan to determine which plan’s rates, benefits, and coverage are most appropriate for you.

For more information on the waiver process and determining comparable coverage, see Waiving Berklee Student Health Insurance. You can view and download a summary of benefits for plan comparison at gallagherstudent.com/Berklee or email Berkleestudent@gallagherstudent.com to find out what questions you should ask your current health insurance plan to make sure it's comparable.

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Q: Where can I get a list of network providers in the area?

To locate participating providers in the Blue Cross Blue Shield Student Blue Plan Preferred Provider PPO network, go to gallagherstudent.com/Berklee, and select "Find a Doctor" in the menu on the left, or visit Blue National Doctor and Hospital Finder to locate healthcare providers within the U.S., Puerto Rico, and U.S. Virgin Islands, or to find a doctor or hospital worldwide.

For students who are new to the Boston area or who do not have an existing relationship with a doctor, there are a number of group practices in the Back Bay - Fenway - Downtown area that are close by and easy to get to. Here are three that are preferred providers in the Blue Cross Blue Shield PPO Student Health Plan.

Harvard Vanguard Medical Associates

133 Brookline Avenue, Boston, MA 02215
Phone: 617 421-1000
harvardvanguard.org

A multi-specialty group practice offering a wide range of medical and surgical specialties. Conveniently located in Kenmore Square, Harvard Vanguard also offers urgent care hours for sudden illnesses "after hours" and during evenings and weekends.

Hours of Operation
Monday through Friday, 8:00 a.m. to 5:00 p.m.
Urgent care hours: Monday through Friday, 8:00 a.m. to 8:00 p.m.; Saturday, 10:00 a.m.–5:00 p.m., and Sunday, 12:00 p.m.–5:00 p.m. Holiday: varied hours

Massachusetts General Hospital (MGH) - Back Bay

388 Commonwealth Avenue, Boston, MA  02215      
Phone: 617 267-7171
massgeneral.org/backbay

Conveniently located on Commonwealth Avenue, MGH Back Bay offers primary care services by appointment. A nurse is also available by telephone or email (Patient Gateway) to answer specific health questions. 

Hours of Operation
Monday through Friday, 8:30 a.m. – 5:00 p.m. by appointment

Massachusetts General Hospital - Medical Walk-In Unit

Wang Ambulatory Care Center, Suite 108
15 Parkman Street, Boston, MA 02114  
Phone: 617 726-2707
massgeneral.org/appointments/walkinunit/

An alternative to the emergency room, the Medical Walk-In Unit provides urgent care for adults (18 years and over). Patients are seen on a first-come, first-served basis, with extremely urgent cases receiving priority attention.

Hours of Operation
The Medical Walk-In Unit is open every day except for Thanksgiving and Christmas:
Monday through Friday, 8:30 a.m. to 8:00 p.m.
Weekends and holidays, 9:30 a.m. to 4:00 p.m.

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Q: What is the difference between "in-network" and "out-of-network"?

A preferred provider or "in-network" provider is a doctor, hospital, or other health care provider that participates in the Blue Cross Blue Shield Blue Care Elect Enhanced Value (PPO) Network. The advantage to using a preferred provider is that these providers have agreed to accept a predetermined fee or preferred allowance as payment for their services. Therefore, when you choose preferred providers, you receive the highest level of benefits under your health care plan and lower out-of-pocket expenses.

You can also obtain covered services from non-preferred or "out-of-network" providers, but since these providers have not agreed to any prearranged fee schedule, your out-of-pocket costs will be higher. Also, you must pay a $250 per person, policy-year deductible for most out-of-network covered services.

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Q: If I'm terminated from my parent's insurance, can I opt in to Berklee's student health insurance?

If you’ve waived the student health insurance plan for fall 2014 – summer 2015, but your alternative insurance plan unexpectedly terminates before August 14, 2015, you may late enroll for Berklee’s plan as follows:

Students must submit a Petition to Add Form within 60 days of the qualifying event in order for the effective date of coverage to be the day of the qualifying event. If the Petition to Add Form is received after 60 days of the qualifying event, the effective date of coverage will be the date the petition is received at Gallagher Student. You can download a Petition to Add Form at gallagherstudent.com/Berklee. In addition to the Petition to Add Form, a letter from the previous insurance company MUST be provided stating the reason for the student’s ineligibility and the date the student became ineligible.

For more information, see "Unexpected Termination of Alternative Insurance Plan" under Eligibility and Enrollment.

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