School-Sponsored Student Health Insurance Program and Waiver Process
Berklee strives to create a healthy and safe community in which you can live, learn, work, and perform. To help you maintain your wellbeing, the institution sponsors a Student Health Insurance Plan (SHIP).
The state of Massachusetts requires that students be enrolled in a health insurance plan that offers comprehensive coverage. All coverage must be in effect while you are in Massachusetts and be compliant with state and federal regulations under the Affordable Care Act. We also recommend that your insurance plan provide coverage anywhere in the United States and abroad, and include provisions for medical evacuation and repatriation of remains.
All students are automatically enrolled in and charged for the Berklee SHIP.
The Berklee SHIP is underwritten by Blue Cross Blue Shield of Massachusetts and administered by Gallagher Student Health and Special Risk (gallagherstudent.com/berklee).
For more information on coverage details, please contact Gallagher Student Health and Special Risk Customer Service.
You may waive (decline) participation in the Berklee SHIP if you can demonstrate coverage with a comparable insurance plan that is consistent with existing state and federal requirements for students enrolled in colleges and universities in Massachusetts. The insurance coverage requirements for waiving the SHIP are not internal policies set by Berklee.
As insurance plans can vary, determining what constitutes comparable coverage in order to waive the SHIP is a complex process. Because of this, we contract with Gallagher Student Health and Special Risk to review all waiver submissions. Berklee defers to Gallagher Student Health's decisions on matters related to waiver approvals and denials.
For more information on what may be considered as a comparable insurance plan, visit the Gallagher Student Health website page for Berklee, select "My Benefits and Plan Information" in the left navigation bar, and download the most recent Frequently Asked Questions PDF.
The waiver is completed online on Gallagher Student Health's website. You must complete an online waiver for each new academic year during which you do not want the institution's plan. Verbal waiver requests, letters, and copies of insurance cards will not be accepted. Should your waiver be denied, information on how to appeal a waiver denial will be available directly to students on the denial email. All decisions made by Gallagher Student Health are final.
Insurance ID cards are mailed directly to students by Blue Cross Blue Shield (BCBS). Cards are sent after our insurance administrator confirms student enrollment, which occurs after the waiver period has ended.
If you need a replacement ID card, you can request one by logging on to the BCBS website at bluecrossma.com/myblue or by calling 800-253-5210.
BCBS will use the address on file with the Berklee Registrar. If the Berklee Registrar only has your home address (instead of your local address), the ID card will be sent to your home address. You will need to have your cards forwarded to you from your home address, or you will need to update your local address with the Registrar. You can also update your address by contacting our insurance administrator, Gallagher Student Health.
Electronic ID cards
Electronic ID cards are available online through the MyBlue app, which is available in the app store or on Google Play. You’ll need your BCBS ID number (not your Social Security number) to create your account. Your BCBS ID number is available in the "Account Home" section of the Gallagher Student Health website.
If you are having difficulty logging in to gallagherstudent.com/berklee, please contact Gallagher Student Health and Special Risk Customer Service.
The preferred provider network for the Berklee SHIP is Blue Cross Blue Shield of Massachusetts. A preferred provider is a doctor, hospital, or other health care provider that participates in the Blue Cross Blue Shield of Massachusetts Blue Care Elect PPO Network. You receive the highest level of benefits under your health care plan when you obtain covered services from preferred providers. These are called your “in-network” benefits.
There are a few ways to find a preferred provider:
Look up a provider in the provider directory. If you need a copy of your directory, call member services at the number on your ID card.
Visit the Blue Cross Blue Shield of Massachusetts website at bluecrossma.com/findadoctor (click the orange "Go to find a doc without logging in" box, then "Select your network to continue without logging in," and chose "PPO/EPO" from the drop-down menu).
Call the Physician Selection Service at 800-821-1388.
In order to find a BCBS participating provider outside of Massachusetts, you can seach for a worldwide provider using the BCBS National Doctor and Hospital Finder.
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.
Gallagher Student Health offers students the option to enroll family members in the Berklee SHIP. This includes a spouse or children under the age of 26 who reside with the student.
As of June 26, 2015, the U.S. Supreme Court ruled that the U.S. Constitution grants same-sex couples the right to marry in all states. Therefore, fully insured health plans in all states must consider same-sex spouses eligible for the same coverage as spouses of the opposite sex. (Note: BCBS of Massachusetts plans currently do not offer coverage for domestic partners, regardless of gender.)
Enrollment of dependent(s) may take place at the time of the student's enrollment in the plan or after a qualifying event.
Qualifying events include the following:
Birth of a child/children
A dependent entering the country for the first time
If the student experiences one of these qualifying events, dependent enrollment must be completed within 31 days of the qualifying event. Applications received more than 31 days after the qualifying event will not be processed. Once a dependent is enrolled, coverage cannot be terminated unless the student loses eligibility.
For more information and to enroll a dependent, visit the Gallagher Student Health page and select "Dependent Enroll" in the left navigation bar. For information about costs and other details, call Gallagher Student Health at 800-391-8057.
There is a pediatric preventive dental benefit and a pediatric preventive vision benefit available for students up to the age of 19 and their enrolled eligible dependents up to the age of 19. Please see the Berklee SHIP brochure for details.
Students enrolled in the Berklee SHIP have access to discount programs available exclusively from Gallagher Student Health at no additional cost. These plan enhancements, called Gallagher Student Complements, include the Basix Dental Savings Program and EyeMed Vision Care.
For information on purhasing voluntary dental coverage, please go to “Other Insurance Products."
Basix Dental Savings Program
The Dental Savings Program, operated by Basix, LLC, provides students with access to general and specialty dental care from a select network of local dentists who have met strict credentialing and quality assurance requirements. The participating dental providers have agreed to charge a reduced fee for the services they provide. Because the Dental Savings Program is not an insurance plan, there are no claim forms, annual maximums, benefit limitations and conditions, or other plan provisions.
Visit basixstudent.com to locate participating dental providers, download the fee schedule, and learn more about the program. A dentist's office may ask for your student ID and student health plan ID card to make sure you have access to the program. If the office needs to check eligibility, call Gallagher Student Health at the number on your SHIP card. Remember, you must pay for the services you receive at the time of service, so make sure you understand what forms of payment (check, credit card, etc.) the dentist accepts. If you cover dependents through your student health plan, the dependents may use the Dental Savings Program as well.
EyeMed Vison Care
Students are automatically enrolled in the discount vision plan available through EyeMed Vision Care. EyeMed's provider network consists of over 45,000 independent providers and retail stores nationwide, including LensCrafters, Pearle Vision, Sears Optical, Target Optical, JC Penney Optical, and many private practitioners. Since this is not an insurance plan, there is no waiting period. Enrolled students can take advantage of the savings through EyeMed immediately upon receipt of their separate ID card.
Gallagher Student Health also offers students the following insurance products:
Personal property insurance
Study abroad insurance
Short-term medical insurance (ideal for graduating students but not available to those staying in Massachusetts)
If you have questions or would like more information, please contact Gallagher Student Health.
First Year Abroad Students
If you are spending your first year on the Valencia, Spain, campus, please see First Year Abroad health insurance information.
Continuing Students Studying Abroad
If you are a continuing Berklee student doing a semester abroad, please see health and travel insurance information for Berklee Study Abroad.
The prescription drug program is available through the Berklee SHIP. BCBS uses the Express Scripts pharmacy network, which includes national retail pharmacies as well as local independent pharmacies.
Detailed information about BCBS's pharmacy program is available at Blue Cross MA Pharmacy Coverage.
To find a participating pharmacy, call Express Scripts customer service at 800-711-0917 or go to gallagherstudent.com/Berklee and select "Pharmacy Program" from the links on the left.
For more information on prescription drug coverage under the Berklee SHIP, visit Blue Cross Massachusetts Pharmacy Coverage.
Mail Service Pharmacy
Prescriptions are also available through Express Scripts' mail service pharmacy.
For questions about using this pharmacy, call member services at the number printed on your BCBS member ID card or visit Mail Service Pharmacy. If you have questions regarding the status of your prescription that you ordered using thepharmacy, call Express Scripts customer service at 800-892-5119.
A claim is a request for payment for services or treatment rendered under the terms of an insurance policy. BCBS of Massachusetts is responsible for processing claims for students that are enrolled in the SHIP. Their dedicated claims analysts and customer service representatives can address any questions you have on an outstanding claim or on how a claim has been paid.
To check on the status of a claim, go to BCBS Member Central and log in to look up a specific claim or view a list of all claims submitted.
For additional questions regarding claims, call BCBS at 800-241-0803.
Students insured under the SHIP may utilize a 24/7 nurse help line service that provides clinical assessment, education, and general health information. This service is performed by a registered nurse counselor to assist in identifying the appropriate level and source(s) of care for insured students (based upon symptoms reported and/or health questions asked by or on behalf of the insured). Nurses will not diagnose an insured person's ailments.
In order to access the nurse help line, call 800-407-7307.
More information is available here: Blue Care Nurse Advice Line.
Students who are enrolled in MassHealth, one of the MassHealth Managed Care Organizations (MCO), or one of the new Accountable Care Organizations (ACO) may qualify to have the SHIP premium paid for through the MassHealth Premium Assistance program.
To qualify to have your SHIP premium paid for by the Premium Assistance program:
you must be an active MassHealth member,
you must maintain eligibility for the SHIP, and
you must qualify for Premium Assistance.
For more information, please visit the MassHealth Premium Assistance (MHPA) for the Student Health Insurance Plan (SHIP) page provided by Gallagher Student Health and Special Risk.