School-Sponsored Student Health Insurance Program and Waiver Process

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.

Blue Cross Blue Shield of Massachusetts is closely monitoring the coronavirus on behalf of its members. Visit home.bluecrossma.com/coronavirus# for more information.

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 their 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.  

Waiver Process

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 in the denial email. All decisions made by Gallagher Student Health are final.  

For more information and to fill out the waiver form, visit the Gallagher Student Health page for Berklee and select "Student Waiver" (login required) in the left navigation bar.

For Fall 2020 Only: Covid-19 Waiver Information

All registered students taking credit hours—regardless of where you are—are automatically enrolled in and billed for the Berklee SHIP offered by Blue Cross Blue Shield of Massachusetts. Due to the pandemic, waiver requirements have been relaxed, and you may be able to waive the SHIP with insurance that is otherwise not comparable.

If you want the SHIP, you do not need to take any action except to pay the charge on your student account.

If you do not want the SHIP, you must take action:

• If you will be in Massachusetts for the fall 2020 semester, you will need to demonstrate that your own insurance plan is comparable to the SHIP, regardless of your citizenship. Please note that out-of-state HMOs, out-of-state Medicaid plans, and all international health plans are not comparable, and your request to waive the SHIP will be declined.
• If you will not be in Massachusetts, but will be in the United States for the fall 2020 semester:
  • Domestic students: You may be able to waive the SHIP with a plan that is not typically considered to be a comparable plan with the SHIP. These include out-of-state HMOs and out-of-state Medicaid plans. However, you will still need to demonstrate proof of coverage wherever you are located in order to request a waiver for the SHIP.
  • International students: All international health plans are not comparable, and your request to waive the SHIP will be declined.
• If you will not be in the United States for the fall 2020 semester:
  • U.S. citizens: You may be able to waive the SHIP with a plan that is not typically considered to be a comparable plan with the SHIP. These include out-of-state HMOs and out-of-state Medicaid plans. However, you will still need to demonstrate proof of coverage wherever you are located in order to request a waiver for the SHIP.
  • Non-U.S. citizens: You may be able to waive the SHIP with a plan that is not typically considered to be a comparable plan with the SHIP, such as international health plans or a government-sponsored health plan in your home country. However, you will still need to demonstrate proof of coverage wherever you are located in order to request a waiver for the SHIP.

If your request to waive the SHIP is approved, your Berklee bill will be updated.

Please note: If you will be taking any classes in the spring 2021 semester while physically being in Massachusetts and you were able to waive the SHIP for fall 2020 with an out-of-state HMO, out-of-state Medicaid plan, or an international health plan, you will be billed for the SHIP on a prorated basis. Spring SHIP coverage runs from January 1, 2021, through August 14, 2021. 

Electronic ID Cards

To ensure ease of access during the pandemic, ID cards will not be mailed to you. 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 Blue Cross Blue Shield ID number (not your Social Security number) to create your account. Your Blue Cross Blue Shield 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.

A verification letter is a letter that provides proof of insurance coverage to any third party (e.g., doctor's offices, hospitals, other insurances). Verification letters are usually available between five and seven business days after your eligibility is confirmed.

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 choose "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.

For more information on preferred providers, please visit Provider Network Information on the Gallagher Student Health and Special Risk website.

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: Blue Cross Blue Shield 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:

• Marriage
• Birth of a child/children
• Divorce
• 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.

A voluntary dental plan is available to all students for an additional cost. To enroll, go to gallagherstudent.com/berklee and click on the "Dental Enrollment Form" link (login required).

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.

For more information or to locate a participating provider, visit the Gallagher Student Health page and select "Discounts and Wellness" in the menu on the left, or visit enrollwitheyemed.com.

Gallagher Student Health also offers students the following insurance products:

• Voluntary dental insurance
• 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

The Commonwealth of Massachusetts requires that U.S. citizens/students who are enrolled in an educational program in Massachusetts be covered by a health insurance plan that provides comprehensive coverage and is compliant with federal regulations under the Affordable Care Act. Therefore, U.S. citizens enrolled in the First Year Abroad program will still be required to submit a waiver request indicating comparable coverage to the SHIP or accept enrollment in the SHIP. The rationale for this includes several factors, including situations where a U.S. citizen needs to return to the U.S. to be sure they have coverage upon their return. Having adequate health insurance coverage that meets the requirements is essential. Covid-19 made this exceptionally clear.

Non-U.S. citizens participating in the First Year Abroad program are exempt from the Commonwealth of Massachusetts requirements for health insurance. Non-U.S. citizens participating in the First Year Abroad program are enrolled in an educational program outside of the U.S. and are citizens of a country other than the U.S., so they are not required to maintain health insurance in the U.S., nor request a waiver or accept participation in the SHIP. 

If you are spending your first year on the Valencia, Spain, campus, please see First Year Abroad health insurance information.

Continuing Students Studying Abroad

Non-U.S. citizens enrolled at the Boston campus will be required to accept enrollment in the SHIP. This will be required of non-U.S. citizens even if they participate in a semester abroad at the Valencia campus because their primary academic enrollment is in the U.S.

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. Blue Cross Blue Shield uses the Express Scripts pharmacy network, which includes national retail pharmacies as well as local independent pharmacies.

Detailed information about this 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 Blue Cross Blue Shield member ID card, or visit Mail Service Pharmacy. If you have questions regarding the status of a prescription that you ordered using the pharmacy, 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. Blue Cross Blue Shield of Massachusetts is responsible for processing claims for students who 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 Blue Cross Blue Shield 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 Blue Cross Blue Shield 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.