Insurance and Patient Billing

 

Update 3/3/23: The Student Health Benefit Plan (SHBP) waiver period has ended. To request an appeal to waive the SHBP for Spring 2023, students can call (413) 577-5192, email patientservices@uhs.umass.edu, or come to UHS to see a Patient Services representative Monday-Friday, 8 a.m. to 4:30 p.m.

REMINDER: SHBP members must print a new insurance card every academic year.

Massachusetts requires full-time college students to have primary health care insurance. Students taking five credits or more credits in an academic semester are automatically enrolled in, and charged for, the UMass-sponsored Student Health Benefit Plan (SHBP). This is an excellent option for students who need insurance. A waiver system is in place for students already covered under another insurance plan.

Coronavirus Testing (OTC) without a doctor order:

Effective for tests purchased on or after 1/15/2022, Wellfleet will cover over the counter (OTC) COVID-19 tests without a doctor order, limited to 8 tests per calendar month per covered member, with no member cost share. The test must be purchased for personal use, not for employment purposes, has not been (and will not be) reimbursed by another source, and is not for resale. This federal regulation applies to both fully insured and self-funded ACA compliant plans. The following documentation must be submitted:

  • COVID-19 OTC Test Reimbursement Form (must be signed)
  • Receipt from seller, documenting date of purchase and price
  • Actual UPC label from COVID-19 test box

Learn more and access the reimbursement form: https://wellfleetstudent.com/covid-19/

Learn About...

Our Contracted Carriers:

UHS works with many major medical carriers, including:

  • Aetna
  • AllWays
  • Blue Cross/Blue Shield
  • Cigna
  • Empire NYSHIP (This coverage may result in large deductibles. Please check your contract.)
  • Fallon Select
  • Harvard Pilgrim
  • Health New England
  • MassHealth
  • Tufts
  • Unicare/GIC
  • United Healthcare
  • U.S. Family Health Plan

UHS Cannot Accept:

  • Out-of-state Medicaid plans
  • MassHealth Limited
  • Health Safety Net
  • Children's Medical Security Plan
  • Emergency/hospital-only coverage plans
  • Closed network plans and Exclusive Provider Organization (EPO) plans

The above insurance also cannot be used to waive the Student Health Benefit Plan (SHBP).

UHS Cannot Accept the Following Plans for Non-Students:

  • Fallon Direct
  • Harvard Pilgrim Primary Choice plan
  • Mass Health MCO & ACO plans
  • Medicare
  • Tufts Spirit plan

Contracts change frequently. For the latest information, call Patient Accounts: 413-577-5256.

Insurance Cards

It is imperative that you have a copy of your insurance card. Many plans have separate prescription drug, eye care, flexible spending account (FSA) and/or health savings account (HSA) cards. You must have copies of all cards related to your plan. The backs of insurance cards are as important as the fronts – be sure you have copies of both sides.

Students who remain enrolled in the SHBP must print a new insurance card each academic year. You can get your insurance card by going to the Wellfleet website and choosing "ID Cards" from the menu at the top. Enter your student ID number (Example: 123456789) and your date of birth to obtain a printable version of your card. Please note that you must print a copy of your new card prior to medical appointments and using pharmacy. Your health plan information changes every year, therefore your old cards will not be sufficient.

Please Note: If you use Walk-in Care and receive prescription medications when the UHS Pharmacy is closed, bring your insurance card to the pharmacy on the next business day. The medications you received will be billed to your insurance plan. If you do not take this step, you'll be billed for the medications received.

Patient Billing

You are ultimately responsible for the cost of your care. If you don't provide us with current insurance information, bills will be sent to you. It is also your responsibility to contact your health insurance carrier to inquire about coverage at UHS.

Before your first visit, download and complete UHS' insurance information form. Return the completed form, along with photocopies of both sides of your insurance card, to UHS' Patient Services department. If you're insured under an HMO or POS plan,  also provide the name, address and telephone number of your primary care provider.

  • Pay your patient bill online.
  • Received a bill and have questions? These FAQs may have the answers you need.
  • Questions about primary health insurance? Call Patient Accounts: 413-577-5256.