Frequently Asked Questions
GENERAL INFORMATION (Scroll down for additional Student Health Insurance FAQs)
Can I enroll in the insurance plan after the enrollment deadline?
You can enroll in our plan within 30 days of a qualifying event (loss of other coverage) regardless of our enrollment deadline. You must supply written proof that your other coverage has terminated through a qualifying event.
I have purchased coverage for myself. Can I also purchase coverage for a member of my immediate family (spouse, child, parent)?
Please consult your plan's enrollment information. Typically coverage is available.
What is COBRA?
Continued health insurance coverage for employees who have lost their health insurance coverage based on a qualifying event.
How long can I have COBRA coverage?
The length of time you can have COBRA for is based on the qualifying event. For example, COBRA coverage as a result of termination of employment is usually 18 months.
What is a "pre-existing condition"? How does this affect me as a consumer of health insurance?
A pre-existing condition is any condition for which you have had symptoms or services provided before the effective date on the plan. You must consult your Student Health & Accident brochure or Plan Document to see if there is a clause that limits the coverage of pre-existing conditions.
How can I check the status of a claim I submitted?
You can check the status of a claim that you have submitted by clicking on the "Inquiry" button and entering your User ID and Password or click here now.
What is my login?
Your login consists of a User ID (your Wellfleet member number) and a Password. The Password is located in the mailer containing your identification card.
What if I don't know what my password is?
Your password is located in the mailer containing your identification card. If you do not have that mailer, click here to request your password.
What if my password doesn't work?
Passwords are case-sensitive. Please be sure you have entered it exactly as it is printed. If you continue to have a problem please call 1-800-633-7867.
What are some of the reasons Wellfleet might not reimburse my medical provider for a claim I submitted?
Other insurance may be responsible for paying the claim; the services may not be covered according to the exclusions listed in your brochure or Plan Document; the claim may not have occurred while you were covered; or the charges may be over Reasonable and Customary. A letter from Wellfleet will accompany any denial of claim indicating the reason for non-payment.
If I am in a car accident or other accident, what kind of documents will I need in order to submit a claim for reimbursement?
You will be asked for a description of the accident, other coverage information and perhaps a police report. Wellfleet will send a letter to you requesting the pertinent information.
What is a Reasonable and Customary charge and how does that charge affect me as a consumer?
Reasonable & Customary (R&C) charges are guidelines developed by an independent source and used by insurance companies to help assure that the fees providers are charging for services are reasonable their geographic area. Wellfleet Insurance utilizes the 80th percentile of R&C for most of its plans.
How can I find a provider in another state?
The Wellfleet Insurance (Wellfleet) Network is available to our Insureds from downtown Boston to the hills of the Berkshires. Insureds accessing the Wellfleet network will locate participating providers using the Massachusetts Provider Search at the top of the PROVIDER SEARCH screen. Insureds accessing other networks will use the National Provider Search Logos at the bottom of the PROVDER SEARCH screen. Click here to access the PROVIDER SEARCH SCREEN.
How can I determine which network I can access?
Insureds that have access to a network other than Wellfleet will have a logo in the upper right-hand corner of the identification card. You can also find this informaiont in your Student Health brochure or Plan Document.
What are those logos under the National Provider Search?
Those are direct links to the websites for the national networks. Click here to access the PROVIDER SEARCH SCREEN.
Can I download and print a directory from Wellfleet's website? If not, where can I get a directory/list of participating providers?
At this time, it is not possible to download/print a directory from the website. You can search and print up to ten providers per page. If you are accessing any of the national networks, you can download and print a directory from their website. Employees or students may request a directory from their benefits department and students can view a directory at the Benefit Administrator or Student Health Services Center.
When scheduling an appointment, should I tell the provider's office that I have Wellfleet?
If you are accessing any network other than Wellfleet, you should inform the office of that network and ask if they are participating (i.e. PHCS, Multiplan, Intergroup, Beech Street and First Health Networks)
Do I have Express Scripts? I see a logo for it on the website.
Some plans do have a pharmacy benefit with Express-Scripts. If your plan is one of these, the reverse side of your identification card will contain an Express Scripts logo.
I am a Provider. How can I access your inquiry screens?
Access is granted to Providers on a case-by-case basis. If you would like to obtain a User ID and Password, please click on the "Contact Us" button and request access via e-mail. You must include the name of your organization, tax identification number and the name of all users. We will reply to you within one business day.
STUDENT HEALTH INSURANCE FAQs:
Do I need a password to print a claim form?
No, passwords are not required to print claim forms. You can obtain a claim form at the Homepage Quick Links or click here.
If I am working on my dissertation or thesis, but I am not enrolled in classes, can I apply for insurance through Wellfleet?
You must consult your Student Health & Accident brochure. Generally the policies allow coverage only for those students who are enrolled full-time. Click here and select your school from the drop-down list to view your plan brochure.
What happens if I drop out of school while I am enrolled in your insurance plan? Will you refund my money? If not, am I still covered?
You will not receive a refund. However, your plan will continue through the period for which you paid.
If I have my own doctor in the community and I don't want to go to the campus health center for care, will Wellfleet consider my claim?
As all our plans are different, you will need to consult your plan brochure, which may be available on this website. Click here and select your school from the drop-down list to view your plan brochure.
Does Wellfleet's student insurance cover dental or eye care?
You must consult your Student Health & Accident brochure. Click here and select your school from the drop-down list to view your plan brochure. Typically plans do not offer dental or vision coverage, only coverage for sickness or accidents to the teeth or eyes. If your plan does not have coverage for dental or vision, you can purchase plans on this site which will help minimize your expenses. Click here for more information on Wellfleet's additional products (located on the left side bar).