Blue Cross Blue Shield coverage includes, but is not limited to:
|Ambulatory Surgery||Mental Health Care Outside HUHS|
|Diagnostic Lab/Radiology Services||Pediatrics|
|Emergency Room Visits||Obstetrics/Gynecology|
|Hospitalizations||Specialty Care Outside HUHS (Limited)|
|Maternity Care||Dental (members under the age of 19)|
Note: The Student Health Insurance Plan does not cover routine preventive exams for a member who is age 18 or older. Routine preventive care at Harvard University Health Services is covered by the Student Health Fee.
In-Network vs. Out-of-Network
You can also choose non-preferred providers, but your out-of-pocket costs are higher. These are called “out-of-network” benefits. For most out-of-network services, you must first pay a plan-year deductible; then you pay a coinsurance once you meet your deductible. Your out-of-network provider may bill you for the difference between his/her charge for services and the amount that BCBS pays for those services. This is known as balance billing.
To find a preferred provider visit Blue Cross Blue Shield (select Blue Care Elect PPO/EPO as your plan's network) or contact Member Services at email@example.com or (617) 495-2008 for assistance. To locate a preferred provider out of state, please call Blue Card World Wide at (800) 810-2583.
Primary vs. Secondary Insurance
When you are enrolled in the Student Health Insurance Plan and another health insurance carrier, the Student Health Insurance Plan is always a secondary payer. This means that all claims are processed first through your other insurance and then processed by the Student Health Insurance Plan. To avoid any claims issues, please notify your providers of both plans. Please contact BCBS Coordination of Benefits at (888) 799-1888 for more information.
Prescription Drug Coverage
The Student Health Insurance Plan’s prescription drug coverage is administered by OptumRx. Prescriptions may be filled on campus at the HUHS Pharmacy or at most retail pharmacies. For copay/coinsurance information, please review the Prescription Drug Plan Summary.
Students enrolled in a comparable health insurance plan may be eligible to waive the Student Health Insurance Plan. Waivers must be completed by the appropriate deadline or the charges will remain on your student bill.
How to find a provider
You have access to “Blue Care Elect PPO” providers within the Blue Cross Blue Shield network.
- Visit the Blue Cross Blue Shield website
- Search for a provider by name, specialty, or location
- Select Blue Care Elect PPO/EPO from the network dropdown (for in-network benefits)
You will have higher out of pocket costs if you choose to see an out-of-network provider. Contact HUSHP Member Services at (617) 495-2008 or Blue Cross Blue Shield of Massachusetts at 1 (800) 257-8141 if you need assistance.
When patients receive ancillary services (such as labs or durable medical equipment) from an in-network provider, those services may be billed at the out-of-network benefit if the ordering provider and the provider rendering care are located in different states. View the Handbook to learn more about how ancillary services are billed.
Limitations and exclusions apply, so it is important to familiarize yourself with the Student Health Insurance Plan benefits prior to seeking routine care.
Disclaimer: All benefits are subject to medical necessity criteria. The benefits description defines the terms and conditions of your coverage, and will govern if questions arise. HUHS services are limited in scope and subject to change.