Health Insurance FAQ
Bates College Health Insurance Policy
What is the Bates College Health Insurance Policy?
Bates College requires that all students have active, comprehensive health insurance coverage while enrolled, including coverage for both emergency and non-emergency care, to ensure that students have coverage for local care to meet their health care needs while at campus.
Why does Bates College require students to have comprehensive and non-emergency health insurance?
Students are required to have comprehensive health insurance coverage to both help minimize catastrophic financial risk for students in the event of a health issue and to increase students’ access to health care during their time at Bates.
The College partners with Central Maine Medical Center to provide health care on campus at Bates Health Services and bills insurance for services utilized, rather than charge a campus health fee. Therefore, to utilize services on campus you must have and provide proof of health insurance that covers primary care.
Annual Health Insurance Enroll-Waive Process
What is the Student Health Insurance Plan Enroll-Waive process?
Annually, all students must enroll or waive health insurance coverage under the Bates Student Health Insurance Plan. The Bates Student Health Insurance Plan is compliant with the Affordable Care Act (the ACA). In order to waive the Bates SHIP, students must have comprehensive health insurance coverage that is considered to be “comparable coverage.”
The Enroll – Waive process for students returning for the fall semester opens on May 1, 2023 and closes on May 31, 2023. The Health Insurance Enroll – Waive process is accessed through Garnet Gateway and administered by the Wellfleet Insurance Group. To complete this process, click on the Student Health Insurance Plan (SHIP) under the To-Do List on Garnet Gateway. This process is completed annually during the spring and summer.
In order to request to waive the Wellfleet SHIP, students will be required to answer a few qualifying questions about their health insurance plan and upload a copy of the front and back of their health insurance card. Based on this information Wellfleet will determine if the insurance plan meets the criteria to waive the Wellfleet SHIP. If the plan doesn’t meet the criteria listed below, students will receive an immediate email letting them know their waiver request has been declined with the reason, and the student will be enrolled in the Bates SHIP. If their plan meets the criteria to waive the SHIP, students will receive an immediate email letting them know their waiver request is “pending” while their insurance information is being audited. Once the audit is complete, students will receive a second email notifying them if their request to waive has been approved or declined. If the waiver is declined, the email will state the reason for the declination, and they will be enrolled in the Bates SHIP. The waiver process is completed on the website of the Wellfleet Insurance Group, which administers the Bates College SHIP.
Students who do not complete the Enroll-Waive process by the appropriate date listed above will be automatically enrolled in the SHIP and charged the premium.
International students cannot decline coverage unless they are insured under a U.S. plan.
Questions about the Enroll-Waive process can be directed to the college’s insurance broker, Lisa Farrington at Cross Insurance at Lisa.Farrington@crossagency.com.
If I submit a waiver request because I have comparable coverage, will the request be verified and how long will that take?
Yes, Wellfleet verifies comparable coverage for all requests to waive the Wellfleet SHIP. Students will be asked to submit their insurance identification number and a copy of the front and back of their health insurance card. After students submit this information, it takes a few days to verify coverage, and students will be notified by email about the outcome of their waiver request. Wellfleet will email students if their request was approved, denied for lack of information or denied for lack of comparable coverage. You have not completed the waiver process until you receive an email from Wellfleet indicating that your waiver request was approved. You have however completed the health insurance waiver process if your plan was denied for lack of comparable coverage. In this case, you will be enrolled in the Student Health Insurance Plan.
What qualifies as “comparable health care coverage”?
Comparable coverage is a medical plan from a company based in the United States that provides health insurance benefits without lifetime maximums or pre-existing condition limitations. International students cannot decline coverage unless they are insured under a U.S. plan.
Generally, comparable coverage complies with the Affordable Care Act and provides equivalent or increased benefits than those provided under the Bates SHIP.
Regional HMO plans may not have providers that provide non‐emergency health care services in Maine and would not be considered comparable coverage.
Comparable coverage must include coverage for:
- participating (In‐Network or Out-of-Network) health care providers who are located in Maine
- benefits for a range of medical services in Maine, including:
- ambulatory care (visits to doctors and other healthcare professionals, outpatient hospital care you get without being admitted) in Maine;
- emergency care;
- hospitalization (such as surgery and overnight stays);
- pregnancy, maternity, and newborn care (both before and after birth);
- mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy);
- prescription drugs (including brand-name drugs and specialty drugs);
- rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills);
- laboratory services; and
- preventive and wellness services and chronic disease management.
Additionally, the annual out-of-pocket limit cannot be more than $9,100 for an individual or $18,200 for a family.
What does not count as “comparable health care coverage”?
There are many types of plans and coverages that are not considered comparable coverage. While many of these plans provide emergency coverage worldwide, they do not cover non-emergency care while you are outside of their service area. Below are examples of plan that are not considered comparable coverage:
- out of state Medicaid plans;
- regional HMO plans;
- travel insurance plans;
- health plans that only cover specific occurrences, such as accidents or certain illnesses;
- health plans that only provide emergency services;
- international plans (includes travel coverage from your home country);
- health care sharing plans;
- plans from insurance companies not located within the United States; and
- prescription discount plans (this is not insurance).
I am studying abroad, do I need to complete the Enroll/Waive process?
All Bates students are required to complete the annual Student Health Insurance Enroll/Waive process through Wellfleet accessed through the Garnet Gateway regardless of if they are studying on campus or as part of a semester/year-long study abroad program. This process requires students to provide proof of adequate medical insurance coverage in the United States in order to request a waiver for Student Health Insurance Plan per Bates College policy. This ensures continuation of coverage and adequate care. The Wellfleet SHIP provides international coverage for your time off campus and you can learn more about the coverage below. More information about health insurance while studying abroad can be found on the Center for Global Education website.
I am an international student, do I need to complete the Enroll/Waive process?
All international students are automatically enrolled in the Bates College SHIP. Only those international students who are covered by an embassy‐sponsored health plan, or other comparable coverage that is based in the United States, are able to ask for a special exception to waive coverage under the Bates SHIP. Travel coverage from your home country is not considered comparable coverage.
What do I do if my comparable coverage changes or terminates after the waiver period?
If your comparable coverage changes or you lose your coverage after waiving, you should notify Bates Health Services within 30 days.
You may be able to enroll in the Wellfleet SHIP if you have lost your comparable coverage due to a qualifying event. Qualifying events include involuntary losses of coverage from a comparable health insurance plan for reasons such as:
- Reaching the age limit of another health insurance plan, or
- Loss of health insurance through due to a job loss/change.
You can enroll within 30 days of the loss of coverage. When enrolling in the Wellfleet SHIP, you must submit a letter from your previous insurance carrier showing your dates of coverage (including the end date) to Wellfleet.
The Bates Student Health Insurance Plan
What is the cost of the SHIP?
The 2023-2024 cost of coverage through the SHIP for the full 12 months is $2,896. For students returning to campus for the first time for the Winter semester and enrolling in the SHIP in January, the premium is $1,796.
Students who elect the Bates SHIP or are required to enroll in the plan will be notified in July that they will be charged the cost of the SHIP. If you are returning for the winter semester, you will be notified in January. Students receiving need-based financial aid from Bates may qualify for a full or partial grant subsidy, depending on their Bates-calculated family contribution, to help offset this cost.
More information about financial aid and affording the cost of the Bates Student Health Insurance Plan can be found here.
Where can I learn more about the coverage included on the Wellfleet SHIP?
All information specific to the SHIP through Wellfleet can be found using these websites:
- Forms and Resources
- Find In-Network Health Professionals
- 24/7 Nurseline
- CareConnect Behavioral Health
Log into the Garnet Gateway to Access your ID card and Claims.
Am I still covered under the SHIP during breaks and vacations?
Yes, the Wellfleet SHIP is effective from August 15, 2023 through August 14, 2024.
Am I still covered under the SHIP if I am living off-campus, traveling, or studying outside of the United States?
In the United States, Wellfleet uses the Cigna PPO provider network. You can search to find in-network providers near you using this Cigna PPO database.
The Wellfleet SHIP provides access to a worldwide coverage and a comprehensive program that will arrange emergency medical and travel assistance services, repatriation services and other services when you are traveling.
For general inquiries regarding the travel access assistance services coverage, please call Wellfleet at (877) 657‐5030, TTY 711.
If you are traveling and need assistance in North America, call the Assistance Center toll‐free at (877) 305‐1966 or if you are in a foreign country, call collect at (715) 295‐9311.
When you call, please provide your name, school name, the group number shown on your ID card, and a description of your situation. If the condition is an emergency, go immediately to the nearest physician or hospital without delay and then contact the 24‐hour Assistance Center.
How do I access my Wellfleet SHIP account?
To access your ID card, claims, and plan documents, log into your Garnet Gateway and select Student Health Insurance. This will take you to your Wellfleet account where you can print or email a copy of your ID card, contact Wellfleet, view your Explanation of Benefits, search for in-network providers, or download other plan documents.
Is there additional insurance available for accidents and injuries?
Yes, Bates College provides a student accident insurance plan for the 2023-2024 school year. Enrolled students are covered for Accident Medical Expense Benefits and Accidental Death and Dismemberment Benefits subject to the terms, conditions, limitations, and exclusions of the Policy. It covers certain medical expenses for the treatment of injuries that are the direct and independent result of a Covered Accident during the policy period. Please visit this website for more information about how to access and use this additional insurance.
Using Insurance at Bates Health Services
Will my insurance cover the services provided at Bates Health Services?
If you have insurance through your family policy, you must let the company know you are at Bates College and determine how to handle all insurance claims while at Bates. Health Services bills your health insurance like your primary care provider. If your health insurance plan will not cover the services provided at Bates Health Services, like out-of-region HMO plans, then students will have the opportunity to enroll in the Bates Student Health Insurance Plan, in order to provide coverage to medical care while at Bates.
Health Services, like most healthcare clinics will be unable to process your claim, handle your bills, or answer any questions about your individual policy – you must work with your health insurance company directly.
In some instances, your insurance policy may require a referral to see a specialist; in this case our staff will contact your Primary Care Provider to expedite the referral. Pre-approval is often needed for x-rays, lab tests, and hospitalizations. If you have purchased the Bates College SHIP, Bates Health Services (email@example.com) and Lisa Farrington at Cross Insurance Agency (Lisa.Farrington@crossagency.com) can help you with certain questions you may have. You are still responsible for understanding your policy and following the needed procedures and claim form requirements.
Who do I call if I have questions about a specific medical bill or claim?
If you have specific questions about your medical bill or procedure from Central Maine Medical Center and/or Bates Health Services, please contact the Central Maine Medical Center Patient Financial Services.
- Phone: (207) 795-2237 or toll free in Maine 888-869-3101
- Location: 29 Lowell Square, Lewiston (1st floor)
- Office Hours: Monday and Wednesday – 8:30 a.m. to 6:00 p.m.; Tuesday, Thursday and Friday 8:30 a.m. to 4:30 p.m.
Questions about Health Insurance
Where do I direct questions about the Student Health Insurance Plan?
General questions can be directed to firstname.lastname@example.org and we will direct you to the appropriate office to address your question.
Questions related to the Enroll/Waive process can be directed to Lisa Farrington at Lisa.Farrington@crossagency.com.
Questions related to affording the cost of the SHIP can be directed to Student Financial Services as email@example.com.
Questions about navigating your health insurance as a college student can be directed to Brenna Callahan at firstname.lastname@example.org.
Questions about the Wellfleet coverage can be directed to Wellfleet Customer Services at 1-877-657-5030 or Cross Benefit Solutions (the insurance broker for the Bates SHIP) at 1-800-537-6444.
Questions about your medical bill or procedure from Central Maine Medical Center and/or Bates Health Services can be directed to the Central Maine Medical Center Patient Financial Services at (207) 795-2237.