Health Insurance Form For Incoming New Students Umass Amherst

To waive the student health insurance plan the student must submit an online waiver to the bursar s office and certify that he or she has alternative coverage the name of the entity offering the plan the policy number or member identification number the name of the subscriber or primary enrollee and the relationship of that person to the student and a statement that the coverage is.

Health insurance form for incoming new students umass amherst. The bursar s office is responsible for assisting students with health dental insurance enrollment. Please contact the bursar office at 508 856 6612 with any questions related to enrollment in the bc bs plan offered. Get information about health insurance. These forms are only necessary once when arriving for your first year.

Please click on the link below for an overview of the umass worcester student health plan offered by bc bs and a summary of. On our patient portal submit immunization information and more required forms. Insurance information july 13 the student insurance health forms insurance waiver and other materials will be available at the gallagher insurance website. Health history pdf students must complete both parts of the health history form.

New student immunization program university health services 150 infirmary way umass amherst amherst ma 01003. Call or visit. Insurance information form pdf complete this form so uhs can bill your insurance company for your care. If you have difficulty accessing the portal e mail uhsportalhelp umass edu.

Health plan enrollment form pdf complete this form if you want to purchase health insurance coverage for your spouse same sex domestic partner and or dependent children 19 or under. Umass spokesman ed blaguszewski said a public health messaging campaign that will be visible to the community is being launched and students recently received a letter from brandi hephner labanc. Browse our provider directory to learn about uhs primary care providers. All newly enrolled full time students should complete the health forms online and upload supporting medical documentation through the health services patient portal link above.

Quinn admin bldg 2nd floor. From this page you can access important information about your plan using the links provided. Visit our immunizations page and download the required immunizations 2020 2021 form. Welcome to wellfleet student s page for umass amherst undergraduate student members.

If you have other questions contact the nsip.