MGH INSTITUTE OF HEALTH PROFESSIONS
Student Health Insurance Plan

Frequently Asked Questions


GENERAL

Who is Consolidated Health Plans? Who is University Health Plans? What are their roles? How do I contact them?

Consolidated Health Plans (CHP) is the claims administrator for the health insurance plan. CHP is responsible for answering questions about insurance benefits, claims and providing replacement ID cards. If you have any questions for CHP, please email info@consolidatedhealthplan.com or call 800-633-7867.
University Health Plans (UHP) is the broker/plan manager who handles the enrollment process for the school health insurance plan. Please email UHP at info@univhealthplans.com or call 800-437-6448 if there are any questions about your enrollment or if there are customer service issues with CHP.

Do I get an insurance card?

Yes. When your enrollment in the Student Accident & Sickness Insurance Plan is submitted to Consolidated Health Plans, you will get an ID card mailed to the address provided to us by your school.

What if I lost my insurance card?

Please contact CHP at 800-633-7867 to request another card. You can also go to https://consolidatedhealthplan.com/members/online_id_card_login to print an online ID card.

How can I determine which providers I can see?

You can seek treatment from any provider. The insurance will pay a percentage of the Reasonable & Customary charges for services that are covered by the plan.

Your out-of-pocket costs may be lower when you utilize the GWH-Cigna PPO Network of Participating Providers. For a listing of GWH-Cigna PPO Network Participating Providers, go to www.mycignaforhealth.com or contact Consolidated Health Plans at (413) 773-4540, toll-free at (800) 633-7867, or www.chpstudent.com.

Who should I contact for updating my personal information such as a mailing address, name, etc.?

Please call UHP at 800-437-6448 to update your personal information.


CLAIMS

Once I receive treatment, is there anything that I need to do to have my claim processed?

Submit all medical claims to:

GWH-CIGNA
1000 Great-West Drive
Kennett, MO 63857-3749
Electronic Payer ID: 62308

Note: Claims submitted directly to CHP will be denied and you will be asked to resubmit them to GWH-CIGNA.

Although you are not required to submit a student claim form to CHP each time, there may be situations where CHP contacts you for additional information about your injury, other insurance plans that are possibly covering you, etc. If CHP sends you a form to complete, the processing of your claim may stop until the form is properly completed and returned to the address indicated in the request.

How can I check the status of a claim I submitted?

You can check your claims status at www.chpstudent.com. To view information unique to you, you must be registered online. For first time users, click the "Login" button in the upper right corner of CHP's website, click on "register here", and complete the form. For returning users, simply "Login" with your username and password.

You can also contact CHP via phone at 800-633-7867 or email at customerservice@consolidatedhealthplan.com.

What if I can't remember my password?

You can retrieve your password by providing answers to the security questions you established when you registered on www.chpstudent.com.

What are some of the reasons CHP might not reimburse my medical provider for a claim I submitted?

CHP will send a letter when a claim is denied. The following are common reasons for denial:

  • The claim was not submitted to GWH-Cigna. Claims submitted directly to CHP will be denied and you will be asked to resubmit them to GWH-Cigna at the address shown on the back of your ID card.
  • Other insurance may be responsible for paying the claim.
  • The services may not be covered according to the exclusions listed in your Student Accident and Sickness Insurance Program brochure.
  • The claim may not have occurred while you were covered.
  • The charges may be over the Reasonable and Customary amount (any questions about the Reasonable and Customary policy please contact CHP).

If I am in a car accident or sustain any other injury, what kind of documents will I need in order to submit a claim form for reimbursement?

You will be asked for a description of the accident, other coverage information and perhaps a police report. A letter from CHP will be sent to you requesting the pertinent information.

I have exhausted my medical benefits, what are my options?

You should speak with your provider to see if they can set up a payment schedule with you that meets your financial needs. Depending on your circumstances you may qualify for some state aid.


BENEFITS/COVERAGE

If I have a benefit question about my policy, who should I ask?

We recommend that you familiarize yourself with your covered benefits located in the Student Accident and Sickness Insurance Program brochure. If you still need assistance, please email or call CHP and a claims administrator can help you with your benefit questions. You may contact CHP at customerservice@consolidatedhealthplan.com or 800-633-7867.

Does MGHIHP's Insurance cover prescription drugs?

Yes. Your student insurance covers prescription drugs to the plan maximum, subject to copays per 30 day prescription. Please refer to the on-line plan brochure for details.

Which pharmacy can I go to get my prescription?

You can go to any participating pharmacy that is part of the Express Scripts Network, such as CVS, Brooks, Costco, Stop & Shop, etc. To find out more about participating pharmacies, please contact Express Scripts at 800-451-6245. If you go to a pharmacy that is not within the Express Scripts Network, you will be required to pay for the full cost of the prescription out-of-pocket. You may then submit a claim to Express Scripts for reimbursement by using the Prescription Drug Reimbursement Form, which is located on the UHP website. To find this form, select your school from the UHP home page and select the Student Accident & Sickness Plan. You will see a blue box on the next page that links to this form.

Does this plan cover dental?

The only dental coverage that you will have is when you need treatment for any injury to sound natural teeth or for the removal of impacted wisdom teeth ($350 maximum per tooth).

There is a voluntary DeltaCare dental plan that is available to you. The premium for the voluntary dental plan is not included with your Accident & Sickness plan premium. You may enroll in and pay for the DeltaCare dental plan on the UHP website during open enrollment periods. Please see the UHP website for enrollment deadlines and more details. From the UHP home page, select your school and then click on "Voluntary DeltaCare Dental Plan".

Does this plan offer any vision benefits?

This plan provides a vision discount plan. For details, go to https://consolidatedhealthplan.com/products/davisvision.

There is also a voluntary VSP Vision Care Plan that is available to you. The premium for the voluntary vision plan is not included with your Accident & Sickness plan premium. You may enroll in and pay for the VSP Vision Care plan on the UHP website during open enrollment periods. Please see the UHP website for enrollment deadlines and more details. From the UHP home page, select your school and then click on "Voluntary VSP Vision Care Plan".

What is a "pre-existing condition"? How does this affect me as a consumer of this health insurance?

A pre-existing condition is any condition which originates, is diagnosed, treated or recommended for treatment within six (6) months immediately prior to the Insured Person's Effective Date of coverage under this Policy (Diagnosis, care and treatment will not include any prior diagnosis of or treatment for infertility.)

What is the policy regarding pre-existing conditions?

Pre-existing conditions are not excluded, and will be covered the same as any other condition and are subject to the same limitations that all other conditions are subject to.

What is a reasonable and customary charge and how does that charge affect me as a consumer?

Reasonable and Customary (R&C) charge means the normal and customary charge of the provider, incurred by the Covered Person, in the absence of insurance for a service or supply, but not more than the prevailing charge in the area. If you are treated by an out-of-network provider, there may be a difference between what they are charging and what is considered Reasonable & Customary. You would be responsible for that difference.