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Brandeis University
STUDENT HEALTH INSURANCE PLAN

Spring 2027 Dependent Enrollment Form
For New Spring Students Only
2026-2027 Academic Year

Dependent coverage, if elected, begins and ends with the student’s coverage and must be purchased at the same time the student enrolls in the plan. 

TO CONTINUE THE DEPENDENT ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

Asterisk (*) denotes required field

 (MM/DD/YYYY)

 

Student Health Plan

Optional Plans

Additional Information

Prescription Drug Search

Your plan uses the Blue Cross Blue Shield of Massachusetts Formulary — Focused

The Focused Formulary does not cover GLP-1 medications approved for weight loss, including but not limited to Saxenda, liraglutide, Wegovy, and Zepbound.

GLP-1 medications that are FDA-approved to treat diabetes will continue to be covered.

To search for medications, click HERE.

Step 1: Select the Blue Cross Blue Shield of Massachusetts Formulary.

Screenshot of form - step 1

Step 2: Search for your medication by name and select the 4-Tier Plan.

Screenshot of form - step 1

University Health Plans Broker License # 000123936000
William E. Devine Broker License # 34773