Health Insurance and Health Forms
The Qualifying Student Health Insurance Plan 2007 - 2008 Summary of Benefits Brochure will be updated as soon as it becomes available.
Health Examinations
The Health Center has Health Examination Reports that need to be filled out by your physician. This report must be returned to the Health Center by the end of July. Summer vacations often make scheduling appointments difficult. Please call your Physician's office today to schedule a physical exam as soon as possible.
Medical Release Form for current students (use when requesting information from your Brandeis medical record)
Undergraduate Health Report and Meningococcal Waiver
Graduate Health Report and Meningococcal Waiver
Health Insurance
Whether you are new to Brandeis or returning for another year, state law requires you to have health insurance. You must provide the Health Center with this information every year including a photocopy of your insurance card. Insurance information is due by June 30th.
Qualifying Student Health Insurance Plan - QSHIP
The QSHIP plan is designed to be used with the Health Service Fee. This allows covered students to use the Brandeis Health Center as their primary care facility.
The following is the 2007 – 2008 brochure. The coverage will remain the same with two enhancements that will begin on August 15, 2008:
- The prescription benefit has been increased from $1,500 to $2,000 per policy year.
- The outpatient miscellaneous benefit has been increased from $3,000 to $5,000 per illness.
Read the full QSHIP brochure (PDF), to learn the details of the QSHIP plan.
Undergraduate health insurance Selection/Reporting form.
Graduate health insurance Selection/Reporting.
Undergraduate Students
Massachusetts and the University require that full and qualifying part-time undergraduate students carry some form of health insurance. The state further requires that proof of insurance coverage be provided to the University each year that one is enrolled in order to be permitted to register for classes. Medicaid, Medicare and Commonwealth Care(except for The State of Massachusetts, MASSHEALTH, and Commonwealth Choice) do not meet the State regulations. Comparable coverage must be provided through Insurance carriers, which are based in the United States.
Undergraduate health insurance Selection/Reporting form.
Undergraduate students may elect the Qualifying Student Health Insurance Plan (QSHIP) or may arrange comparable coverage through their own insurance carrier. Those who do not provide documentation of another carrier on a form/website provided by the University will be automatically enrolled in the QSHIP per state law. Do not wait to be automatically enrolled - there is a delay in coverage.
Reporting your Insurance to Brandeis
Undergraduate students already enrolled are encouraged to fill this form out online in the SAGE self service system.
If you are not enrolled, you may use this form to enroll or to waive QSHIP by selecting another carrier: Undergraduate Health Insurance Selection/Reporting form (PDF).
Please mail the form to:
Health Center
MS 034 Brandeis University
P.O. Box 549110
Waltham, MA 02454-9110If you are faxing the information PLEASE print clearly. Our fax number is 781 736-3675. On occasion we cannot read a faxed form. We prefer a mailed original.
Graduate Students
State Law requires all graduate students to have health insurance that meets state requirements. Graduate students who have their own health insurance must provide documentation of this coverage to the University Health Center at the beginning of each year in order to be permitted to register. Students who do not have health insurance may choose to participate in either the Qualifying Student Health Insurance Plan (QSHIP) or one of Tufts' Associated Health Plans offered through the University. If a student does not indicate a health plan preference, the University will automatically enroll the student in the Qualifying Student Health Insurance Plan (QSHIP) per State Law. Medicaid and Medicare (except for The State of Massachusetts, MASSHEALTH), do not meet the State regulations. Comparable coverage must be provided through Insurance carriers, which are based in the United States.
Graduate health insurance Selection/Reporting form.
Navigating the Graduate Health Options
A special resource page has been created to diagram your options for health coverage as a graduate student. This will help you understand the differences between different coverage plans.
Reporting your Insurance to Brandeis
Graduate students are encouraged to fill this form out online in the SAGE self service system.
Use this form only if sage is unavailable, to enroll or to waive QSHIP by selecting another carrier: Graduate Health Insurance Selection/Reporting form (PDF).
Please mail the form to:
Health Center
MS 034 Brandeis University
P.O. Box 549110
Waltham, MA 02454-9110If you are faxing the information PLEASE print clearly. Our fax number is 781 736-3675. On occasion we cannot read a faxed form. We prefer a mailed original.
Private Insurance
If you have private insurance in another state, please call your insurer to make sure that you have adequate and comparable coverage while in Massachusetts and that they will cover you for non urgent visits while you are here at Brandeis. It is important that even if you have private insurance, you carefully evaluate your coverage before waiving the Qualifying Student Health Insurance Plan. Your own insurance must provide coverage equivalent to or exceeding that of QSHIP. Please consider the following questions before making your choice.
- Will your current plan cover expenses incurred in the Boston area, or services provided by The Brandeis University Health Center but not covered by your health fee?
- Does your plan cover you as long as you are a student at Brandeis? (some plans terminate coverage as of a particular age or based on enrollment status) What if you take a leave of absence, or travel abroad?
- Does your plan provide worldwide assistance with locating qualified medical care and emergency medical transportation if you become ill or injured away from either home or campus?
- Does your plan cover prescription drugs?
If you have private insurance you may waive/decline the university sponsored plan by providing all pertinent information regarding that coverage to the University. Please include a photocopy of your insurance card.
If you do not currently have adequate health insurance or insurance that meets the state's minimum requirements you may enroll in the University sponsored Student Health Insurance Plan (SHIP).
Failure to complete the Reporting/Selection Form by the deadline will result in an unnecessary charge to your student account.