Cardinal Care & Dependent Care Health Insurance for 2025-2026

Stanford requires that all registered students carry health insurance that meets minimum standards set by the university. This requirement can be met either through Cardinal Care, the university-sponsored student health insurance plan, or through use of an alternative health insurance plan that has comparable benefits.

Key Points Regarding Cardinal Care 

• We are providing preliminary information about the Cardinal Care student health insurance program for 2025-2026. Additional details will be available in late June.
• An outside vendor administers the Cardinal Care insurance program. For 2025-2026, Stanford invited competitive bids from marketplace insurance carriers in an effort to obtain the best possible services at the best possible price.
• As a result of the competitive bidding process, Cardinal Care will be administered by Wellfleet in the 2025-2026 year, using the Blue Shield of CA PPO network for services within California. For services outside of California, the program will use the Cigna PPO network.
• The annual premium has been set at $8,232 for the 2025-2026 plan year, which runs September 1 through August 31. This amount reflects an 8% increase over the current year’s published premium. It’s important to note that many students may not pay this premium in whole or part:
  • For graduate students who have a research or teaching assistantship of at least 25% or equivalent fellowship funding, the premium cost of Cardinal Care is fully covered by the university.
  • Many undergraduates use their family’s health insurance; those who do not, and enroll in Cardinal Care, may be eligible for financial aid to cover the cost of Cardinal Care. (Students who have zero expected parental tuition contribution are typically eligible for scholarship funds to cover the full cost of Cardinal Care.)
• The costs associated with health care continue to rise at a pace that routinely exceeds general inflation, and the Bay Area is a particularly high-cost region for health care. In addition, Cardinal Care is categorized as a ‘Platinum’ plan under the rating system used by the US Affordable Care Act (ACA) marketplace. Platinum plans offer the highest level of coverage, and are characterized by the lowest out-of-pocket costs at the time medical care is needed.
• The university will be providing a temporary financial subsidy for 2025-2026 plan year to keep the costs of the health plan for students and dependents lower than they otherwise would be. The published premium amount reflects this subsidy.
• Below are key features for the 2025-2026 plan year. (Note - this listing is not meant to be representative of all benefits. More detailed information about the changes will be available in late June):
  • The network ‘tiers’ associated with past design of Cardinal Care have been eliminated. For 2025-2026, the plan will offer ‘in-network’ benefits through Blue Shield of CA in California and through Cigna PPO outside of CA.
  • An ‘out-of-network’ option will also be available, but the benefits will be substantially less comprehensive.
  • Stanford Hospital and Sutter Health will continue as ‘in-network’ options for care. Referrals will be required when students need specialty care.
  • The deductible for an individual will be $150. The deductible for a family will be $300.
  • The out-of-pocket maximum will be $3,000 for an individual and $6,000 for a family.
  • Primary Care (outside of Vaden), Specialty Care, and Rehabilitative Services (such as Physical Therapy) will have a $35 copay.
  • Urgent Care will have a $50 copay.
  • Complex Imaging (such as MRI), Outpatient Surgery*, and Inpatient Hospitalization for mental health care* will have a $250 copay.
  • A visit to the Emergency Room will also have a $250 copay; the copay is waived if admitted for hospitalization.
  • Inpatient Hospitalization* for medical care will have a $500 copay.
  • Diagnostic lab analyses and x-rays will have a $0 copay*
  • Copays for Pharmacy Prescriptions (per Rx, per 30 supply) will be as follows:
    • $10 Generic
    • $35 Preferred Brand
    • $50 Non-preferred Brand
    • $50 Specialty
  • The plan will include coverage for dental care.
  • The plan will include Travel Assistance for urgent and emergent services, medical evacuation and repatriation if more than 100 miles from home.
  • Dependents of students enrolled in Cardinal Care will be eligible for “Dependent Care”

*Deductible applies

Stanford University is committed to managing Cardinal Care attentively given these circumstances and to helping students and others in our community be effective and responsible consumers of health care services. We will be providing more information in late June and over the summer about the network(s), about options for care, and about the referral process.