If you are currently being treated by a physician or other type of provider, and you are contemplating using Cardinal Care as your health insurance coverage starting September 1, 2026, the first step is to determine whether your provider(s) is in network with the Blue Shield of California PPO network (and Cigna PPO network outside of California, if applicable). The same is true if you have an inpatient stay planned – check to see if the facility is in network.
- If the provider / facility is IN NETWORK, let your provider know you will be changing health insurance carriers. Care or services you are receiving that required pre-certification may need to be re-reviewed.
- If the provider / facility is NOT IN NETWORK, you can apply to receive Transition of Care once you are enrolled in Cardinal Care (September 1 for students entering the university in Autumn). With Transition of Care, you may be able to continue care with your out-of-network provider for a specified period of time at the plan’s in-network coverage levels.
Is Your Provider IN-Network or OUT-of-Network
Check to see whether your provider is IN-network or OUT-of-network under the new Cardinal Care plan administered by Wellfleet Student:
If Your Provider Is OUT-of-Network
| # | If… | Then… | What happens next… | Questions? |
|---|---|---|---|---|
| 1 | You have a planned inpatient hospitalization that begins prior to September 1, 2026 but you don’t anticipate being discharged prior to September 1, 2026 | Complete the Wellfleet Transition of Care (TOC) form once you are enrolled in Cardinal Care (i.e., September 1, 2026) and refer to #3 in this section of the table. | Wellfleet will allow you to continue your stay at the out-of-network facility in a manner that provides for transition of care (i.e., at in-network benefits) until you are discharged. | Contact Wellfleet Customer Service: 833.343.5338 |
| 2 | You have a planned inpatient hospitalization that begins prior to September 1, 2026 but you don’t anticipate being discharged prior to September 1, 2026 | Complete the TOC form once you are enrolled in Cardinal Care (i.e., September 1, 2026) and refer to #3 in this section of the table. | Wellfleet will help you arrange to access treatment by a participating in-network provider or allow you to continue to receive treatment with the out-of-network provider in a manner that provides for transition of care (i.e., at in-network benefits) for up to 6 months. | Contact Wellfleet Customer Service: 833.343.5338 |
| 3 | Prior to September 1, 2026, you received an insurance prior authorization (pre-certification) for a medical service that is anticipated to occur after September 1, 2026. | Once you are enrolled in Cardinal Care (i.e., September 1, 2026), email a copy of the prior authorization approval notice to the Wellfleet Clinical Team at clinical@wellfleetinsurance.com or fax to 413.781.1958,Attn: Wellfleet Clinical Team.Include your name, DOB, and member ID. | Wellfleet will honor your prior authorization until it expires or for 6 months, whichever is later. | Contact Wellfleet Customer Service: 833.343.5338 |
*Examples of relevant medical treatments include chemotherapy, scheduled cancer surgery or follow up visits, second/third trimester pregnancy, gender affirming surgery, rehabilitation, etc.
If Your Provider Is IN-Network
| # | If | Then | What happens next… | Questions? |
|---|---|---|---|---|
| 1 | You have a planned inpatient hospitalization that begins prior to September 1, 2026 and you don’t anticipate being discharged prior to September 1, 2026 | Refer to #3 in this table. | N/A | Contact Wellfleet Customer Service: 833.343.5338 |
| 2 | You are undergoing medical treatment* that begins prior to September 1, 2026 and you don’t anticipate that treatment will end prior to September 1, 2026 | Refer to #3 in this table. | N/A | Contact Wellfleet Customer Service: 833.343.5338 |
| 3 | Prior to September 1, 2026, you received an insurance prior authorization (pre-certification) for a medical service that is anticipated to occur after September 1, 2026. | Once you are enrolled in Cardinal Care (i.e., 9.1.26), email a copy of the prior authorization approval notice to the Wellfleet Clinical Team at clinical@wellfleetinsurance.com or fax to 413.781.1958, Attn: Wellfleet Clinical Team. Include your name, DOB, and member ID. | Wellfleet will honor your prior authorization until it expires or for 6 months, whichever is later. | Contact Wellfleet Customer Service: 833.343.5338 |
*Examples of relevant medical treatments include chemotherapy, scheduled cancer surgery or follow up visits, second/third trimester pregnancy, gender affirming surgery, rehabilitation, etc.
