Cardinal Care Student Health Insurance

Cardinal Care Overview

Cardinal Care is a comprehensive health insurance plan specifically designed for Stanford students. In 2025-2026, medical and mental health benefits will be administered by Wellfleet Student, through the Blue Shield of California PPO network in California, and the Cigna PPO network outside of California. Cardinal Care offers robust coverage at school, at home, and while traveling or studying abroad. This is important for Stanford students, many of whom are on the move.

Cardinal Care also provides coverage during school breaks, immediately following graduation, and during quarters when students might not be registered for classes. Students enrolled in Cardinal Care have access to Stanford faculty specialists and to hospital and emergency care at the university medical center.

What to Know

All students, in their first active quarter of each year, will be auto-enrolled in the university-sponsored health insurance plan, Cardinal Care, administered by Wellfleet Student.
Although Cardinal Care offers the most robust level of benefits for those who are in the Stanford area, it also provides coverage nationally and internationally.
Students who have alternative health insurance that provides adequate coverage may waive Cardinal Care, if desired. For students in the Stanford vicinity, this means having coverage for inpatient and outpatient medical and mental health care in the San Francisco Bay Area, ideally with access to providers at Stanford University Medical Center and/or the Sutter Health Network.
If you do not waive Cardinal Care coverage by the applicable deadline, you will be enrolled in Cardinal Care health insurance for the remainder of the plan year through Aug. 31, 2026 (with exception for some Autumn or Winter graduating students who petition to come off the plan or students who permanently withdraw from the university and similarly petition to cancel).

Cardinal Care Overview; Summary of Medical and Mental Health Benefits

Policy Year	Sept. 1, 2025 - Aug. 31, 2026
Plan Administrator	Wellfleet Student
Network	California = Blue Shield PPO, Outside California = Cigna PPO
Dependent Care Eligibility	Students enrolled in Cardinal Care can enroll their spouse, registered domestic partner, and unmarried dependent children up to the age of 26 (or older if unable to support themselves due to a physical or mental handicap) in ‘Dependent Care’

Network Definitions

In Network	Out of Network
California = All Blue Shield PPO network providers Outside California = All Cigna PPO network providers	Coverage offered for out of network providers includes covered plan services only.

Plan Management Features

Referral Requirements	A Vaden referral for outside care is unnecessary for the following conditions: An Emergency Medical Condition; Medical care provided at Stanford Health Care’s Express Care Clinic or Walk in Clinic; Medical care received when the student is more than 25 miles from campus; Maternity care;* When service is rendered at another facility during breaks, holidays, or periods when Vaden is closed; Medical care obtained by a student who is not eligible to use Vaden; Mental health care, including Psychiatry; The routine annual eye exam; Transfers of care between specialties or coordination of care within Stanford Health Care when such care occurs as a result of an Emergency Department visit, an Express Care visit, a Walk In Clinic visit or a Vaden Health Center referral except as follows*: Students in Cardinal Care who are referred by Stanford Health Care’s Emergency Department, Express Care, or Walk In Clinic to Stanford Health Care’s Dermatology or Physical Therapy Department for follow up must seek evaluation and referral from Vaden Health Center. Additionally, no authorization or referral requirement will apply to obstetrical or gynecological care provided by In Network Providers (including IUD services, colposcopy, and pregnancy termination). **A written referral from Vaden is recommended for any follow-up care with a provider other than Vaden, after Emergency Services. A Vaden referral does not constitute a guarantee of benefits when treatment is provided outside of Vaden.
Precertification Requirements (precertification is not a guarantee that benefits will be paid)	All Inpatient admissions, including length of stay, to a Hospital, Skilled Nursing Facility, a facility established primarily for the Treatment of a Substance Use Disorder, or a Residential Treatment Facility, surgical procedures; All Inpatient maternity care after the initial 48 hours following vaginal delivery/96 hours following a Cesarean section; Home Health Care; Durable Medical Equipment over $500 per item; Outpatient Surgical Procedures; Transplant Services; Diagnostic Testing and Radiology services listed on the Wellfleet website. See Prior Authorization Requirements section; Complex Imaging; Biomarker Testing; Chemotherapy/Radiation; Fertility Preservation; Infusions/Injectables; Botox Injections; Genetic Testing, except for BRCA; Orthotics/Prosthetics; Non-emergency air Ambulance (fixed wing)

Referral Requirements

A Vaden referral for outside care is unnecessary for the following conditions:

An Emergency Medical Condition;
Medical care provided at Stanford Health Care’s Express Care Clinic or Walk in Clinic;
Medical care received when the student is more than 25 miles from campus;
Maternity care;*
When service is rendered at another facility during breaks, holidays, or periods when Vaden is closed;
Medical care obtained by a student who is not eligible to use Vaden;
Mental health care, including Psychiatry;
The routine annual eye exam;
Transfers of care between specialties or coordination of care within Stanford Health Care when such care occurs as a result of an Emergency Department visit, an Express Care visit, a Walk In Clinic visit or a Vaden Health Center referral except as follows**:

Students in Cardinal Care who are referred by Stanford Health Care’s Emergency Department, Express Care, or Walk In Clinic to Stanford Health Care’s Dermatology or Physical Therapy Department for follow up must seek evaluation and referral from Vaden Health Center.

*Additionally, no authorization or referral requirement will apply to obstetrical or gynecological care provided by In Network Providers (including IUD services, colposcopy, and pregnancy termination).

**A written referral from Vaden is recommended for any follow-up care with a provider other than Vaden, after Emergency Services. A Vaden referral does not constitute a guarantee of benefits when treatment is provided outside of Vaden.

Precertification Requirements (precertification is not a guarantee that benefits will be paid)

All Inpatient admissions, including length of stay, to a Hospital, Skilled Nursing Facility, a facility established primarily for the Treatment of a Substance Use Disorder, or a Residential Treatment Facility, surgical procedures;
All Inpatient maternity care after the initial 48 hours following vaginal delivery/96 hours following a Cesarean section;
Home Health Care;
Durable Medical Equipment over $500 per item;
Outpatient Surgical Procedures;
Transplant Services;
Diagnostic Testing and Radiology services listed on the Wellfleet website. See Prior Authorization Requirements section;
Complex Imaging;
Biomarker Testing;
Chemotherapy/Radiation;
Fertility Preservation;
Infusions/Injectables;
Botox Injections;
Genetic Testing, except for BRCA;
Orthotics/Prosthetics;
Non-emergency air Ambulance (fixed wing)

Deductible	In Network	Out of Network
Individual/ Family	$150/$300	$1,500/$4,500 Cost sharing for out-of-network services that accumulates toward the out-of-network deductible does not accumulate toward the in-network deductible
Applies to:	All services, except: Preventive care and wellness Pediatric dental Types A, B, C and Medically Necessary Orthodontic care Pediatric vision care services and supplies Physicians Office Visits including Specialists/Consultants Emergency Services in an Emergency Department for Emergency Medical Conditions Urgent Care Centers for non-life-threatening conditions Outpatient Mental Health and Substance Use Disorder Benefits Community Based Care Program (CARE) Emergency Ambulance Service ground and/or air, water transportation Routine adult vision exams Abortion Expense Telemedicine or Telehealth Services Benefit Acupuncture Services (Medically Necessary Treatment only) Chiropractic Care Benefit Diagnostic Complex Imaging Services Cardiac Rehab Pulmonary Rehab Rehabilitation Therapy including Physical Physical Therapy, and Occupational Therapy and Speech Therapy Habilitation Services including Physical Therapy, Occupational Therapy and Speech Therapy Medical Evacuation Expense Repatriation Expense	All services, except: Pediatric dental Types A, B, C and Medically Necessary Orthodontic care Pediatric vision care services and supplies Urgent Care Centers for non-life-threatening conditions Community Based Care Program (CARE) Routine adult vision exams Abortion Expense Medical Evacuation Expense Repatriation Expense

Deductible

In Network

Out of Network

Individual/
Family

$150/$300

$1,500/$4,500

Cost sharing for out-of-network services that accumulates toward the out-of-network deductible does not accumulate toward the in-network deductible

Applies to:

All services, except:

Preventive care and wellness
Pediatric dental Types A, B, C and Medically Necessary Orthodontic care
Pediatric vision care services and supplies
Physicians Office Visits including Specialists/Consultants
Emergency Services in an Emergency Department for Emergency Medical Conditions
Urgent Care Centers for non-life-threatening conditions
Outpatient Mental Health and Substance Use Disorder Benefits
Community Based Care Program (CARE)
Emergency Ambulance Service ground and/or air, water transportation
Routine adult vision exams
Abortion Expense
Telemedicine or Telehealth Services Benefit
Acupuncture Services (Medically Necessary Treatment only)
Chiropractic Care Benefit
Diagnostic Complex Imaging Services
Cardiac Rehab
Pulmonary Rehab
Rehabilitation Therapy including Physical
Physical Therapy, and Occupational Therapy and Speech Therapy
Habilitation Services including Physical Therapy, Occupational Therapy and Speech Therapy
Medical Evacuation Expense
Repatriation Expense

All services, except:

Pediatric dental Types A, B, C and Medically Necessary Orthodontic care
Pediatric vision care services and supplies
Urgent Care Centers for non-life-threatening conditions
Community Based Care Program (CARE)
Routine adult vision exams
Abortion Expense
Medical Evacuation Expense
Repatriation Expense

Out of Pocket Maximum	In Network	Out of Network
Individual/ Family	$3,000/$6,000	No-out-of-pocket maximum

Preventive Screening and Counseling Services	In Network	Out of Network
Cost share	No copayment or deductible applies. Subject to age limit guidelines.	Benefits are paid at 50% of the Usual and Customary Charge. Deductible applies.
Services Included	See a list of all covered preventive services.

Non-Preventive Office Visits, Rehab and Therapies	In Network	Out of Network
Category 1
Cost Share	$35 copayment. Deductible does not apply.	50% of Usual and Customary Charge. Deductible applies.
Services	Physician, specialist including Consultants Office visits (nonsurgical/non-preventive care by a physician and specialist) includes telemedicine consultations Outpatient mental health office visits (includes telemedicine consult) Walk-in clinic visits, when billed as an office visit
Category 2
Cost Share	$25 copayment. Deductible does not apply.
Services	Adult routine vision exam (1 visit)
Category 3
Cost Share	$35 copayment. Deductible does not apply.	50% of Usual and Customary Charge. Deductible applies.
Services	Outpatient physical, occupational, speech, and cognitive therapies. Combined for rehabilitation services and habilitation therapy services (30 visits) Cardiac rehab Pulmonary rehab Acupuncture – medically necessary only (30 visits) Chiropractic (30 visits)
Category 4
Cost Share	10% of negotiated charge. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Services	Allergy testing and injections
Category 5
Cost Share	10% of negotiated charge. Deductible applies	50% of Usual and Customary Charge. Deductible applies.
Services	Outpatient Chemotherapy, Radiation and Respiratory Therapy Home Health (100 visits)
Category 6
Cost Share	10% of negotiated charge. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Services	Infusion therapy
Category 7
Cost Share	Covered according to the type of benefit and place where service is received
Services	Non routine foot treatment, and medically necessary foot treatment resulting from injury, infection or disease

Emergent/Urgent services	In Network	Out of Network
Urgent Care	$50 copayment. Deductible does not apply.	$50 copayment. Deductible does not apply.
Emergency Services in an Emergency Department	$250 copayment which is waived if admitted. Deductible does not apply

Diagnostic Testing	In Network	Out of Network
Complex Imaging	$250 copayment. Deductible does not apply.	50% of Usual and Customary Charge. Deductible applies.
Diagnostic Lab and Radiology	0% coinsurance. Deductible applies	50% of Usual and Customary Charge. Deductible applies.

Inpatient	In Network	Out of Network
Medical Room and Board	$500 copayment per admission. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Mental Health Room and Board	$250 copayment per admission. Deductible applies	50% of Usual and Customary Charge. Deductible applies.
Skilled Nursing Facility	$500 copayment per admission. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Hospice	0% of negotiated charge. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.

Outpatient	In Network	Out of Network
Outpatient Surgical Facility and misc. expenses for services and supplies	$250 copayment. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Physician and surgical services	0% coinsurance. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Abortion	0% coinsurance. Deductible does not apply.
Dermatologic treatment	Covered according to the type of benefit and the place where the service is received
Bariatric Surgery	0% coinsurance. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.
Comprehensive Infertility Services	10% of negotiated charge. Deductible applies	50% of Usual and Customary Charge. Deductible applies.
Mental Health / Substance Use
Other outpatient mental health treatment (includes physical, occupational, speech, cognitive therapies and skilled behavioral health services in the home) Partial hospitalization treatment Intensive outpatient program	0% coinsurance. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.

Drugs and Supplies	In Network	Out of Network
Drugs (30 day supply): Generic Preferred Brand Non-Preferred Specialty	$10/Rx $35/Rx $50/Rx $50/Rx Deductible does not apply.	Not covered
Specialty prescription drugs purchased and injected or infused by your provider in an outpatient setting	Covered according to the type of benefit or the place where the service is received.
Diabetic Supplies	Paid the same as any other Retail Pharmacy Prescription Drug Fill.
Durable Medical Equipment	$25 payment per device plus 10% of the negotiated charge. Deductible applies.	50% of Usual and Customary Charge. Deductible applies.

For a listing of general exclusions to the benefits described herein, please click here.

Cardinal Care Overview; Summary of Dental Benefits

Cardinal Care Dental benefits will be administered by Ameritas PPO in partnership with Wellfleet Student.

Carrier	Ameritas
Plan	Ameritas PPO
Effective Date	Sept. 1, 2025
Eligibility	Cardinal Care Members and Dependents

Benefit Attributes	In-Network	Out-of-Network
General Plan Information
Annual Deductible - Individual	$25	$50
Annual Deductible - Family	$75	$150
Annual Plan Maximum	$1,000	$1,000
Dental Emergency Services	Coverage provided under Cardinal Care
Waiting Period	None	None
Diagnostic Services
Periodic Oral Evaluation	100%	50%
Radiographs	100%	50%
Preventive Services
Prophylaxis (Cleaning)	100%	50%
Fluoride Treatment (under age 16; 1 per year)	100%	50%
Sealants	100%	50%
Space Maintainers	100%	50%
Basic Services
Restorations (Amalgams or Composite)	80%	50%
Fillings for Cavities	80%	50%
Complex Extractions	80%	50%
Simple Extractions	80%	50%
Major Services
Oral Surgery (including surgical extractions)	80%	50%
Periodontics	80%	50%
Endodontics	80%	50%
Inlays/Onlays/Crowns (stainless steel only)	80%	50%
Denture Repair	80%	50%
Orthodontic Services
Diagnose or correct misalignment of the teeth or bite	Not Covered	Not Covered

Other Cardinal Care Features

Identification Cards

To access your insurance ID card, you will need to establish an account with Wellfleet Student. Use the last eight digits of your Stanford University ID number (with no preceding number) to set up your online accounts with Wellfleet Student. Wellfleet will assign you a subscriber number that is linked to your University ID number. You will have a separate ID number for Ameritas (dental). Ultimately, you will have a separate ID card for medical/mental health versus dental.

Hinge Health

Cardinal Care includes Hinge Health as one of the benefits offered to students. Hinge Health provides virtual access to licensed physical therapists and health coaches for personalized musculoskeletal services, including virtual physical therapy. Whether you are at school, home, or traveling, Hinge Health can assist in providing exercise therapy wherever and whenever students need treatment at no additional cost.

Teladoc

Teladoc is a contracted provider that gives students access to virtual Mental Health care by phone, video or app.

Teladoc gives students access to board-certified physicians for Mental Health (at no additional cost to the student) services.

Emergency Medical and Travel Assistance

Through Travel Guard®, Wellfleet offers access to a comprehensive program that provides emergency medical and travel assistance services, repatriation services and other travel assistance support for students who are traveling. For general inquiries regarding these benefits, contact Wellfleet Student at 833.343.5338, TTY 711.

Students who are traveling 100 or more miles from home and need travel assistance services, repatriation services and other travel assistance support in North America\can call the Assistance Center toll-free at: 877.305.1966 or email assistance@aig.com.

Students who are traveling 100 or more miles from home and need assistance in a foreign country can request that an international operator call the Assistance Center collect at: 715.295.9311.

When you call, you will be asked for some or all of the following information: name, date of birth, school name, the group/policy number shown on your ID card, and a description of your situation. You will also be asked to provide your current location, contact phone number and email address, and a secondary point of contact.

Travel Guard® offers

Medical assistance

Medical evacuation coordination
Medical/dental/vision referrals and assistance with appointments when medical attention is required
Emergency prescription replacement
Assistance with sending a doctor or specialist to you
Inpatient and out-patient medical case management
Assistance with visitors to hospital bedside
Eyeglasses and corrective lens replacement assistance
Return travel arrangements

Emergency travel assistance

Travel expertise for solving last-minute travel problems and/or emergencies
Flight rebooking assistance
Hotel rebooking assistance
Rental vehicle booking assistance
Emergency return travel arrangement
Missed connections coordination

Worldwide travel assistance

Lost baggage search and luggage replacement assistance
Lost or stolen document assistance
Immunization, visa, and passport information
Emergency language interpretation and
Translation services
Urgent message relay to family, friends, or university associates
Foreign exchange, ATM, and weather information
Guidance on local medical advisories, epidemics, required immunizations
Legal referrals/bail bond assistance

Personal security assistance

Arrange emergency and security evacuations
Coordinate consultants to return clients to safety
4/7 access to security specialists who can provide safety and security information and advisories
Provide immediate security support over the phone

More information about Travel Guard®