What’s New and Important Considerations for 2025–2026

We are pleased to announce a transition to Wellfleet Student as the Cardinal Care student health insurance carrier for the 2025-2026 academic year (Sept. 1 through Aug. 31). Students who choose to have health insurance coverage through Cardinal Care will have medical, prescription, and mental health benefits administered by Wellfleet Student (with the Blue Shield of California PPO network inside CA, and the Cigna PPO network outside of CA) and dental coverage administered by Ameritas in partnership with Wellfleet Student. 

Features of the New Plan

Several changes are occurring for 2025-2026. Features of the new plan include:

• In-network coverage through the Blue Shield of California PPO network (in California) and the Cigna PPO network (outside California).
• Removal of the tiers and introduction of an out-of-network benefit.
• An annual deductible of $150 for an individual or $300 for a family (i.e., if the student enrolls dependents in Dependent Care).
• Addition of a referral requirement for students who require specialist care. This referral requirement applies to Stanford Heath Care, Menlo Medical, Sutter Health, and any other provider within 25 miles of campus (some exclusions apply).
• Copays for primary care and specialist office visits will be $35.
• The Urgent Care copay will remain at $50; the Emergency Room copay will increase to $250 (waived if subsequently admitted).
• Dental benefits through Ameritas for students in Cardinal Care.
• Travel assistance for urgent and emergent services, medical evacuation and repatriation 100 miles or more from home administered by TravelGuard.

In addition, Wellfleet will offer:

• A dental plan for students who are not enrolled in Cardinal Care (and dependents who are not enrolled in Dependent Care) and who need or want dental coverage.
• A vision plan for ALL students who need or want vision coverage beyond what their plan offers (whether through Cardinal Care or another plan)

Students who waive Cardinal Care and their dependents may elect to enroll in Voluntary Dental. Students and dependents who wish to have added vision coverage may enroll in Voluntary Vision. To enroll in either option, visit this link. Payments for these voluntary plans are made directly to Ameritas Dental PPO and are entirely separate from Cardinal Care or Dependent Care enrollment and cost.

The partnership with Academic HealthPlans (AHP) to administer the waiver request process will continue.

Students who opt to remain enrolled in Cardinal Care can enroll their dependents (spouse or registered domestic partner; child or children) in Dependent Care, with the same network and benefits as Cardinal Care, including dental coverage and travel assistance, during the applicable enrollment period.

Transition of Care – Medical / Mental Health / Facility

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 Sept. 1, 2025, 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. 

See the table below for more detail. These transition of care options are available for the first 6 months of the 2025-2026 plan year.

Check to see whether your provider is IN-network or OUT-of-network under the new Cardinal Care plan administered by Wellfleet Student:

• Search for CA providers here (under "Plan Type" select "Blue Shield of California PPO Network").
• Search for providers outside of CA here (under "Select a Plan" choose "PPO).
• 2025-2026 Wellfleet Provider Search Guide

If your provider is OUT-of-network:

*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:

*Examples of relevant medical treatments include chemotherapy, scheduled cancer surgery or follow up visits, second/third trimester pregnancy, gender affirming surgery, rehabilitation, etc.

Transition of Care – Pharmacy

The Wellfleet Rx Program will be your pharmacy benefit coverage as of Sept. 1, 2025. To view the current version of the Wellfleet Rx Formulary, click here. This file is searchable (Ctrl+F) by the name of the medication listed on your prescription label.