Student Health Insurance Plan
2025– 2026
Underwritten by: Wellfleet New York Insurance Co.
We are pleased to provide you with this summary of the 2025 – 2026 Student Health Insurance Plan (“Plan”), which is fully compliant with the Affordable Care Act. This is only a brief description of the coverage(s) available under Certificate form NYSHIP Cert. The Certificate will contain reductions, limitations, exclusions, and termination provisions. Full details of coverage are contained in the Certificate. If there are any conflicts between this document and the Certificate, the Certificate shall govern in all cases.
This ACA-compliant plan includes:
- Coverage while at school and at home
- Comprehensive coverage both for emergency and non-emergency situations
- Access to the Cigna PPO network
This Plan is paired with the Cigna Network. Note that the benefits are not insured by Cigna or affiliates.
This Plan also offers the following Value-added services. These services are not part of the Student Health Insurance Plan underwritten by Wellfleet Insurance Co.:
- Vision Discount Program VSP- optional
- Dental Plan- Guardian- optional
Manhattan University Insurance Requirements
All registered full-time undergraduate domestic and international students, all degree seeking international students, all students residing in the university dormitories and all Division 1 athletic participants are automatically enrolled and charged for the Manhattan University Student Health Insurance Plan on their Tuition bill.
If you have existing medical insurance you will have the opportunity to remove the fee you can complete the waiver request by providing details of your current insurance plan coverage. If you require assistance you may contact the plan administrator AHP at 1-844-408-3088.
How to Waive Coverage:
If you have existing medical insurance coverage under another policy (self, parent, spouse, etc.) – you may have the charge for the Manhattan University Student Health Insurance Plan removed from your tuition bill.
Go to: manhattan.edu/studenthealthinsurance for the waiver instructions. Please note that to waive the insurance premium, the student must upload proof of other health coverage.
The deadline to file a waiver is August 15, 2025
Health Insurance Benefit Summary
|
Benefit item (Deductible applies unless otherwise stated) |
Participating Provider |
Non-Participating Provider |
|---|---|---|
|
Individual Deductible Per person, per policy year |
$250 |
$500 |
|
Individual Out-of-Pocket Limit Maximum Per person, per policy year |
$7,900 |
$15,800 |
|
Preventive Services (Deductible waived) |
100% |
70% |
|
Hospital Care*-includes room and board expense *Preauthorization required |
30% coinsurance after deductible |
40% coinsurance after deductible |
|
Inpatient and Outpatient Surgery*- includes surgeon services, Anesthetist and Asst Surgeon. *Preauthorization required |
Covered 70% |
Covered 60% |
|
Primary Care Office Visit Including Specialist Office Visits |
100% after a $25 Copayment |
70% |
|
Urgent Care Center |
70% covered |
70% covered |
|
Emergency Care Services |
70% |
70% |
|
Diagnostic Imaging Services and Laboratory Procedures Pre-Authorization Required |
70% |
60% |
|
Prescription Drugs Up to a 30-day Supply At pharmacies contracting with Wellfleet Rx/ESI |
100% after Tier 1:$20 copay Tier 2:$50 copay Tier 3:$100 copay |
100% after Tier 1:$20 copay Tier 2:$50 copay Tier 3:$100 copay |
|
*For prescriptions purchased at non-participating pharmacies,you must pay in full and then submit a claim for reimbursement. *This summary is provided as a courtesy and is not meant to replace or override the terms and conditions detailed in the insurance policy/brochure. Please refer to the policy/brochure to verify medical coverage, eligibility, exclusions, limitations, and for more detailed information. |
||
|
I need to: |
Visit: |
|
Waive the Insurance Plan |
|
|
Ask Any General Questions on the Program |
Plan Administrator AHP 1-844-408-3088 |
|
Learn about: • Insurance Benefits • Participating PPO Provider Listings • Claims Processing • ID card |
Wellfleet 1-877-657-5030 |
|
Find a PPO Provider:
|
Cigna PPO (PPO, Choice Fund PPO) or Wellfleet 1-877-657-5030 |
|
Find a Prescription Drug Provider: |
Wellfleet Rx/ESI 1-877-657-5030 |
Cost and Period of Coverage
|
Coverage For |
Annual Coverage* 8/1/25-7/31/26 |
Spring Coverage* 1/1/26-7/31/26 |
|
Student Only |
$2,392 |
$1,389 |
|
*Premiums include an Administrative Service Fee |
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WELLFLEET
Accessible, Responsive, Flexible.
(877) 657-5030
2077 Roosevelt Ave.
Springfield, MA 01104
www.studentinsurance.com