The American healthcare system

Where should I go when I need healthcare?

Primary Care Physician

You should visit a primary care physician (PCP) when general services are needed or for urgent health concerns during typical office hours. Your PCP can provide you with prescriptions, assist with illness and disease, and manage health conditions. Your PCP can refer you to specialists. For preferred providers, there is no copay for routine physical exams (one per year) and a $25 copay for general office visits. For non-preferred providers, you are responsible for 20% coinsurance after the deductible has been met.

Blue Cross Blue Shield’s 24/7 Nurse Line

You should call the 24/7 Nurse Line if you are unsure if your symptoms or an injury require immediate care. This benefit is included in your insurance plan at no additional cost.

Urgent Care

Go to an urgent care when you can’t wait for an appointment with a doctor but are not in critical enough condition to require the emergency room. Remember: if the urgent care determines that you actually need to go to the emergency room, they will send you there. There is a $25 copay to visit an in-network urgent care and 20% coinsurance after the $250 deductible has been met at out-of-network locations.

Emergency Room

Go to the emergency room if your mental or physical health is in immediate need or medical attention. The emergency room is open 24/7 and will provide stabilizing care to every patient. Considerable wait times should be expected if you are not in immediate need of medical attention, as those in dire need of care will always be treated first. There is a $50 copay (which is waived if you are admitted for an observation stay in the hospital) to visit an emergency room, then 10% coinsurance for the services you require. This is the cost both when at in-network locations or out-of-network locations.

Ambulance

If you or someone you are with is in a potentially life-threatening condition, call an ambulance. Emergency medical services (EMS) workers can begin necessary treatment while in transportation to the emergency room. The ambulance will take you to the closest emergency room. Ambulances typically cost patients about $1000 out-of-pocket. If you do not need the immediate assistance of EMS workers, it might be a good idea to consider other means of transportation.

Navigating the American healthcare system

We understand that the American healthcare system is complex, for nationals and international students alike. Here’s a brief understanding of how to navigate the system so you can be an informed consumer!

General insurance terminology:

  • Deductible: the amount of money you must pay out-of-pocket before the insurance covers costs. There is no deductible for preferred providers. For non-preferred providers, there is a $250 deductible.
  • Copay: a fixed dollar amount for which you are responsible to pay for certain covered services.
  • Coinsurance: a cost-sharing method of payment, where you pay a fixed percentage of the cost.
  • Out-of-Pocket: this refers to costs for which you, the member, are solely responsible.
  • Out-of-Pocket Maximum: the maximum amount of out-of-pocket costs for which you are responsible for during the plan year for deductibles, copays, and coinsurance.
  • Preferred Provider: also known as “in-network” providers. These are providers that will be the most cost-effective, as they are contracted with Blue Cross Blue Shield. You can find preferred providers here.
  • Non-Preferred Provider: also known as “out-of-network” providers. You have coverage with non-preferred providers, but you will have higher out-of-pocket costs. You will pay 20% coinsurance for non-preferred providers after you have paid the $250 deductible.

For more information about your coverage, please check out the Summary of Benefits (PDF).

How do I use insurance for an appointment?

  1. Access your Verification of Coverage letter

    Your Verification of Coverage letter includes your policy number, insurance ID, pharmacy information, and the start and end dates of your insurance policy.

    To locate your Verification of Coverage letter:
    1. Log into your Student Hub at me.northeastern.edu
    2. Navigate to Resources/Health & Wellness and look for the Health Plan Fee Waiver. Click this link and it will direct you to the Gallagher website.
    3. Under “Profile” click “Sign Up”
    4. Scroll down to “Account Details”
    5. Click on “Verification of Coverage”

      **Please note that your full member ID number includes the prefix “NUQ”
  2. Download Your Insurance Card

    Blue Cross Blue Shield does not automatically send out insurance cards. To access a virtual insurance card, we are encouraging all students to download the MyBlue app. After you have accessed your Verification of Coverage Letter, download the MyBlue app. Create an account to have access to your insurance card and all plan information through your phone.

    If you prefer the physical card, please reach out to BCBS or visit the Gallagher Student Health website to request one.
  3. Find a doctor and estimate.
  4. When you go to the doctor/facility, present them with your insurance information so they can bill the insurance.