The US healthcare system is most likely much different than your own. Make sure you are prepared with health, vision, and dental insurance before your arrival.

Understand how deductibles, coinsurance and copays work in health insurance.

Students may petition to waive the SMIP through their Gallagher account if the following criteria are met:

•   The student does not hold an F1 or J1 visa.
•   Plan must be in compliance with the Affordable Care Act (ACA Compliant)
•   The claims administrator of the plan is based in the United States, has a U.S. telephone number and address for submission of claims, and the insurance policy has not been issued outside the U.S.
•   The policy is not a traveling policy.
•   The plan provides unlimited emergency and non-emergency routine health care and mental health benefits in the Durham, NC area, including at Duke Medicine. (In order to meet these criteria, your plan must provide in network benefits at Duke Health facilities for the following services: Primary Care Doctors office visits, Specialty office visits, Preventative care office visits, Lab services, X-rays, and imaging)
•   The plan provides inpatient and outpatient mental health care (with at least 30 visits per year) with chemical dependency benefits that are comparable to the coverage provided by the Duke SMIP.
•   The plan provides unlimited coverage for prescription medication.

Common Errors experienced during enrollment:

• ID number issue (student ID vs Duke Unique ID)
• Student unable to log in when using their Duke Unique ID
  • Double check the ID number and date of birth entered, both must match our system in order to create an account
  • Recently registered students may take time to show up on a roster.
    • If the Duke unique ID number and DOB are correct and they have recently registered the student should try again in a week.
    •  If the student has not recently registered, they should contact our team at studentservices@jcbins.com
• Students should have their health insurance ID card with them when completing the waiver
• Students reaching out for assistance should include their Duke Unique ID and full name so we can assist them easily.

In addition to waiver approval by the automated system, please note that all waivers may be audited. If the waiver submitted does not meet the waiver criteria, you will be enrolled in the SMIP.

For questions regarding Eligibility, Enrollment or Waivers, please reach out to 866-931-5275 or email the team at insurance@studentaffairs.duke.edu.

The annual cost of coverage for all eligible students for the 2024-2025 plan year is $3,461.64.*

For dependents, the annual premium rates are as follows:

• Add Spouse, $3,342.00* (in addition to the student premium)
• Add Child(ren), $3,724.80* (in addition to the student premium)
• Add Family, $7,066.80* (in addition to the student premium)

A portion of the cost of the SMIP is retained by Duke University to pay for administrative costs incurred by the University and for reserve funds. Any portion of the cost of the plan retained by Duke University is encumbered solely for the purpose of funding plan expenses or the equitable and non-discriminatory benefit of plan participants.

*Rates pending regulatory approval.

The Duke SMIP continues to provide excellent benefits at a valuable cost.

The plan has received a platinum tier rating under the Affordable Care Act rating system.

All out-of-pocket costs (coinsurance, copayments, and deductible amounts) will apply to the out-of-pocket limit. In addition, all students will be charged the same rate regardless of age.

If you are enrolled in SHIP and paid the premium, you'll be covered. Your plan also provides you with 24-Hour Worldwide Travel Assistance, which includes services ranging from a lost passport to helping with emergency medical assistance or arranging emergency medical evacuation or repatriation of remains. It’s important to contact Geoblue (855-445-1301) before making arrangements on your own. Otherwise, these services will not be covered.

Other information about seeking medical care abroad:

•   Always keep your SHIP ID card with you.
•   Save a copy of the plan brochure and/or bookmark your student health website.
•   If you get sick while abroad, you will likely need to pay for your care first and then submit bills for reimbursement. Your covered expenses will likely be considered an out-of-network expense.
•   Before you submit claims for reimbursement, have the itemized bill(s) translated into English.
  Also include a letter informing the claims administrator you already paid for the healthcare service
  and need to be reimbursed.

·   Write your name, ID number, address and school name on your bill(s). This will help the claims
company process your reimbursement request correctly and promptly.

Dental insurance is offered to Duke Students and their dependents.

We are pleased to announce a new Dental plan for the 2024/25 school year! Duke has partnered with Aetna Student Health to provide an enhanced dental plan for students. The Aetna dental plan provides 100% coverage (up to the policy limits) at Campus Smiles and all In-network providers. This plan can be used nationwide.

Domestic Students

• Domestic (non-PhD) students must Opt-in to dental coverage. You will not be automatically enrolled.
• Domestic (non-PhD) students can choose to Opt-in to the Aetna Dental plan by visiting www.gallagherstudent.com/duke. Student Dental Premium will be billed to your student account. You can enroll your eligible dependents online at www.gallagherstudent.com/duke.
• If you do not wish to enroll in the Aetna dental plan, no action is required. Only students who Opt-in to coverage will be enrolled and billed for the plan.

International Students

• International students will be automatically enrolled in the Duke dental plan through Aetna unless you Opt-out of coverage by the established deadline.
• International students are automatically enrolled in the Aetna dental plan. The premium is billed to your student account. You may enroll your eligible dependents online at www.gallagherstudent.com/duke.
• If you do not wish to be enrolled in the Aetna dental plan, Opt-out of coverage online at www.gallagherstudent.com. 

Domestic PhD Students

• Domestic PhD students will be automatically enrolled in the Duke dental plan through Aetna unless you Opt-out of coverage by the established deadline.
• Domestic PhD students are automatically enrolled in the Aetna dental plan. You may enroll your eligible dependents online at www.gallagherstudent.com/duke.
• If you do not wish to be enrolled in the Aetna dental plan, you can Opt-out of coverage online at www.gallagherstudent.com. 

Important Information

• The Annual cost of coverage is $329.00
• Coverage effective from August 1, 2024 through July 31, 2025
• There is no deductible
• $2,000 benefit maximum 
• In-network clinic on site at Duke
• The online enrollment site will be live June 17, 2024 through September 14, 2024.
  Note: enrollment and opt-out applications must be completed and submitted online by 11:59pm on September 14, 2024.

Enrollment Exceptions
New students enrolled at the University during the summer term, or students who have lost individual coverage, may enroll in the SMIP through the month of July. Please complete a Duke Exception Form and send to Student Health Insurance at insurance@studentaffairs.duke.edu. Alternatively, you may print the form and fax to 919-681-2874. A charge will be added to your Bursar account for the cost of the plan through the month of July. To ensure that you are enrolled beginning on August 1st, please complete the enrollment process through your Duke Hub account during open enrollment.

Dependent Coverage
Dependents (i.e. spouse and/or children) of eligible students may be enrolled in the SMIP. Any dependents to be covered under Duke SMIP should be enrolled by August 30 (Fall enrollees) or January 30 (Spring Enrollees) by visiting www.studentbluenc.com/#/duke, NO EXCEPTIONS. Payment for dependent premiums will be made directly to Student Blue (Blue Cross). Duke DOES NOT enroll dependents. Please contact Student Blue at 1-888-234-2417 for dependent enrollment questions.

December Graduates 
Will you be graduating in the fall? If so, you will have the option of ending your Duke SMIP coverage with a December 31 termination date. Please submit your termination request to insurance@studentaffairs.duke.edu during Spring Open Enrollment - November 15 through January 31.

If we do not receive your termination request prior to the end of open enrollment, your policy will stay active until July 31, NO EXCEPTIONS. 

Continuation of Coverage 
We do not offer continuation of coverage, which means your current insurance plan will end July 31. As an option, you can apply for insurance at www.healthcare.gov (domestic students) and geobluetravelinsurance.com (international students) at least 30 days prior to your plan termination date.

Who should I reach out to for additional questions?

For questions regarding Eligibility, Enrollment or Waivers, please reach out to 866-931-5275 or log into the Gallagher portal and click Help Center.

How do I log into the portal to enroll in or waive the Student Medical Insurance Plan (SMIP)?

1. Visit https://www.gallagherstudent.com/duke
2. Under “Profile,” click "Log In" and enter your student login credentials.

How do I enroll?

International and PHD Students:

No action is needed as you are automatically enrolled in the student medical insurance plan (SMIP). To view your coverage details:

1. Go to https://www.gallagherstudent.com/duke .
2. Follow the login Instructions.
3. View “Account Details,” found on the lower left side of landing page.

Domestic Students: 

1. Go to https://www.gallagherstudent.com/duke
2. Follow the login instructions.
3. Click on the “Enroll” button under “Plan Summary.”
4. Follow the instructions to complete the form.
5. Enrollment confirmation email will be sent.

Please note that students who do not submit a waiver by the September 14, 2024 deadline will be automatically enrolled.

How do I enroll my dependents?

1. Go to https://www.gallagherstudent.com/duke.
2. Follow the login instructions.
3. Click on the “Enroll” button under “Plan Summary.”
4. Follow the instructions to complete the form to enter and enroll your “dependent spouse/partner” and/or “dependent children.”
5. Enrollment confirmation will be sent.

You must purchase dependent insurance for the same coverage period as your own coverage; it can’t be for a longer or shorter period than your own. For example, if you enroll for fall coverage, your dependents need to be enrolled for fall coverage; you wouldn’t be able to enroll them for annual coverage. If you enroll for fall coverage and do not enroll your dependents at that time, you cannot enroll your dependents unless a qualifying event occurs.

Note: If enrolling a dependent for the first time in SHIP, documentation needs to be uploaded at the time of submission. For example, a marriage certificate for a dependent spouse or birth certificate for a dependent child.

For further information regarding dependent enrollment, please refer to the FAQ page here or visit Gallagher Student Health. If you have additional questions, feel free to contact customer service at 1-866-931-5275.

Waiving SHIP Coverage

Please note:  If you are an international student holding an F1 or J1 visa, enrollment in the SMIP is mandatory.

To be eligible to waive your SHIP, you must be currently enrolled in a health insurance plan that meets Duke University’s waiver requirements.

•   The student does not hold an F1 or J1 visa.
•   Plan must be in compliance with the Affordable Care Act (ACA Compliant)
•   The claims administrator of the plan is based in the United States, has a U.S. telephone number and address for submission of claims, and the insurance policy has not been issued outside the U.S.
•   The policy is not a traveling policy.
•   The plan provides unlimited emergency and non-emergency routine health care and mental health benefits in the Durham, NC area, including at Duke Medicine. (In order to meet these criteria, your plan must provide in network benefits at Duke Health facilities for the following services: Primary Care Doctors office visits, Specialty office visits, Preventative care office visits, Lab services, X-rays, and imaging)
•   The plan provides inpatient and outpatient mental health care (with at least 30 visits per year) with chemical dependency benefits that are comparable to the coverage provided by the Duke SMIP.
•   The plan provides unlimited coverage for prescription medication.

 To submit a waiver:

1. Go to https://www.gallagherstudent.com/duke
2. Follow the login instructions.
3. Click on the “Waive” button under “Plan Summary.”
4. You will need your health insurance information.

Note: Your insurance information is required to complete the waiver form; you do not need to upload documents at the time of initial submission. You will receive an email notification if additional documents are needed.

If you successfully waived SHIP coverage but decide to enroll at a later date, you can cancel the waiver form after it’s been submitted by following the directions below.

This must be completed prior to September 14, 2024. 

1. Go to https://www.gallagherstudent.com/duke
2. Follow the login instructions.
3. Navigate to “Account Details.”
4. Click “Click Here to Rescind Your Waiver.”
5. Click “Rescind My Waiver.”

Note: Once your waiver is rescinded, this action cannot be reversed. You may not edit your form after September 14, 2024.

If I waive, but then lose my coverage, can I enroll in SHIP or enroll my dependents if they lose coverage?

If you waive SHIP and then lose coverage, you can enroll in the plan. Losing coverage is categorized as a Qualifying Life Event. Other Qualifying Life Events include:

•   Reaching the age limit of another health insurance plan.
•   Involuntary loss of coverage from another health insurance plan.

You can only add eligible dependent(s) outside of the enrollment period if one of these qualifying events occurs:

•   You get married
•   You have a child
•   You get divorced
•   Your dependent enters the country for the first time
•   Your dependent loses coverage under another insurance plan

To initiate the Qualifying Life Event process:

1. Go to https://www.gallagherstudent.com/duke
2. Follow the login instructions.
3. Click on “Enroll-Qualifying Life Event.”
4. Complete the online form and upload the required supporting document, such as the loss of coverage letter from your prior health insurance company showing your name and the last day of coverage.

Note: Read the form carefully as it contains very specific information on the Qualifying Life Event process.

Once enrolled, can I cancel? Get a refund?

Once you are enrolled in SHIP, you will remain enrolled in the plan for the full coverage period. You have no option to terminate coverage unless you enter the armed forces. In that case we will refund — or your student account will be credited — a pro-rated share of your premium.

Where can I get more information about my plan?

Go to  https://www.gallagherstudent.com/duke

Have changes been made to this year’s plan?

No changes were made to the plan for the 2024–2025 Policy Year.

Am I still covered while traveling? When studying abroad?

With Travel Assistance:

Yes, your plan covers you wherever you are. If you are enrolled in SHIP and paid the premium, you'll be covered. Your plan also provides you with 24-Hour Worldwide Travel Assistance, which includes services ranging from a lost passport to helping with emergency medical assistance or arranging emergency medical evacuation or repatriation of remains. It’s important to contact Geoblue (855-445-1301) before making arrangements on your own. Otherwise, these services will not be covered.

Other information about seeking medical care abroad:

•   Always keep your SHIP ID card with you.
•   Save a copy of the plan brochure and/or bookmark your student health website.
•   If you get sick while abroad, you will likely need to pay for your care first and then submit bills for reimbursement. Your covered expenses will likely be considered an out-of-network expense.
•   Before you submit claims for reimbursement, have the itemized bill(s) translated into English. Also include a letter informing the claims administrator you already paid for the healthcare service and need to be reimbursed.
•   Write your name, ID number, address and school name on your bill(s). This will help the claims company process your reimbursement request correctly and promptly.

I received a letter from Blue Cross Blue Shield of North Carolina asking me to provide my social security number.  Why do they need this information?  What should I do? How do I know what was reported to the IRS?

The IRS requires that all health plans provide information on members to keep track of who has had health insurance and for what months during the tax year. You received the letter because BCBSNC currently doesn’t have the needed information.  You can call 1-800-326-0052 and speak to an agent to update your information or you can fill in the blank boxes on the letter provided and return it in the addressed envelope that BCBSNC enclosed in the mailing.

In January of every year, you will receive Form 1095-B from BCBSNC which will show you what BCBSNC is reporting to the government each year.