How Wellfleet is raising the bar with healthcare quality improvement programs

At Wellfleet, we’re committed to never-ending improvement. Always mindful of new research and developments, we regularly refine our student health insurance plan offerings to align more closely with students’ needs. We complete healthcare quality improvement programs to ensure our student health plans have the greatest benefit for our members.

Our latest healthcare quality improvement initiatives include:

  • Improved continuity of care by reminding students of upcoming prior authorization expirations
  • Access to specialty drug savings for certain medications through our Copay Assistance Program
  • Enhanced behavioral healthcare resources with the addition of SilverCloud® by Amwell ®
  • Better education on our coverage of gender-affirming care through our newly published guides

Read on to learn more about how each of these Wellfleet Student initiatives is improving the student healthcare experience for our members.

Better member experience through our prior authorization reminder letter

The Wellfleet Rx team continually looks for ways to enhance member satisfaction and reduce friction for students receiving the care they need. After noticing that some students are experiencing gaps in medication coverage due to expired prior authorizations, we decided to address that.

What is a prior authorization?

A prior authorization is approval given from an insurer stating that they will cover a member’s medical care, treatment, or medication. This authorization ensures the member receives medically necessary, appropriate, and safe treatment. If a medication requires prior authorization, the member’s healthcare provider either fills out a request form or submits the necessary information in a secure online portal. If approved, most drug prior authorizations last for 12 months

What does this prior authorization letter do?

Although students and their prescribers are informed of the duration of prior authorization approvals when granted, it is not surprising that the expiration date may not be top of mind when that date is 12 months later. As a result, students and prescribers may not prepare in advance, which results in an unexpected claim denial when attempting to fill the medication after the prior authorization expiration.

In a proactive effort to benefit our student members, we have streamlined the healthcare experience to avoid medication delays. By keeping track of upcoming prior authorization expirations, we can send students reminder letters in advance. Allowing them time to request a renewal from their provider prevents uninterrupted coverage and facilitates timely prescription fulfillment.

Not wanting our students to run out of their needed medications while waiting for a prior authorization renewal, we decided to make the healthcare experience as easy and cohesive as possible for our student members.

Decreasing specialty drug costs with the Copay Assistance Program

As students navigate a sea of financial responsibilities while preparing for their future career, affordability is key to getting the right healthcare. Wellfleet Rx, our student-centered pharmacy solution, is taking action to reduce the financial burden on students through our Copay Assistance Program.

We have partnered with PillarRx to implement a copay assistance program that helps members save money on certain qualifying high-cost medications.* This program contributes toward our goal of offering a robust yet cost-effective prescription drug plan for students and their families.

What is copay assistance?

Copay assistance is a process in which drug manufacturers provide financial support to patients by covering all or most of the copay applied to a specialty medication.

Wellfleet’s Copay Assistance Program assists members with obtaining copay assistance from drug manufacturers to reduce their out-of-pocket expenses for eligible medications. Using the Copay Assistance Program may result in savings for students and their families.

Benefits of copay assistance for students and schools

Here are a few of the ways the Copay Assistance Program benefits members and schools:

  • Members can pay lower out-of-pocket costs for their specialty medications.
  • Members can fill their prescription as normal, at their chosen participating pharmacy.
  • Members can use copay assistance for multiple specialty medications, if available.
  • Schools may see future premium savings because of lower drug costs to the plan.

For what medications is copay assistance available?

The Copay Assistance Program is available for a variety of specialty medications. For more details, see our Copay Assistance Program document with a complete list of approved drugs and frequently asked questions about the program.

Enhancing behavioral healthcare with SilverCloud® by Amwell®

With the many stressors college students face, mental health plays a central role in student success. It can be hard for college campuses to meet the behavioral health needs of their students, which is why Wellfleet Student goes further to provide support.

We’ve added the digital behavioral health program SilverCloud® by Amwell® to our lineup of behavioral health resources for students. That’s along with other resources, such as telehealth and in-person mental health visits, 24/7 support via CareConnect, and prescription coverage through Wellfleet Rx.

SilverCloud® by Amwell® offers 24/7 online, self-guided activities and tools that can help students feel better by managing:

  • Anxiety
  • Depression
  • Stress
  • Sleep issues

In fact, 65% of SilverCloud’s users experience clinically significant improvement.1

We provide free access to SilverCloud® by Amwell® for any of our partner schools who elect our SHIP plans and complete three simple promotional activities to inform students of its availability.2 Students at participating schools can access SilverCloud® by Amwell® for free.

For more information on how Wellfleet Student partner schools can enroll in SilverCloud® by Amwell® at no cost, visit our website.

Supporting students’ unique needs through gender-affirming care

College can play an important role in facilitating a student’s gender identity exploration.3 Creating an open and supportive environment with ample resources can help all students feel secure. Wellfleet continues to be a leader among Student Health Insurance Plans regarding coverage of transgender services.

To reach that goal, we regularly revisit how we review and approve gender-affirming treatments and procedures. We created our own set of transgender coverages that we offer as a baseline for schools, as well as enhanced coverage if desired. Our gender-affirming policies include coverage and processes that make gender-affirming care accessible for transgender and non-binary students.

For more information about gender-affirming services, we have three guides available for your reference — a standard version, a California-specific version, and an enhanced coverage version.

To find the guide, head to our website. Search for your school, and on your school’s page, head to the forms and resources section, where you’ll see a link to our guide to gender-affirming services for transgender and non-binary members.

Learn more about Wellfleet Student

Contact our Sales team to learn more about these programs and how Wellfleet Student can build a custom plan for your students. As the only health plan designed for students, we’re committed to ensuring your students get the right care at the right price.


*The Wellfleet Rx Copay Assistance program is subject to state approval and can only be filed in certain states. This means not all plans under Wellfleet Rx will be eligible for the program.

1 Enrique, Angel, et al. The Association Between Usage and Outcomes of an Online Intervention for Depression.

2 Program is free to schools with fully funded Wellfleet Student plans. Schools must agree to standard use terms and conditions. For more information, contact your Wellfleet Student Account Manager. SilverCloud. All rights reserved. SilverCloud and the SilverCloud logo are trademarks of SilverCloud.

3 Goldberg, Abbie. (2018, August). Transgender Students in Higher Education. The Williams Institute, UCLA School of Law.


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