Flexible MIT Health Plan

For benefits-eligible employees of MIT Cambridge, Lincoln Laboratory, and the Whitehead Institute. Not available to Broad Institute or Draper Laboratory employees. Retirees under age 65 may be eligible to continue with the same benefits they had while actively working. Speak with your benefits office to determine your coverage eligibility.

The Flexible MIT Health Plan allows you to arrange for medical care in a number of ways:

Care at MIT: When you receive care at MIT Medical or at one of our affiliate hospitals through a referral by an MIT physician, nearly all services are covered in full.

Care outside MIT: You can choose to receive services from any licensed doctor or general hospital anywhere without a referral, subject to a deductible and 20 percent coinsurance. If the provider isn’t part of the Blue Cross Blue Shield of Massachusetts (BCBSMA) network, you may also be billed for the difference between the BCBSMA-allowed amount and the provider’s fee.

Care outside MIT Medical: You can choose to receive services from any licensed doctor or general hospital anywhere without a referral, subject to a deductible and 20 percent coinsurance. Coverage is provided according your benefit plan and subject to BCBSMA guidelines. If the provider isn’t part of the Blue Cross Blue Shield of Massachusetts (BCBSMA) network, you may also be billed for the difference between the BCBSMA-allowed amount and the provider’s fee.

Depending on where you seek health care, coverage for you and your family includes the following (copayments apply in some cases; see the 2009 or 2010 MIT Flexible Health Plan brochure under "Resources" below):

Office visits, with no referral needed, to most MIT clinical services
Urgent care 24 hours a day during the academic year (summer hours may vary)
Routine physical exams (only at MIT Medical, except limited pediatric visits)
Routine eye exams at MIT Medical
A range of women’s health care services, including gynecological exams, mammograms, interrupted pregnancies, and maternity coverage
Outpatient psychotherapy evaluation and some treatment at MIT Medical
Inpatient care at cooperating hospitals or substance abuse treatment facilities
Mental health and substance abuse benefits through BCBSMA’s Managed Care Behavioral Health Network
Cancer treatment
Vision, hearing, cholesterol, and other screening tests (as part of an annual physical)
Diagnostic lab and X-ray services
Immunizations (only at MIT Medical, and excluding pediatric immunizations)
Prescription drugs dispensed at MIT Medical or outside of MIT Medical with participating Express Scripts pharmacies (copayments may vary)
Emergency care
Out-of-area urgent and emergency care services

Worldwide emergency service: If you have a medical emergency anywhere in the world, your care is fully covered as long as you follow our authorization and follow-up procedures. To find a health care provider outside the United States, go to the Blue Cross Blue Shield Doctor and Hospital Finder.

Download the 2010 MIT Flexible Health Plan brochure or the 2009 MIT Flexible Health Plan brochure (PDF) for a complete explanation of the MIT Medical services and benefits available to you and your family. Or contact Claims and Member Services at 617-253-5979 or mservices@med.mit.edu.

Resources