The fall waiver period is now closed. The spring 2014 waiver period will open in December 2013, with a waiver deadline of February 15.
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Many MIT students choose full protection through the MIT Student Extended Insurance Plan, which is specifically designed to coordinate with the free care we provide on campus through the MIT Student Medical Plan. But deciding on a health plan can be a difficult process. To help you choose the right coverage, here are the most frequently asked questions we receive from students.
Massachusetts has set minimum standards for qualified student health insurance programs. All MIT students must have health insurance that meets these requirements. Students enrolled at MIT have the option of enrolling in the MIT Student Extended Insurance Plan or waiving this coverage if they are enrolled in a U.S.-based health insurance program that meets Massachusetts requirements. This coverage must be in effect for the entire academic year. You are responsible for determining whether your health insurance meets these requirements. Because of the extremely high cost of medical care in Boston, we recommend that your coverage be comparable to the MIT Student Extended Insurance Plan. In addition, make sure your insurance plan covers services while you are in Massachusetts.
Your coverage must include all benefits mandated by Massachusetts insurance law, including (but not limited to):
If there are overall maximum limits, coverage for all benefits for each illness or accident must be at least $25,000.
Hospital charges for room and board and special services in a semiprivate or intensive care unit must be covered at 80 percent of allowed charges for each illness or accident.
Physician fees (excluding surgery) must be covered at 80 percent of allowed charges for each illness or accident.
Surgical services must be covered at 80 percent of allowed charges for expenses actually incurred for surgery, up to a maximum of at least $5,000 for each surgical procedure. This includes coverage for anesthetist or assistant surgeon services up to 30 percent of the amount reimbursed under the surgical coverage.
Basic benefits for expenses actually incurred in a physician's office, hospital outpatient department or emergency room, clinical lab, radiological facility, or other similar facility licensed by the state must be covered at 80 percent of allowed charges, up to a maximum of at least $1,500 for each illness or accident. A deductible or copayment may be charged for each visit but cannot be larger than:
Surgical services are covered at the same rate as listed above for inpatient surgery.
High-cost procedures (over $200) must be covered at 80 percent of allowed charges up to a maximum of at least $2,000 per illness or injury.
Outpatient mental health must fully cover at least 24 outpatient visits per year. For biologically based conditions, treatment of rape-related post-traumatic symptoms, and care for persons under age 19, coverage must be at least as extensive as coverage for outpatient medical conditions.
Outpatient contraceptive services, if offered, must be offered on the same terms and conditions as all other outpatient services. If prescription drug coverage is offered, it must cover FDA-approved contraceptive drugs on the same terms and conditions as all other drugs.
Students with J-1 visas under MIT visa sponsorship must have insurance that not only meets state requirements, but also meets United States Department of State regulations for themselves and their spouses and children who accompany them. These requirements include:
For non-Institute visiting students, please email firstname.lastname@example.org for additional requirements.
The MIT Student Extended Insurance Plan provides students with exceptional health care and services right on campus. In addition to the convenience of location and breadth of services available, students benefit from being part of the greater Blue Cross Blue Shield network and having access to in-network providers and facilities. Students also have access to coordinated care at MIT Medical’s affiliate hospitals, which include Massachusetts General Hospital and Mt. Auburn Hospital.
Before you decide to waive the MIT Student Extended Insurance Plan, make sure you compare the benefits to those in your existing plan, and find out how your current insurance works away from home. For example, would your current insurer expect you to seek care at its in-network hospitals, and if so, where are those hospitals located?
If you decide to waive, find out if your insurance requires prior authorizations or referrals in order for services to be covered. If so, it will be up to you to obtain any authorizations or referrals before seeking care. You should also carry your insurance card with you at all times.
No. As of August 1, 2006, MIT Student Health Plans no longer accepts insurance plans with international carriers. The state of Massachusetts stipulates that students cannot waive with coverage from insurance carriers outside of the U.S., unless the student is studying in a foreign country, and the student's insurance provides coverage in that location.
No, even if you waive the Extended Insurance Plan, you still have access to the MIT Student Medical Plan, which is free with tuition.
Your home HMO might not work well in the Boston area. You may even find that you have to leave campus and return home to get the care you need, because many HMOs have restrictions on out-of-area coverage. This may be a problem for you if a care provider at MIT Medical refers you for care off campus, or if you decide to seek care off campus yourself.
For you to be eligible for coverage, most HMOs insist that all care be authorized in advance and coordinated by your primary care physician. Further, HMOs generally prefer or require members to use services in their networks.
Read your policy carefully, and ask your HMO’s member services department about the requirements.
Most sports injuries can be treated promptly on campus. The MIT Student Medical Plan (automatic enrollment for all students with tuition) covers medical services provided at MIT Medical. MIT Medical offers urgent care 24 hours a day, seven days a week. Lab tests and X-rays are available at MIT Medical during normal business hours.
Evaluation and treatment services provided outside MIT Medical (for sports injuries that occur while traveling, for example), or more extensive services such as hospitalization, surgery, or physical therapy, are not covered by the MIT Student Medical Plan. In these situations, the coverage provided by either the MIT Student Extended Insurance Plan or your parent's insurance would apply.
The MIT Student Extended Insurance Plan covers a wide variety of treatments off campus. Some of these covered off-campus services will require you to pay a deductible, copayment, or coinsurance. The MIT Student Extended Insurance Plan coverage meets or exceeds all Massachusetts and varsity/NCAA health insurance requirements. For more information, please refer to the "Resources" section on the MIT Student Extended Insurance Plan page.
If you plan to use your parent's insurance plan, you should review your coverage carefully to see what is covered if you are injured while at MIT. Would you need to obtain prior authorization from your insurance plan before receiving care? How long would this process take? Does the coverage meet the requirements for varsity/NCAA athletes? In addition to Massachusetts insurance requirements, varsity/NCAA sports team participants need to ensure that they have coverage for sports injuries, that the coverage remains active during participation, and that the plan includes a provision for sports injury/illness-related medical care with a limit of at least $90,000. For more information about the requirements related to varsity/NCAA sports teams, please click here.
With the MIT Student Health Plan, you have two excellent sets of coverage: the MIT Student Medical Plan and MIT Student Extended Insurance Plan.
First, we encourage you to use the services at MIT Medical, including primary care, mental health services, and gynecology. As a tuition-paying student, you are automatically enrolled in the MIT Student Medical Plan, which provides full coverage for these services and other office visits at MIT Medical.
If you enroll in the MIT Student Extended Insurance Plan, you have additional coverage for services outside MIT Medical. Your MIT Medical care provider will refer you to appropriate outside medical providers when you need services that are not available at MIT Medical. (Please note that coverage for office visits outside MIT Medical, other than for mental health, is subject to an annual visit maximum.)
No, students must complete the online waiver form using their own certificates.
You must file a new waiver form each academic year. In the fall, you can waive for fall only or for both fall and spring semesters. You will automatically be enrolled in, and billed for, the MIT Student Extended Insurance Plan for the fall semester each year. You must submit a waiver by September 15 to have the charge removed from your account. If you waive for the fall term only, you will automatically be enrolled in, and billed for, the MIT Student Extended Insurance Plan for the spring semester as well, and you will need to submit another waiver request by February 15 for the spring term.
In order to purchase MIT health insurance for your spouse and/or children, you must be enrolled in MIT health insurance as well. For example, if you want them covered under the MIT Student Extended Insurance Plan, you must be enrolled in the MIT Student Extended Insurance Plan yourself.
Please contact the MIT Health Plans office at 617-253-4371, or stop by E23-308. Be sure to have information about your current health plan available when you talk with MIT Health Plans representatives.
A graduate student may receive an award—a research or teaching assistantship or a fellowship—that covers the cost of the MIT Student Extended Insurance Plan. The student may then decide to waive the plan, but if so, he or she will not receive reimbursement for what the cost of the plan would have been.
If you decide to waive the MIT Student Extended Insurance Plan, please follow the instructions for our online waiver process (MIT certificate required). If you are unable to use the online form, contact us at email@example.com.
Waiver request deadlines:
Please print and save the automatically generated email you will receive upon successful completion of this waiver process.