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Waiver FAQ

The fall 2014/2015 waiver is now closed. Our spring 2015 waiver will open in December 2014.

To file a waiver application, you must submit your comparable coverage health insurance information as defined by the Massachusetts Student Health Insurance Program. Please note, it is your responsibility to determine whether your coverage is comparable. If you have questions, email us at stuplan@med.mit.edu or call us at 617-253-4371.

Please read the following information before you scroll down to waive.

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.

  1. What requirements do I need to meet to waive the MIT Student Extended Insurance Plan?
  2. I already have health insurance through my parent's plan, and it meets all the requirements for waiving the MIT Student Extended Insurance Plan. Why should I consider the Extended Insurance Plan?
  3. Can I waive with international insurance?
  4. If I waive the Extended Insurance Plan, do I waive all medical coverage on campus?
  5. How will my home HMO coverage work for me when I'm on campus?
  6. If I am injured playing sports, will my insurance cover prompt treatment?
  7. What about other services beyond treatment for injuries and medical tests?
  8. I have an MIT certificate; can I complete the waiver form online for my son or daughter?
  9. Do I have to waive every year?
  10. I'm covered under another plan, but my spouse and children don't have health insurance. Can I get them insurance through MIT?
  11. I waived but now have changed my mind. When can I enroll in the MIT Student Extended Insurance Plan?
  12. What if I have a graduate student award that covers the cost of the Student Extended Insurance Plan, but I still decide to waive?
  13. I'd still like to waive the MIT Student Extended Insurance Plan. What should I do?

1. What requirements do I need to meet to waive the MIT Student Extended Insurance Plan?

  • Massachusetts law sets minimum standards for student health insurance programs. These standards are summarized below. Click here to view the complete standards.
  • Students with J-1 visas under MIT visa sponsorship must also meet U.S. regulations
  • Your insurance must meet all these requirements in order to waive the MIT Student Extended Insurance Plan
  • If you waive the MIT Student Extended Insurance Plan and you are referred to a health care provider outside MIT Medical, you are responsible for the expenses incurred. MIT and the MIT Student Extended Insurance Plan will not pay for this care.

Requirements Summary

General Requirements

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):

  • Treatment for mental and nervous conditions (including biologically based conditions and rape-related post-traumatic symptoms) for up to 60 inpatient days per year
  • Alcohol and drug abuse treatment
  • Emergency services
  • Maternity care
  • Christian Science practitioners, with the same exclusions, limitations, and benefit levels as other services
  • Ambulance transport in an emergency, subject to a $25 deductible, up to a maximum of $125 per illness or injury
  • An annual deductible of no more than $250

If there are overall maximum limits, coverage for all benefits for each illness or accident must be at least $25,000.

Inpatient hospitalization requirements

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.

Outpatient services requirements

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:

  • $100 for each hospital or emergency room visit that does not result in an admission
  • $50 per visit to a hospital outpatient department
  • $25 per visit to a physician's office

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.

For J-1 visa holders only

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:

  • Medical benefits of at least $50,000 per accident or illness
  • In case of death, repatriation of remains in the amount of $7,500
  • In case of serious illness or injury, payment of expenses associated with the medical evacuation of the student to their home country in the amount of $10,000
  • A deductible not to exceed $500 per illness or accident

For non-Institute visiting students, please email stuplan@med.mit.edu for additional requirements.

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2. I already have health insurance through my parent's plan, and it meets all the requirements for waiving the MIT Student Extended Insurance Plan. Why should I consider the Extended Insurance Plan?

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.

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3. Can I waive with international insurance?

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.

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4. If I waive the Extended Insurance Plan, do I waive all medical coverage on campus?

No, even if you waive the Extended Insurance Plan, you still have access to the MIT Student Medical Plan, which is free with tuition.

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5. How will my home HMO coverage work for me when I'm on campus?

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.

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6. If I am injured playing sports, will my insurance cover prompt treatment?

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.

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7. What about other services beyond treatment for injuries and medical tests?

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.)

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8. I have an MIT certificate; can I complete the waiver form online for my son or daughter?

No, students must complete the online waiver form using their own certificates.

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9. Do I have to waive every year?

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.

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10. I'm covered under another plan, but my spouse and children don't have health insurance. Can I get them insurance through MIT?

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.

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11. I waived but now have changed my mind. When can I enroll in the MIT Student Extended Insurance Plan?

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.

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12. What if I have a graduate student award that covers the cost of the Student Extended Insurance Plan, but I still decide to waive?

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.

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13. I'd still like to waive the MIT Student Extended Insurance Plan. What should I do?

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 stuplan@med.mit.edu.

Waiver request deadlines:

  • Fall term or academic year—Waiver requests will be accepted beginning in July and must be submitted by September 15.
  • Spring term only—Waiver requests will be accepted beginning in December and must be submitted no later than February 15.
  • Summer term—Waiver requests for summer term will be accepted beginning in April and must be submitted no later than June 15. Please note that the summer term waiving period is only for students registered for the summer term.

Please print and save the automatically generated email you will receive upon successful completion of this waiver process.

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Resources

MIT Student Health Plan – Overview (2012-13) (PDF)
Full list of student-related publications and forms >>>

Related Links

Online waiver
Student Health Plan Enrollment Form (2012-13) (PDF)
MIT Medical services directory

Student Enrollment Questions

Health Plans Office
E23-308
617-253-4371
stuplan@med.mit.edu

Walk-in/Phone Hours
M–F, 8:30 a.m. to 5 p.m.

Coverage Questions

Claims and Member Services
E23-191
617-253-5979
mservices@med.mit.edu

Phone Hours
M–F, 8:30 a.m. to 5 p.m.

Walk-in Hours
M–F, 9 a.m. to 5 p.m.