Most incoming MIT freshman have never given much thought to their healthcare coverage. But here at school, they’ll need to start making certain healthcare decisions on their own. That also means thinking about how things are paid for. This is particularly true for students who have waived Extended Plan coverage and won’t have access to MIT Medical’s in-house referral and claims specialists, who can help with making appointments and resolving billing issues.
Help your student learn to navigate the healthcare system and avoid unexpected out-of-pocket expenses. Here’s what to tell your student:
- Carry your insurance card at all times. Students with Extended Plan coverage should receive a Blue Cross Blue Shield of Massachusetts ID card in the mail during the fall semester. Students remaining on a parent’s plan should carry an ID card for that plan. Students do not need to show an insurance card to receive care at MIT Medical, but they will need to provide insurance information if they need to receive care outside of MIT Medical.
- Know what’s covered. Some services at MIT Medical—like routine eye exams, contact lens fitting, and HPV vaccines—are available to all students at MIT but are covered only for students who have the Extended Plan. If your student has waived the Extended Plan but chooses to receive these services on campus, you will be billed. Your outside insurance may cover these services at MIT Medical, but if not, you could be responsible for the full charge. Detailed information about what’s included with tuition is available in the Student Medical Plan Benefit Description. Information about Extended Plan coverage is in the Student Extended Insurance Plan addendum.
Know how to fill prescriptions. Find a pharmacy that accepts your insurance plan before you need it. When your student is sick and needs to fill a prescription, it’s the last thing any of you should worry about.
The MIT Pharmacy can fill prescriptions written by clinicians at MIT Medical, but it doesn’t accept most outside prescription drug plans. Students with the Extended Plan will always have the lowest possible copayment when they fill prescriptions at the MIT Pharmacy. But most students who have waived the Extended Plan will have to pay full retail price for prescriptions at the MIT Pharmacy, though they may be able to submit a claim to the insurer and receive reimbursement.
Know how to find providers outside of MIT Medical. Students with the Extended Plan can use MIT Medical’s Referral Office to find an appropriate provider and book the first appointment. Our Claims and Member Services Office can answer questions about what’s covered and deal with any billing issues that may arise.
If your student has waived, clinicians at MIT Medical can still recommend outside providers or facilities, but it will be up to the student and family to find out if that provider is part of your insurance company’s network. This is important, because out-of-network visits may incur a large deductible or not be covered at all.
Know your insurer’s requirements for care outside of MIT Medical.
- The MIT Student Extended Insurance Plan is a Blue Cross Blue Shield PPO (preferred provider organization). It does not require referrals or prior authorizations for services outside of MIT Medical, however, having a referral on file allows your student to fill prescriptions from the outside provider at the MIT Pharmacy and enables your student’s primary care provider at MIT Medical to receive reports from the outside facility, so he or she can coordinate your student’s care and follow up as needed. Read more.
- If your student has waived, it’s important to know your insurer’s requirements for obtaining care in the Cambridge area. Some insurers may require a referral from the student’s doctor at home or authorization from the company itself.