Please review the 23-24 Summary of Benefits and Coverage and note the out-of-pocket maximum and coinsurance required for specialty drugs.

• Out-of-pocket maximum is $8,700 for medical and prescription drug expenses.
• The 5-Tier Plan prescription drug copays:
  • Tier 1: $10 copay (generic)
  • Tier 2: $20 copay (preferred brand)
  • Tier 3: $30 copay (non-preferred brand)
  • Tier 4: 30% coinsurance (preferred specialty)
  • Tier 5: 30% coinsurance (non-preferred specialty)

To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.

We encourage students anticipating high out-of-pocket costs to compare other insurance options to the SHIP. The Massachusetts Health Connector offers information about their online insurance marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).

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The following changes have been made to the 2022-2023 policy:

• Out of Pocket Maximum will increase to $8,700 for combined medical and prescription expenses.
• The prescription drug copayments will change to a 5-Tier Plan:
  • Tier 1: $10 copay (generic)
  • Tier 2: $20 copay (preferred brand)
  • Tier 3: $30 copay (non-preferred brand)
  • Tier 4: 30% coinsurance (preferred specialty)
  • Tier 5: 30% coinsurance (non-preferred specialty)

To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.

Continue to the Summary of Benefits and Coverage

The following changes have been made to the 2022-2023 policy:

• Out of Pocket Maximum will increase to $8,700 for combined medical and prescription expenses.
• The prescription drug copayments will change to a 5-Tier Plan:
  • Tier 1: $10 copay (generic)
  • Tier 2: $20 copay (preferred brand)
  • Tier 3: $30 copay (non-preferred brand)
  • Tier 4: 30% coinsurance (preferred specialty)
  • Tier 5: 30% coinsurance (non-preferred specialty)

To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.

Continue to the Plan Highlights

The 2024-2025 policy year summary of benefits is pending approval and will be posted as soon as available.

Please note, with the rising costs of healthcare, and increase in utilization of the Plan, the following plan changes have been imposed for the 2024-2025 academic year to help keep the insurance premium and the plan a viable option for all students.

• Deductible will be $500
• Out-of-pocket maximum will be $9,100
• In-network preventive care - deductible will not apply.
• In-network office visit copay will be $30 for primary and mental health visits and $65 for specialist visits (deductible will not apply in-network).
• Emergency room copay will be $200 (deductible will not apply).
• Ambulance services - new deductible will not apply.
• Diagnostic Tests & X-rays - In-network copays will be $50 for lab and $100 for x-ray (deductible does not apply). Out-of-network will be a 20% coinsurance.
• Imaging (CT/PET scans, MRIs will be a 20% coinsurance in-network/40% coinsurance out-of-network
• The 5-Tier Plan prescription drug copays: deductible does not apply
  • Tier 1: $20 copay (generic)
  • Tier 2: $40 copay (preferred brand)
  • Tier 3: $60 copay (non-preferred brand)
  • Tier 4: 50% coinsurance (preferred specialty)
  • Tier 5: 50% coinsurance (non-preferred specialty)

To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.
We encourage students anticipating high out-of-pocket costs to compare other insurance options to the SHIP. The Massachusetts Health Connector offers information about their online insurance marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).