Patient Rights & Responsibilities
HOW DO I ...
Waiver requests are now being accepted for the 2014 spring term.
At this time, you may choose to waive the Student Extended Insurance Plan
only for the spring term (February 1, 2014 - August 31, 2014). Spring
term waiver requests must be submitted no later than February 15, 2014.
Important future online waiver notice
Student wishing to request waivers for the 2014-2015 Academic Year
(September 1, 2014 - August 31, 2015) must resubmit their online waiver request
during the 2014/2015 fall term open enrollment period (deadline September 15, 2014).
The Fall and Spring term online waiver will be available July 2014.
If you have any questions, please e-mail us at email@example.com
or call us at 617-253-4371.
How the Waiver Works
All MIT students are automatically enrolled in the MIT Student Extended Insurance Plan.
Students whose current insurance coverage meets the minimum standards required by the
Commonwealth of Massachusetts may complete an online waiver request which is submitted
to the MIT Student Health Plans. Upon submission of a waiver request, an email will be
sent confirming its receipt as the application is checked for comparability against the
Commonwealth of Massachusetts state insurance requirements. Please print and save this
email confirmation as a receipt of your waiver transaction. If the waiver request is
approved, the cost of the MIT Student Extended Insurance Plan will be removed from the
student's term bill. Students waiving the MIT Student Extended Insurance Plan should
carry their insurance card with them. Waiver requests must be submitted each academic year.
You must read and agree with the following statement to continue:
I am currently participating in and will continue to participate in a health insurance
program other than the MIT Student Extended Insurance Plan. I have compared my current
insurance to the Massachusetts Student Health Insurance Program (SHIP) minimum requirements and my plan meets all
Massachusetts SHIP requirements.
You must read and agree to the following statement to continue:
I wish to waive enrollment in the MIT Student Extended Insurance Plan. I understand that by
waiving the MIT sponsored student health insurance plan, I will be fully responsible for
all medical expenses resulting from services that are not covered by my health insurance.
I acknowledge that even if I am referred for services outside of MIT Medical, all cost for
that medical care (including prescription drugs) are my responsibility and neither MIT nor
MIT Medical will be responsible for those expenses.
I certify that my insurance coverage is with a U.S. based company.
The state of Massachusetts no longer allows waivers with insurance
policies that have an international carrier based outside of the U.S.
Are you an NCAA sponsored student-athlete?
Yes, I am a student-athleteNo, I am not a student-athlete
Student-Athletes must read and agree to the following statements:
I understand that as a student-athlete at MIT, I am required to have and maintain
current individual medical/health insurance coverage, before and while participating
in any strength and conditioning session, practice, game, competition, and/or team
travel that is supervised by approved MIT coaching staff, and approved by the
Director of Athletics, according to NCAA regulations.
I understand that my health insurance coverage shall include a provision for sports
injury/illness related medical care with a limit of at least $90,000.
I understand that if my health insurance coverage lapses I shall discontinue
participation until I procure an acceptable level of coverage.
I understand that since participation in the program is voluntary, MIT shall not be
responsible for medical bills, including deductibles, not covered by my medical/health
insurance policy. I understand that coverage or reimbursement for costs associated
with hospital emergency room visits, off-campus office visits, off-campus hospitalization,
and other health care (e.g. lab tests, imaging, orthotics, physical therapy), even when
referred by the Sports Health Care Team, MIT Medical providers, or others (e.g. coach
and non MIT Healthcare providers), shall be determined solely by my health insurance policy.
Please select your school:
Sloan Fellows Program (Not MBA)
MIT Medical Services Directory
Health Plans Office
M–F, 8:30 a.m. to 5 p.m.
Claims and Member Services
M–F, 8:30 a.m. to 5 p.m.
M–F, 9 a.m. to 5 p.m.