At this time, you may choose to waive both the fall term (September 1, 2015 - January 31, 2016) and spring term (February 1, 2016 - August 31, 2016) Student Extended Insurance Plan. Fall term waiver requests must be submitted no later then September 15, 2015.
If you have any questions, please e-mail us at firstname.lastname@example.org or call us at 617-253-4371.
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.
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.
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.
There are certain services that are not covered under the MIT Medical Plan (the plan every actively registered MIT student has, which is included with tuition). By waiving the MIT Student Extended Insurance Plan, you agree that you will be responsible for those charges if you receive these services. For more information, please see the MIT Student Health Plan brochure for this upcoming term.
Are you an NCAA sponsored student-athlete?
Yes, I am a student-athlete No, I am not a student-athlete
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.