Babson College

DEPENDENT INSURANCE OPTIONS

Even though colleges are not mandated to provide an insurance program for dependents, historically Babson’s student insurance plan has provided coverage for dependents. However, because of soaring medical costs and in order to fulfill our goal of providing a quality and affordable health plan for students, dependents will no longer be eligible to participate in the student plan.

Despite this new development, the College understands that it is important to have your dependents enrolled in a health insurance plan while you pursue your academic career. Therefore, alternative health insurance programs have been identified for you and your family to examine and determine which might be appropriate for your health care needs.

The following information is provided to help you understand the different types of insurance programs and how they work.

Health Maintenance Organization (HMO): If you choose to purchase insurance through an HMO, you will be required to select a Primary Care Provider (PCP) who will be the professional who will manage your care. If your PCP determines that your condition requires the evaluation and care of a specialist, the PCP will refer you to the appropriate specialist.

HMOs require that you get your care within in the network of their providers and receive a referral from your PCP before you are seen by another provider. For most HMOs the cost to you at each visit is your co-pay and the remaining cost is paid at 100% by the HMO.

If you become ill while you are outside of their network coverage area, HMOs will only pay for emergency services.

Preferred Provider Organization (PPO): If you choose to purchase insurance coverage through a PPO, you are not limited to which providers you can see. Instead, your benefits are paid at different levels based on whether you access care within a particular network or outside of a particular network.

PPOs require that you meet individual calendar year deductibles before your benefits start. If you have three or more family members covered under the same policy, there is usually a maximum deductible per family per calendar year. Once this deductible is met, the PPO will pay a percentage of your benefit. This is called the co-insurance. You are then responsible for any remaining balance. In-network and out-of-network providers are usually paid at different benefit levels (i.e. 100% in-network – 80% out-of-network or 90% in-network – 70% out-of-network) and co-pays may apply.

If you use a provider who is within the network, that provider will submit a claim for payment to the insurance company. The insurance company pays a portion and the provider will bill you for your responsibility for that service (if co-pays apply you will pay the required co-pay at the time of the visit). If you use a provider outside of the network, that provider may require payment at the time of your visit and that you submit your bill to the insurance company to be reimbursed later.

For further details on any of these programs please log on to the websites that we have provided.