Qualifying Event Enrollment Form

Students who waived the Student Health Insurance Plan (SHIP) and recently lost their other coverage should contact the UMass Chan Medical School Bursar's Office at 508-856-6641 or 508-856-5249 to request a qualifying event enrollment. The deadline to complete the enrollment form is 60 days from the qualifying life event.

Students will be asked to provide supporting documentation and the prorated premium will be added to the tuition statement. The first day of coverage in the SHIP will be the first day without coverage under the prior plan or entry into the US.

The following changes have been made to the 2023-2024 policy to keep the premium and Student Health Insurance Plan (SHIP) a viable option for students.

• Out of Pocket Maximum will increase to $9,100 for combined medical and prescription expenses.
• The prescription drug copayments will change to a 5-Tier Plan:
  • Tier 1: $15 copay (generic)
  • Tier 2: $30 copay (preferred brand)
  • Tier 3: $50 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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