MASSACHUSETTS MARITIME ACADEMY
STUDENT HEALTH INSURANCE PLAN
2025-26 ANNUAL WAIVER FORM
2025-26 Annual Waiver Form
(August 1, 2025 - July 31, 2026)
Student Health Plan
- Waiver Form
- Enrollment Form
- Provider Search
- Worldwide Providers &
Travel Assistance - Insurance ID Card
Optional Plans
Additional Information
Please note, with the rising costs of healthcare, and increase in utilization of the Plan, the following plan change has been made for the 2025-2026 academic year to help keep the insurance premium and the plan a viable option for all students.
- Deductible will be $2,000 (does not apply to in-network preventative care, office visits, ER visits, ambulance, lab work, x-ray, or prescription drugs).
Plan benefit information is available on this website for your review. If you are enrolling in the SHIP, be sure to familiarize yourself with the Plan prior to receiving services. For specific benefit or claims questions contact Blue Cross Blue Shield of Massachusetts at 1-888-753-6615.
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).
Please note, with the rising costs of healthcare, and increase in utilization of the Plan, the following plan change has been made for the 2025-2026 academic year to help keep the insurance premium and the plan a viable option for all students.
- Deductible will be $2,000 (does not apply to in-network preventative care, office visits, ER visits, ambulance, lab work, x-ray, or prescription drugs).
If you are enrolling in the SHIP, be sure to familiarize yourself with the Plan prior to receiving services. For specific benefit or claims questions contact Blue Cross Blue Shield of Massachusetts at 1-888-753-6615.
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).
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).
Please note, with the rising costs of healthcare, and increase in utilization of the Plan, the following plan change has been made for the 2025-2026 academic year to help keep the insurance premium and the plan a viable option for all students.
- Deductible will be $2,000 (does not apply to in-network preventative care, office visits, ER visits, ambulance, lab work, x-ray, or prescription drugs).
If you are enrolling in the SHIP, be sure to familiarize yourself with the Plan prior to receiving services. For specific benefit or claims questions contact Blue Cross Blue Shield of Massachusetts at 1-888-753-6615.
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).
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).