Health Insurance Requirement
Effective September 1, 1989, the Massachusetts Law C.15A, s. 18 requires that every full-time and part-time student enrolled in an institution of higher learning in Massachusetts participate in a qualifying student health insurance program or in a health benefit plan with comparable coverage. Since the passage of the law, the mandatory qualifying health insurance program covers clearly defined minimum benefits. Some of these benefits are:
- Inpatient hospitalization (excluding surgery): Covers 80% of the actual expenses up to a maximum of $25,000.
- Outpatient Services (excluding surgery): Covers 80% of the actual expenses up to a maximum of $1,500 per illness or accident.
- Surgical Coverage: Covers 80% of the actual expenses for surgery performed in inpatient or outpatient up to a maximum of $5,000.
One of the primary reasons for mandatory health insurance is to reduce the utilization of the Uncompensated Care Pool (Free Care Pool) by students. The legislative intent of the Qualifying Student Health Insurance Program (QSHIP) is to promote students' access to quality health insurance.
As a result, institutions of higher learning automatically bill full-time and part-time students for individual membership in the health insurance plan sponsored by the colleges or universities. Students must purchase the school sponsored health plan or show proof of comparable coverage in an alternate health plan in order to enroll in the college/university of their choice.
Comparable coverage is an alternate insurance plan deemed comparable to the qualifying student health insurance plan. It must meet the following requirements:
The alternate health insurance plan should provide the student with reasonable and comprehensive coverage of inpatient and outpatient hospital services and physician services. The services covered under the alternate health plan must be accessible in Massachusetts and the student must have access to health services in the area where the school is located.
If a student has a health plan with comparable coverage, the student can request a waiver from participating in the college sponsored student health plan. The burden of proof that the alternate insurance is adequate falls on the student who is signing the waiver card.
Not all students that have alternate coverage get the services they need at the time and place they need them. If the plan that the parent enrolled in is other than an indemnity plan, the student faces the possibility of being denied services if the particular managed care plan does not have a network of providers in the vicinity of the school. Students should be aware of this very important fact.
Malpractice Insurance
Students who are officially enrolled participate in the MGH malpractice insurance plan, which covers them for their clinical experiences.
Injuries or Illness during Educational Activities
In the event of any injury or illness that occurs to a student during any educational activities, the Institute will assist the student in finding appropriate medical care, however, the student will be responsible for any medical expenses through his or her health insurance policy or otherwise. The MGH Institute of Health Professions assumes no responsibility for the costs of health care associated with activities that are part of its educational programs.