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Health Insurance

Student health insurance requirements under Massachusetts law

Massachusetts law requires all full-time and three-fourths-time matriculated students to have comprehensive health insurance. These students will be billed automatically for health insurance. ("Matriculated" means that a student has been accepted into a degree-granting program at UMass Dartmouth. "Three-fourths-time" at UMass Dartmouth means at least 9 credits for undergraduate students and at least 7 credits for graduate students, 9 credits for the school of law.)

Students who are charged for the university student health insurance plan may choose to enroll in the plan or may choose to waive the charge if their own health insurance meets minimum qualifications for coverage in the UMass Dartmouth area.

Before you decide to waive out of the plan: The UMass Dartmouth student health insurance plan offers advantages for students who may be covered under a parent/guardian's plan, but who may not be adequately covered in the UMass Dartmouth area. See below for more information.

Students may either enroll or waive enrollment via their COIN account.

International students

All enrolled international students (F1 and J1 visas) are required to purchase the university student health insurance plan (regardless of the number of credits for which they are registered). These students are enrolled automatically. An exception can be made if the student is covered under an American insurance through a spouse or the studet's embassy that meets the minimum requirements. (Massachusetts law requires that international students have health insurance and not use any of the free health care pools available in various communities.)

Information about waiving coverage

Deadline: If full-time and three-fourths-time students fail to waive out of the plan by the fall 2010 deadline of October 4th or the spring 2011 deadline of February 25th, they will automatically be enrolled in the plan. Students who wish to appeal this enrollment need to fill out the petition to waive form, which will be available on this site after October 4th and must be completed by the deadline of November 5th. The spring deadlines to appeal will be February 25th with a deadline of March 25th.

Enrollment: Be aware that if a student chooses to waive out of the student health plan, he or she will not be eligible to enroll again for one year. The only exceptions are if a student is dropped from his or her health plan and submits proof to the Health Services office within 30 days of being dropped from coverage. Only new students can enroll in January.

UMass Dartmouth’s student health insurance plan

UMass Dartmouth is pleased to offer Blue Cross Blue Shield - Blue Care Elect (PPO) as our student health insurance. This plan is administered by University Health Plans. The plan begins coverage on August 1 and ends July 31.

To view the complete plan visit www.universityhealthplans.com and select the University of Massachusetts Dartmouth link.

This plan is like most employer plans in that your annual plan deductible is waived and most services are paid in full (after per-visit co-pays). If you seek services from non-preferred providers, you will be responsible for meeting the annual plan deductible of $200 per member and paying 20% co-insurance for covered services.

Additional information

  • To find participating providers, visit www.bluecrossma.com for Massachusetts providers
  • To find participating providers out-of-state, visit the BlueCardProvider Finder web site at www.bcbs.com/healthtravel/finder.html
  • If you are purchasing coverage for your dependents under this plan, you will need to enroll them online by visiting www.universityhealthplans.com and selecting the University of Massachusetts Dartmouth link

Minimum requirements to waive coverage

US students with proof of insurance who meet the Qualifying Student Health Insurance Program (QSHIP) criteria and who do not want to purchase the student plan may waive out of the plan.

As part of the waiver process, you will be asked if your policy provides all of the following:

  • Preventive primary care
  • Emergency care
  • Surgical services
  • Hospitalization benefits
  • Ambulatory patient services
  • Mental health services, both inpatient and outpatient
  • Coverage for pre-existing conditions
  • Coverage for accident or illness that occurs during travel outside of the US
  • $50,000 minimum aggregate indemnity (Aggregate indemnity is the total dollar amount paid out over the life of the policy.)
  • Coverage for outpatient care in the UMass Dartmouth area, including office visits, outpatient mental health care, laboratory and radiology procedures (Coverage for emergency care only does not satisfy this requirement. Note: UMass Dartmouth Health Services uses UMass Memorial for blood work.)

If you are unsure of the answers to any of the above questions, consult your private insurance provider. Students who are covered under a parent/guardian's plan should review this information with the parent/guardian prior to completing the online waiver.

You may also review the requirements at the QSHIP site: go to the Massachusetts Health and Human Services web site, then click on “Qualifying Student Health Insurance Program” in the left menu.

Students taking at least 75% of the full time curriculum are NOT eligible for Commonwealth Care Insurance (956 CMR 3.09)Although Commonwealth Care benefits meets "comparable coverage" requirements, Commonwealth Care regulations prevent students from using Commonwealth Care as a waiver.

Students may either enroll or waive enrollment via their COIN account.

Frequently asked questions about the student health insurance plan

Who is eligible to purchase the student health insurance plan?

Matriculated undergraduate and graduate students who are at least three-fourths or full time are eligible to purchase this plan. Matriculated students who are not currently registered, or who have requested a leave of absence, are not eligible to enroll in this plan. ("Matriculated" means that a student has been accepted into a degree-granting program at UMass Dartmouth. "Three-fourths-time" at UMass Dartmouth means at least 9 credits for undergraduate students and at least 7 credits for graduate students, 9 credits for law students.) In special circumstances, with the approval of the Director of Health Services, a graduate student taking 6 credits can be allowed to enroll in the insurance. Online courses can be counted toward the minimum number of credits; at least one class, however, must be on campus.

Non-matriculated students (continuing education students) who meet minimum credit requirements may be permitted to purchase the school insurance; to enroll, they must pay a health fee and submit a health form with all required immunizations.


How much does the student health insurance cost?

The basic annual cost is $1999 for studentsfor academic year 2010/2011.

Visit the web site for more information about dependents and supplemental benefits:

I have not been charged for student health insurance. Can I enroll?
 
If you are not charged for the university student health insurance but you wish to enroll in the plan, contact the University Enrollment Center (508-999-8857 or 508-999-8866) or the Bursar's Office (508-999-8832). You must meet the following criteria: undergraduate student registered for 9 credits or more, graduate student registered for 7 credits or more, law students for 9 credits or more. As above noted, in special cirumstances, with the approval of the Director of Health Services, a graduate student taking 6 credits can be allowed to enroll in the school insurance.

I am insured under my parent's health insurance at home. Do I need to purchase the UMass Dartmouth student health insurance plan?

Massachusetts law (QSHIP) requires that your insurance be billable in the Dartmouth area. If it is not, then you must purchase the school insurance plan.

Generally, UMass Dartmouth recommends that all resident undergraduate students consider purchasing the plan, since it gives students access to local care when they may need it most. Be aware that many "home" insurance plans will not cover non-emergency services when students are away from home. Many HMOs may require that blood work, x-rays, physical therapy and specialist referrals only be done at "in-network" facilities. Students may find it difficult or inconvenient to return home for these types of services. Some plans will only let prescriptions be filled if ordered by an "in-network" provider.

Note: UMass Dartmouth Health Services uses UMass Memorial for blood work.

Before you decide to waive out of this plan, you should check with your parent's insurance to make sure you are covered not only for emergency care, but also for any non-emergency, follow-up, specialist consultation or rehabilitative services in the UMass Dartmouth area. If not, then you are required by law to purchase the school insurance.Most if not all, out of state HMO's are not acceptable to waive the health insurance coverage.

College or university students who are eligible to purchase the school insurance cannot sign up for a low or no cost Commonwealth Care plan.These unacceptable plans are offered by Boston Medical Center (BMC) Health Net Plan, Fallon Community Health Plan, Neighbor Health Plan and Network Health.Students may not waive the school insurance with any of these plans.

The Children's Medical Security Plan does not provide hospitalization coverage and also is not acceptable to waive the school health insurance.

Mass Health is acceptable health insurance to waive buying the school insurance. Many students on Mass Health will no longer be eiligible once they reach age 19. If your Mass Health Insurance will stop at age 19 and you will turn 19 during the academic year, you will need to enroll in the school health insurance plan at the start of the academic year.As noted above,students cannot sign  up for low cost or no-cost Commonwealth Care Plans.

How does the student health insurance plan work?

Students with the student health insurance plan may be seen in Health Services and will not pay a co-pay. Students may use the provider networks available at the links above. When you use a participating provider, you will pay your $20 co-pay and most of your care will be covered at 100%.

If I am at home or traveling away from UMass Dartmouth, am I still covered?

Yes, when classes are not in session and you are home on break or traveling, the school plan provides coverage 24 hours a day anywhere in the US for as long as you are insured. When you are traveling abroad away from your home country, your coverage is in effect.

What if I have an emergency while traveling more than 100 miles from home?

If you experience a medical emergency while traveling more than 100 miles from home or campus, you have access to a comprehensive group of emergency assistance services provided by Meridian VIP Travel Assist Program. Meridian will assist you with medical referrals, legal and interpreter assistance, foreign hospital admission guarantee, prescription assistance, lost luggage assistance, travel information such as visa and passport requirements, travel advisories, etc. This coverage will provide medically necessary travel back to your home country when this is deemed necessary by your physician in collaboration with the Meridian physician. For more information on this coverage please visit www.universityhealthplans.com and click on University of Massachusetts Dartmouth, and then on the travel assistance program.

What are the vision benefits?

Routine vision exams are limited to one visit per 24 months in and out of network combined. There are discounts for glasses, etc.

Are prescriptions covered?

Yes. There is a $15 co-pay for Tier 1 prescription, $30 co-pay for Tier 2 and $50 co-pay for Tier 3. This applies to a 30-day supply filled at a local retail pharmacy or a 90-day supply filled by mail order.

Does the student health insurance cover intercollegiate sports accidents?

Intercollegiate sports injuries will be covered as any other injury.

Is dental covered?

No. There is an optional Dental Insurance available for $302. See www.universityhealthplans.com and click on University of Massachusetts Dartmouth. This insurance must be purchased by the deadline of August 15th, and is purchased directly from University Health Plans.There is also a vision plan available for $125. If you miss the August deadline for both of these optional insurances there are other effective dates available on the university health plans website.  You do not have to be enrolled in the school insurance to enroll in the Dental or Vision insurance.

Can I purchase the student health insurance for half the year?

Only NEW students can purchase the insurance in January for the second semester. The only exception is a student who is dropped from his or her parent/guardian’s plan. These students would then need to submit proof that they were dropped from their parents/guardians’ plans.

Do I need the student health insurance to seek care at UMass Dartmouth Health Services?

No. All matriculated students who pay the Health Fee are eligible to use Student Health Services.

What if I have questions about the policy, claims or need assistance with filing a claim?

There is an insurance clerk who can assist you with the school health insurance plan from Aug 15 through June 30. The insurance representative is available to talk to you in person in Health Services from Monday through Friday.

Frequently asked questions about Health Services and insurance

Can I be seen at the Health Services office if I do not purchase the student health insurance plan?

Yes. Services are available to all students who pay the Health Fee each semester.

Will UMass Dartmouth Health Services submit information to my family’s insurance company?

Yes. There is no co-pay. Lab tests are sent to UMass Memorial, who then bills your insurance, including the school insurance. We will be billing your health insurance company for visits to Health Services and for certain procedures. There will be no out-of-pocket charges to the student or family from UMass Dartmouth Health Services other than a $15 administration fee for immunizations.

If I am a Part -time student who lives in Massachusetts can I buy one of the Connector Plans or should I purchase the school insurance?

Only students who are enrolled in three quarter credit hours or more are eligible to purchase the school insurance.There is a new Massachusetts law that now requires everyone over the age of 18 to be enrolled in a health insurance plan. If you are not eligible to purchase the school insurance then you should look into one of the Connector Plans. The subsidized plans are not eligible for a waiver if you should change your academic standing from part time to full time the second semester. The Commonwealth Choice plans are acceptable to waive the school insurance plan.If you plan to change your academic standing within an academic year you need to keep this information in mind when you choose a health insurance plan.

What else should I know if I have my own insurance under a parent or if this plan is an HMO-style plan?

If you are waiving the school insurance because you are a US student and have insurance, you must be sure that it is billable in the Dartmouth area. Many HMOs are not; if this is the case, you would need to purchase the student health insurance.Out of state HMO's (for example Health Net of Northeast, a CT HMO) do not have providers in Massachusetts and are not acceptable to waive. These insurance companies have closed networks with no providers in Massachusetts.These students need to purchase the school plan.

It is important to always carry your health insurance card with you and have the plan booklet and contact information with you. It is the student's responsibility to obtain pre-authorization if off-campus or hospital care is needed.

Likewise, if you need pre-authorization for lab work, x-rays or prescriptions, it is the student's responsibility to obtain this authorization and know how to obtain the authorization.

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