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. Students must then complete an online form through their COIN account stating whether or not they are requesting the insurance.
Requirements, overview, right to waive
What are the student health insurance requirements under Massachusetts law?
Note: "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.
Only students who are matriculated are enrolled for full to three-fourths time, and are taking at least one class on campus are eligible to take the school health insurance. (Matriculated graduate students taking 6 credits may take the insurance if they request it through bursar's office.)
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. (In the Finances section, select the Waive/Enroll Health Insurance Form link.)
All enrolled F1 visa international students and matriculated J-1 students are required to purchase the university student health insurance plan (regardless of the number of credits for which they are registered). An exception can be made if the student is covered under an American insurance through a spouse or the student's embassy that meets the minimum requirements or is a Fulbright Scholar.. (Massachusetts law requires that international students have health insurance and not use any of the free health care pools available in various communities.) All non-matriculated J-1 students must either purchase the student health insurance or show evidence that they have adequate insurance that can be used in this country.
Information about waiving coverage
Deadline: Full-time and three-fourths-time students must complete the online waiver form indicating whether or not they want to enroll in the school health insurance plan by the fall 2013 deadline of October 1. Students newly enrolled for the spring 2014 must complete the online waiver by February. 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.
What is 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 for Academic Year 2013/2014. This plan is administered by University Health Plans. The plan begins coverage on August 1, 2013 and ends July 31, 2014. The fee for the 2013/2014 plan is $2,154.
To view the complete plan visit www.universityhealthplans.com and select the University of Massachusetts Dartmouth link.
- 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
What are the 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
- No annual or lifetime maximum.
- Prescription coverage
- 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 Quest Diagnostics 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. (In the Finances section, select the Waive/Enroll Health Insurance Form link.)
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 including those students 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.) Matriculated graduate students taking 6 credits can be allowed to enroll in the insurance by contacting the bursar's office. . 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 annual cost is $2,154 for students for academic year 2013/2014
Visit the insurance web site at www.universityhealthplans.com and click on UMass Dartmouth 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, a graduate student taking 6 credits can be allowed to enroll in the school insurance by contacting the Bursar's Office. Although on-line courses can be counted toward the minimum number of credits, at least one course must be on-campus.
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 Quest diagnostics 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. Commonwealth Care 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. If, however, any of these plans are "Commercial" plans, you may waive the school insurance.
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, and you are at least 3/4 to full time, you will need to enroll in the school health insurance plan within 30 days of loss of Mass Health eligibility. As noted above, if you are eligible for school insurance, you 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. The mandatory Health Fee is considered their co-pay. Students may use the provider networks available at the links above. For Academic Year 2013/2014 when you use a participating provider for outpatient visits, you will pay your $25 co-pay and most of your outpatient care will be covered at 100%. Most in hospital care is covered at 80% at participating hospitals. To review the brochure, go to www.universityhealthplans.com and click on UMass Dartmouth.
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.
Are prescriptions covered?
Yes. For Academic Year 2013/2014 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. The cost for mail away prescriptions would be a $30 co-pay for Tier 1, $60 for tier 2 and $100 for tier 3 for up to a 90 day supply.
Does the student health insurance cover intercollegiate sports accidents?
Intercollegiate sports injuries will be covered as any other injury.
Is dental or vision covered?
Dental is not covered. For Academic Year 2013/2014 there are two optional Dental Insurances; DeltaCare Dental Plan costs $315.00 for an individual student and Delta Dental PPO+Premier Plan is $479 for an individual student. Family rates are also available. 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. If you miss the August deadline for this optional insurance, there are other effective dates available on the university health plans website.
Regarding vision, the 2013/2014 insurance covers one routine eye exam visit per 24 months (in and out of network combined). There is an optional vision insurance ,VSP Vision Care available for $145 for an individual student. Family rates are also available. 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.
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 spring semester. The only exception is a student who is dropped from his or her individual plan or a parent/guardian’s plan. These students would then need to submit proof to Student Health Services that they were dropped from the plan within 30 days of loss of insurance.
Students graduating in December should contact the bursar's office regarding purchasing a fall only policy.
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 insuran and is available to talk to you in person in Health Services Monday through Friday. Call (508) 999-8986 to speak with the clerk.
What happens if I drop out of school or take a leave while I am enrolled in your insurance plan?
Insured students who withdraw from school after the first 31 days of the policy period will remain enrolled in the student health insurance plan for the full period for which the premium was paid. There will be no refund of premium.
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 Quest Diagnostics, which then bills your insurance, including the school insurance. We bill your health insurance company for visits to Health Services. There are no out-of-pocket charges to the student or family from UMass Dartmouth Health Services.
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 Commonwealth care or one of the Commonwealth Connector Plans. The Commonwealth Care plans are not eligible for a waiver if you should change your academic standing from part time to three quarter or 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.