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MIT Employee Benefits

You have fewer choices if you fall into one of these categories:

• If you live outside the New England (CT, ME, NH, RI, and VT) area, you may enroll in only the preferred provider organization (PPO) plan Blue Care Elect. Please check with the health plan if you live outside of MA to make sure you will have coverage in your area.
• If you are a postdoctoral fellow who is enrolled in a health plan through MIT, you are able to continue your existing coverage by paying 100% of the cost or you can enroll in one of the MIT Affiliate Health Plans.
• If you are an eligible postdoctoral fellow with no previous health coverage through MIT, an affiliate fellow, a visiting scholar, a visiting professor, or a visiting scientist, you may enroll in one of the MIT Affiliate Health Plans only.

Use the Health Care Comparison Chart (PDF) and the Health Plan Rate Comparison Chart to determine which plan works best for you and your family.

Health maintenance organization (HMO) plans

When you enroll in an HMO, you

• choose a primary care physician (PCP) from either the HMO's network of physicians or the staff of physicians at a designated health center
• request a referral from your PCP when choosing a specialist (except for Access Blue, where a referral isn't required)
• use only doctors and facilities in the network of the HMO plan, except when you require treatment for a life-threatening emergency outside the HMO service area
• receive coverage for most of your health care needs, including routine and preventive care
• pay a copayment for most care you receive within the HMO network
• contact the HMO at any time to change your PCP

Your primary care physician (PCP)

• provides treatment for most of your health care needs, including routine and preventive care
• coordinates your care
• may refer you to specialists within the network as needed (except for Access Blue)

MIT offers these HMO plans

Traditional MIT Health Plan
(Group # 2221013)
Under this plan, you receive care through a staff of medical professionals at MIT Medical centers in Cambridge and Lexington, Massachusetts. When you enroll, you choose a PCP on the staff at MIT Medical to coordinate your medical care. You also may choose a mental health provider from the Blue Cross Blue Shield of Massachusetts Managed Care Behavioral Health Network.

Tufts Health Plan
(Group # 14792-000)
Similar to a traditional HMO plan, the Tufts Health Plan Exclusive Provider Organization (EPO) delivers care through a network of providers established by Tufts Health Plan. When you enroll, you choose a PCP from the Tufts network to coordinate your medical care.

Network Blue New England
(Group # 4022818)
This plan coordinates your care through area medical centers, specialty groups, and independent practitioners. When you enroll, you choose a PCP from the HMO Blue Network.

Point-of-service (POS) plan

When you enroll in the POS plan, you have the flexibility to use both in-network providers (at no additional cost) and out-of-network providers (at some additional cost):

Flexible MIT Health Plan
(Group # 2264345)
Under the Flexible MIT Health Plan, you receive care either through MIT Medical (in-network care) or through referrals from the PCP you choose within the plan's network. You also have the option of arranging your own care using any provider within the Blue Cross Blue Shield network (out-of-network care). You pay a portion (copayment) of any out-of-network services you receive. You are reimbursed by the plan for these expenses only after you satisfy the annual deductible and copayments.

Preferred provider organization (PPO) plan

Unlike the HMO and POS plans, the PPO plan allows you to obtain care from a network of providers that exists in every state in the U.S. Your cost is determined by whether you use a preferred or non-preferred care provider. MIT offers the following Preferred Provider Organization plan:

Blue Care Elect
(Group # 2313307)
Under the Blue Care Elect plan, you determine how much you pay for a service whenever you receive care. If you use a provider in the Blue Care Elect preferred network (in-network care), you typically pay nothing or a copayment of $10. If you receive care from a non-preferred provider (out-of-network care), you will pay more for each service. In addition, you must pay a 20% copayment for many services until you reach the plan's annual deductible.