MIT High Deductible Health Plan

MIT High Deductible Health Plan

In addition to the MIT Traditional and MIT Choice Health Plans, MIT will also offer the new MIT High Deductible Health Plan (HDHP), effective January 1, 2018.

MIT is offering this additional health plan option because:

  • The new HDHP gives you more flexibility in how you pay and save for health care, while still providing comprehensive, high-quality coverage for you and your family.
  • Many employees have asked for a HDHP, which has a lower premium (the amount taken out of your paycheck each pay period for health insurance), a higher deductible (the amount of covered expenses that you must pay each calendar year before the health plan begins paying for services), and a tax-advantaged health savings account (HSA).
  • The HDHP will accommodate new MIT employees who had a high deductible health plan and HSA with a previous employer.
  • Employers of choice offer the HDHP as an option.

The HDHP will require you to take a more active role in your health care than just paying a health plan premium. You will need to manage an HSA, which you will use to pay for your qualified health care expenses. It's important for you to fully understand how an HSA works before you enroll in the HDHP.

What you should know about HDHP coverage

It is a Blue Cross Blue Shield (BCBS) plan that offers the same qualified medical services as the MIT Traditional and Choice Health Plans, including 100% coverage of the cost of medical preventive services (see preventive services fact sheet below). (Note: A preventive visit may have an associated cost if another health issue or concern is treated at that appointment.) Preventive prescriptions have a copay, but are not subject to the deductible (see list of preventive medications below).

You will have a deductible

While your health plan premium will be lower than MIT's other health plans, you are responsible for paying for non-preventive services and non-preventive prescriptions, until you reach a deductible.

  • For employee coverage, the deductible will be $1,500 for services and prescriptions (combined).
  • For employee + spouse/domestic partner, employee and child(ren) or family coverage, the deductible will be $3,000 for services and prescriptions (combined).

Remember: MIT will contribute to your HSA annually, which you can use to pay for qualified medical expenses.

To estimate costs for non-preventive health care services and to find providers, use the BCBS "Find a Doctor" tool (see instructions below).

To estimate prescription costs, use the Express Scripts cost estimator tool.

You may need to pay co-insurance

Once you reach your deductible, you then pay 10% of the cost of the non-preventive service (in-network); this percentage is called “co-insurance." You will also pay copays for preventive and non-preventive prescriptions. Please note that if you choose to have your medical services at MIT Medical, you will not have any co-insurance.

There is an out-of-pocket maximum

You are responsible for paying co-insurance and copays for prescriptions until you reach an out-of-pocket maximum (the total amount you will pay out-of-pocket for health care in a given year, excluding premiums), which includes your deductible.

  • For employee coverage, the out-of-pocket maximum will be $3,000.
  • For employee + spouse/domestic partner, employee and child(ren) or family coverage, the out-of-pocket maximum will be $6,000.

Note: The deductible and out-of-pocket maximum will not be pro-rated if the HDHP is added during the year (e.g., you are a new hire or experience a life event).

Once you reach your out-of-pocket maximum, all non-preventive services will be covered 100% by your health plan.

In case of an unexpected medical emergency, you need to be able to pay for medical and prescription expenses up to the out-of-pocket maximum.

insurance pays - you pay chart

You will have access to a nationwide network

The HDHP does not require a primary care provider (PCP) and has a larger network (nationwide) than the MIT Choice (MA, RI, VT, CT, NH, ME) or Traditional (MA) plans.

Additional Resources