Important Legislation: Know Your Rights
Women's Health and Cancer Rights Act
To comply with the Women's Health and Cancer Rights Act of 1998, MIT is required to provide all employees who are eligible for medical coverage with the following notice annually:
If you undergo a mastectomy and elect reconstructive breast surgery in connection with your mastectomy, then you will receive benefits for the mastectomy-related services listed below:
- All stages of reconstruction of the breast on which the mastectomy has been performed
- Surgery and reconstruction of the other breast to produce a symmetrical appearance
- Prostheses and treatment of physical complications of all stages of the mastectomy, including lymphedema
Coverage will be provided as determined in consultation with you and your attending physician.
Notice of Creditable Coverage
The purpose of this notice is to advise you that the prescription drug coverage under the MIT health plans is expected to pay out, on average, at least as much as the standard Medicare prescription drug coverage will pay in 2010. This is known as “creditable coverage.”
Important: If you or your covered dependent(s) are enrolled in any prescription drug coverage during 2010 offered through the MIT health plans, and you are or become covered by Medicare, please note the following:
- You may decide to enroll in a Medicare prescription drug plan later and not be subject to a late enrollment penalty—as long as you had creditable coverage within 63 days of your Medicare prescription drug plan enrollment.
If you or your family members are not currently covered by Medicare and will not become covered by Medicare within the next 12 months, this notice does not apply to you.
You should keep this notice with your important records.
HIPAA Special Enrollment Rights Notice
If you are declining enrollment either for yourself or for your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in an MIT health plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your coverage or your dependents' coverage).
However, you must request enrollment within 31 days after the date your coverage, or your dependents' coverage, ends (or after the employer stops contributing toward the other coverage).*
In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption.*
*Documentation is required for each life event within 31 days from the life event.
Newborns' and Mothers' Health Protection Act (NMHPA)
Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section.
However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable).
In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).
Mental Health Parity Act of 2009
The Mental Health Parity Act of 2009 requires group health plans to provide mental health or substance abuse coverage (e.g., number of doctor visits or duration of care) on par with medical-surgical benefits.
For years, standard medical plan designs have included different coverage limitations for mental health benefits as compared to coverage for medical-surgical benefits. Medical plans typically placed annual limits on the number of office visits for outpatient mental health services or limited the frequency or duration of services.
Check your MIT health plan for information on mental health benefits.
