Health Reimbursement for WHOI-based Students

It’s not reasonable to expect WHOI-based students who are ill or injured to travel to MIT Medical to receive urgent or emergency care.  WHOI-based students covered by MIT extended insurance who are unable to seek care at MIT Medical for conditions requiring prompt, but not immediate, attention (sprains, earache, high fever, etc.) are eligible to make up to eight office visits per year at a physician’s office within the Blue Cross Blue Shield PPO network.  To find in-network hospitals or providers, click here.

The Health Insurance Enhancement Plan is available for WHOI-based students in need of urgent care or those with chronic illnesses requiring frequent doctor visits.  Students must use MIT Medical for preventative care.

How it works:

1. For emergency care (e.g. heart attack, stroke, poisoning), go to an in-network hospital emergency room.  There is a $100-copay for an emergency room visit after the $100 annual outpatient deductible.  For urgent or chronic care, see an in-network doctor or local urgent care center.  There is a $50-copay at participating Urgent Care Centers after the $100 annual outpatient deductible.
2. Claims for all services should be submitted directly to Blue Cross Blue Shield of MA (BCBSMA).  BCBSMA will send you a “Summary of Health Plan Payments” which will show your patient balance for covered services, and any non-covered services.
3. If there is a cost incurred that would not have been incurred had you gone to MIT Medical, submit a completed Reimbursement Claim Form (under Related Files) with a copy of the original medical bill and the insurance denial to the WHOI Registrar at WHOI MS #31.  If approved, use WHOI Unanet (project #00351500 Student Exp General Clark, object code 5803 Medical) to submit for reimbursement.  When prompted to submit receipts, you can indicate that the receipt is on file in the Academic Programs Office to maintain confidentiality.  You will receive reimbursement for your copay and co-insurance up to $1,000 per year.  Students who exceed the $1,000 maximum may request an exception to the limit.