About the Plan
You may be interested in an HDHP because:
- An HDHP gives you more flexibility in how you pay and save for healthcare, while still providing comprehensive, high-quality coverage for you and your family.
- Compared to the MIT BCBS PPO+ Health Plan, an HDHP 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 accommodates new MIT employees who have had a high deductible health plan and HSA with a previous employer.
The HDHP will require you to take a more active role in your healthcare than just paying a health plan premium. You will need to manage an HSA, which you will use to pay for your qualified healthcare expenses. It's important for you to fully understand how an HSA works before you enroll in the HDHP.
More Benefits of This Plan
- BCBS TrueCare 360 Advocacy and Care Management – Dedicated Blue Care Managers and Service Advocates will help you and your family navigate the complex healthcare system, find resources in your community, coordinate care and access to services for complex cases, provide education about conditions, and support caregivers.
- BCBS Virtual Primary Care – $0 cost for virtual primary care and mental health visits offered via chat, text, phone, and video with select providers.
- Expanded and updated fertility benefits (new egg cryopreservation benefit and updates to frozen embryo requirements) and enhanced gender-affirming care benefits.
What You Should Know
The plan is a Blue Cross Blue Shield (BCBS) plan that offers the same qualified medical services as the MIT BCBS PPO+ Health Plan, 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 plan, you are responsible for paying for non-preventive services and non-preventive prescriptions, until you reach a deductible.
- For employee coverage in 2025, the deductible is $1,650 for services and prescriptions (combined).
- For employee + spouse/domestic partner, employee and child(ren) or family coverage in 2025, the deductible is $3,300 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, visit Express Scripts and look for "Price a Medication" under Prescriptions.
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 Health, 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.
You will have access to a nationwide network
The BCBS HDHP does not require a Primary Care Provider (PCP) and has a large nationwide network.
HSAs and Medicare
Individuals enrolled in the High Deductible Health Plan may receive MIT seed money and contribute to their HSA until they retire as long as they defer enrollment in all parts of Medicare. Individuals who enroll in Medicare while funding an HSA may incur an excess contribution tax penalty.
Need Help or Have Questions?
Visit our Health Plans overview for information on eligibility, enrollment, mental health and other services, and more. If you still have questions, see the plan contacts below.
| Contact | Phone | More Information |
|---|---|---|
| MIT Benefits For plan benefits or enrollment |
617-253-6151 | benefits@mit.edu |
| Blue Cross Blue Shield of MA | 1-888-376-0218 | Blue Cross Blue Shield |
| Express Scripts | 1-866-454-7118 | Express Scripts |
