We're doing more to keep you healthy!

Exciting changes to the MIT Affiliate Extended Insurance Plan benefits will go into effect on September 1, 2007. The changes are described below. Additional information is available in the Affiliate Health Plan Overview and the MIT Affiliate Extended Insurance Plan - Summary Plan Description.

Urgent care and office visits. Effective September 1, 2007, the MIT Affiliate Extended Insurance Plan will cover up to four medically necessary office visits per calendar year. This coverage is available for services referred by MIT Medical, such as a consultation with a specialist not available at MIT Medical, as well as for sick visits while traveling. Services provided by a participating Blue Cross Blue Shield provider will be covered at 80 percent after you pay a $25 copayment. You are responsible for payment of the $25 copayment and the 20 percent coinsurance. If you see a provider who is not participating with Blue Cross Blue Shield the service will be subject to the out-of-network deductible and covered at 60 percent. You will be responsible for payment of the deductible and the 40 percent coinsurance. Always ask the provider, or go to the Blue Cross Blue Shield of MA website, to verify the participating status of any provider.

Prescription drug benefit. Effective September 1, 2007, the MIT Affiliate Extended Insurance Plan will increase the annual pharmacy benefit from $2,500 to $3,500. The copayment will remain $15 for up to a 30-day supply per prescription. The copayment for birth control devices will increase to $45 and the device must be obtained through MIT Medical. Prescriptions should be purchased through the MIT Pharmacy to minimize your out-of-pocket expenses.

Oxygen and equipment. Effective September 1, 2007, the MIT Affiliate Extended Insurance Plan will cover oxygen therapy, including oxygen concentrators, without any annual benefit limit. Previously these services were included in the annual $1,500 benefit limit for Durable Medical Equipment. Services must be ordered by an MIT Medical clinical to be covered. Services provided by a participating Blue Cross Blue Shield provider will be covered at 80 percent. You are responsible for payment of the 20 percent coinsurance. If you see a provider who is not participating with Blue Cross Blue Shield the service will be subject to the out-of-network deductible and then covered at 60 percent. You will be responsible for payment of the deductible and 40 percent coinsurance. Always ask the provider, or go to the Blue Cross Blue Shield of MA website, to verify the participating status of any provider.

Infertility treatment. Effective September 1, 2007, the MIT Affiliate Extended Insurance Plan will cover all services related to infertility treatment, subject to a $5,000 annual benefit limit. The following services are included in this annual benefit:

• Office visits and consultations related to the treatment and diagnosis of infertility. These office visits will be counted towards the $5,000 annual benefit limit and the Blue Cross Blue Shield guidelines, but not counted towards the urgent care/office visit annual visit limit.
  
  
• Laboratory and diagnostic tests related to infertility treatment. Services provided by a participating Blue Cross Blue Shield provider will be covered at 90 percent. You are responsible for payment of the 10 percent coinsurance. Laboratory and diagnostic tests provided by a provider who is not participating with Blue Cross Blue Shield will be subject to the out-of-network deductible and then covered at 60 percent. You will be responsible for payment of the deductible and the 40 percent coinsurance. Always ask the provider, or go to the Blue Cross Blue Shield of MA website, to verify the participating status of any provider.
  
  
• Outpatient surgical services, including anesthesia, related to the treatment of infertility. When provided by a participating Blue Cross Blue Shield provider, these services will be covered in full, up to the $5,000 benefit limit. When these services are provided by a provider who is not participating with Blue Cross Blue Shield the service will be subject to the out-of-network deductible and then covered at 60 percent. You will be responsible for payment of the deductible and the 40 percent coinsurance. Always ask the provider, or go to the Blue Cross Blue Shield of MA website, to verify the participating status of any provider.
  
  

If you have questions about these changes, you may contact Claims and Member Services, located in E23-191, by phone at 617-253-5979 or by e-mail at mservices@med.mit.edu.