Qualifying Event Enrollment Form

Students who waived the Student Health Insurance Plan (SHIP) and recently lost their other coverage should contact the UMass Chan Medical School Bursar's Office at 508-856-6641 or 508-856-5249 to request a qualifying event enrollment. The deadline to complete the enrollment form is 60 days from the qualifying life event.

Students will be asked to provide supporting documentation and the prorated premium will be added to the tuition statement. The first day of coverage in the SHIP will be the first day without coverage under the prior plan or entry into the US.

Please note, with the rising costs of healthcare, and increase in utilization of the Student Health Insurance Plan (SHIP), the following plan changes have been imposed for the 2024-2025 academic year to help keep the insurance premium and the plan a viable option for all students. The plan design is based on a replication of the 2023-2024 plan design with the below benefit changes.

• Change from HMO to EPO
• Change deductible from $0 referral/$250 self-referral to $500 individual/$1,000 family, not applicable to office visits
• Increase ER copay from $150 to $250
• Add $250 copay for high-cost imaging
• Add $500 copay for outpatient surgery
• Add $1,000 copay per hospital admission
• Add $200 ambulance copay
• Exclude lab and x-ray from deductible

We encourage students anticipating high out-of-pocket costs to compare other insurance options to the SHIP. The Massachusetts Health Connector offers information about their online insurance marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).

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