Due to the rising cost of healthcare and increased utilization of the University of Massachusetts - Boston Student Health Insurance Plan, the following changes have been made:

• The plan deductible increased to $1,000 per member*
• The cost for x-rays changed to a $30 copay in-network and 20% coinsurance out-of-network
• The retail prescription copays are now $15 for Generic, $50 for Preferred Brand, $70 for Non-Preferred Brand and 50% coinsurance for Specialty Preferred Brand and Specialty Non-Preferred Brand.

*The plan deductible DOES NOT APPLY to in-network Primary Care Visits, Specialists, X-ray, Blood Work (Labs), Imaging (CT/PET Scans, MRIs), Prescriptions, Emergency Room Visits, Urgent Care and Emergency Transportation, Outpatient Mental and Behavioral Health, Prenatal Care and Outpatient Rehabilitation.

I have read and acknowledge the above statement and would like to enroll