Massachusetts Requirements for Student Health Insurance

In September 1989, Massachusetts passed a law requiring every full-time and part-time student to have health insurance. The Division of Health Care Finance and Policy outlined the requirements for a Student Health Program (SHP). These requirements are the minimum benefits a SHP or a comparable health insurance plan must offer students. The law defines "student" as anyone enrolled in at least 75% of a full-time curriculum.

"Reasonably Comprehensive" Coverage

• The Massachusetts law states that all Student Health Programs (SHP) must offer "reasonably comprehensive" coverage to students. "Reasonably comprehensive" includes basic coverage of primary and preventive care, emergency services, mental health services, hospitalization, surgical services and ambulatory patient services. These are the basic coverage requirements of any SHP, and plans do vary beyond this.

Minimum Indemnity

• The Division of Health Care Finance and Policy included a minimum aggregate indemnity health insurers had to pay for all benefits. This number could not be less than $50,000. For example, if an insured student suffers a severe injury and the hospital bill totals more than $50,000, the SHP is required to pay at least $50,000 of the bill per year.

Alternate Plans

• The Massachusetts law requires colleges to offer their students health plans. Students are automatically billed for these plans. In addition, if someone wishes to attend a Massachusetts college, they must have a student health plan or a comparable plan. Students can opt out of the plan their school offers for another plan. To do this, students must show that the alternate plan provides "reasonably comprehensive" coverage. In addition, the plan must offer its services in the area where the student lives, namely, near the college campus.