Frequently Asked Questions

FAQ About Student Health Insurance

Do I need to buy insurance?
All full time students who are attending college within the Commonwealth of Massachusetts are required by state law to have health insurance. Visit the Mass.gov website for information on Student Health Insurance Program and FAQs.

The Student Health Insurance Plan provides primary coverage for a full calendar year and has a national network of medical and mental health providers. Many students choose this plan in addition to continued coverage under the parent’s plans. For those who feel their current coverage is adequate for major illness and emergencies, the Prepaid Health Center Option provides a low cost “bridge” between the Health Center and your HMO/PPO for common illnesses and injuries.

Will my daughter be able to use the services of the Health Center at Mount Holyoke College?
The services of the Mount Holyoke College Health Center are available to all MHC students irrespective of the decision to purchase the Student Health Insurance Plan or the Pre-Paid Health Center Option. A full description of MHC Health Center services is available online.

Will my health insurance cover payment of fees at the Health Center?
The majority of the services at the Health Center are provided free of charge, however there are charges for lab tests, medications, x-rays, physical therapy and infirmary admissions of greater than 4 hours duration. The Health Center does not participate in any HMO or PPO networks and does not contract with any indemnity plans. Please check specifically with your insurance carrier regarding their policy for payment of lab, x-ray, mental health visits, prescriptions, etc that are out of network.

What about coverage for Mental Health Services?
Mount Holyoke College, along with most colleges across the country has seen an increase in the number of students seeking support for acute and chronic mental health concerns. Annually 20-25% of MHC students contact our Counseling Service. Our Counseling Service provides assessment and brief intervention which for many students is all that is required. However there are a number of our students that do require referral or may prefer referral off campus to an area provider for ongoing support and therapy. Coverage for outpatient mental health services varies greatly among insurance plans. Many plans have this benefit managed separately with different referral procedures and provider networks. Please review this benefit in your current coverage carefully regarding referral process, definition of the network and out of network coverage.

How are referrals to specialists covered?
Please refer to the specific sections on the referral process and the outpatient benefits. If you choose not to participate in the Student Health Insurance Plan, contact your carrier regarding the availability of specialists within your provider network and procedures for referral. Many plans require the Primary Care Provider (PCP) to make the referral. The most common reasons for referral by the Health Center staff include: orthopedics, dermatology, infectious disease and mental health.

What about medications?
The Student Health Insurance Plan has a pharmacy benefit of $1000 annually. Refer to the enclosed brochure for details on co-pays. A local pharmacy works with the Health Center to electronically match insurance information and deliver prescribed medications to the health center daily. When the current and correct insurance information is verified, the student pays only the co-pay as defined by her insurance benefit. If the information is not available, not correct or the claim is denied, the student is responsible for payment in full at the time the medication is picked up. There is no medication benefit available under the Pre-Paid Health Center Option.

If my daughter has a chronic or pre-existing medical or mental health condition, should I buy the Student Health Insurance Plan?
Please refer to the enclosed brochure regarding pre-existing conditions. Also please note the design of this plan is to meet the needs of a generally healthy young population of women; therefore there are significant limitations on several areas of benefit. If you have adequate major medical insurance, you may consider purchase of the Prepaid Health Center Option to provide lab, x-ray, etc with minimal travel, costs and improved coordination of care.

Does my daughter need to have a PCP in South Hadley?
The majority of students/families do not find this necessary. The clinicians at the Health Center have a wide range of experience in managing acute and chronic conditions. They also work very cooperatively and collaboratively with primary care and specialist providers outside of the area to manage chronic illnesses. Please talk with your daughter’s providers for a recommendation for the management of her chronic illness. Consult your insurance plan regarding the availability of network providers or temporary/guest privileges while your daughter is in this area. Please remember this process may take several weeks.

Can students with Commonwealth Care plans waive the Student Health Insurance Plan?
No. Students who are subject to the QSHIP requirement (students in MA colleges) are not eligible for Commonwealth Care.  Students may obtain health insurance through their parents’ health insurance, health insurance offered by their employer, the school’s QSHIP plan, or enroll in a Commonwealth Choice plan.  Commonwealth Choice offers a wide range of commercial health insurance plans. There are special Young Adults Plans for 18 to 26 year-olds. Please visit the Commonwealth Connector’s website for more details.

My daughter is very healthy, why would she need to come to the health center?
Please see the chart below for details on the most commonly seen illnesses and costs based on the various coverage options at Mount Holyoke.

All visits with the nursing staff, nurse practitioner and physician and counseling staff are without charge. Referrals to specialists are not covered by the Prepaid Health Center Option.

 

Common Situation Service/Test Health Center Charge Student Health Ins. Prepaid Health Center All Other Options Waived
Cold/sore throat   Throat culture

CBC

 

$19

$20 

Covered, no charge to student  Covered, no charge to student  Charged to student's bill 
Urinary tract infection  Urinalysis and culture  $18  Covered, no charge to student  Covered, no charge to student  Charged to student's bill 
  Antibiotics  $15-$60  $5-$15  Based on family drug benefit  Based on family drug benefit 
Sprained ankle  X-ray  $75  Covered, no charge to student  Covered, no charge to student   Charged to student's bill 
Neck/back or shoulder pain  X-ray

Physical therapy 

$75-$120

$75  

Covered, no charge to student   Covered, no charge to student  Charged to student's bill 
Abdominal pain  Observation in Infirmary   If greater than 4 hours
$150 
Covered, no charge to student   Covered, no charge to student  Charged to student's bill 
Acute anxiety attack/ 
Depression
EKG

Observation in Infirmary 

$65

$150

 

Covered, no charge to student  Covered, no charge to student  Charged to student's bill