A $ 6,000 bill and inadequate coverage: How MIT’s health insurance is failing graduate workers

To get full health coverage, MIT graduate workers must band together to form a union

All MIT graduates know the cost of living in the Boston / Cambridge area is outrageous. Now imagine being hit by a surprise medical bill of $ 6,000 – this is nightmarish reality for some MIT graduates.

Despite MIT’s extreme wealth, many of its graduates with chronic health needs do not receive affordable care with the student insurance currently on offer; in addition, aid funds intended to help cover unforeseen medical costs receive little publicity and may be refused for arbitrary technical reasons to graduate workers who need them the most. To ensure comprehensive health coverage and ensure that every graduate worker can afford the health care they need, we must come together to form a union.

Most graduate workers are covered by MIT’s Student Extended Insurance, our only option for affordable health care. Unfortunately, as Alex, a graduate worker in the biology department, discovered, a critical category of care insufficiently covered by MIT is meal support and nutritional counseling – the standard of care for eating disorders. Over the past year, Alex has been hospitalized several times and required daily nutritional support to be able to do his research and prepare for his degree. She had to pay a co-payment of $ 25 per daily session; while $ 25 may not seem like a lot, it adds up to over $ 2,000 over three months.

After accumulating this $ 2,000 debt, Alex could no longer pay her co-payment and was forced to prematurely stop some of her recommended treatments. At the same time, she still suffered from severe mental health symptoms and, after exhausting traditional pharmaceutical care lines in previous years, was prescribed a new drug to treat symptoms of PTSD and severe depression and resistant to treatment. The worker received a pre-authorization for the treatment, but despite this, MIT’s insurance did not fully cover the cost of the drug, leaving her with an additional $ 4,000 bill on top of the $ 2,000 debt. that she had already contracted.

What graduate worker can cover a surprise bill of almost $ 6,000?

MIT ostensibly offers financial assistance for unforeseen medical expenses through the Miller Fund, but has refused to cover the cost of Alex’s new drug and the co-payments accumulated on an outrageous technicality. Since the worker had to bill most of the costs of the treatment to a credit card (Alex was never told this could be disqualifying, but had no other option to pay her for the necessary health care) , the expenses were considered “already paid”. As a result, Alex was not eligible, even though she had no way of paying the resulting credit card bill other than by seeking personal loans from her friends.

Accessing the Miller Fund is made even more difficult and confusing by the requirement that applicants must have a sponsor for their application. When the worker’s psychiatrist left MIT for a new position, she was told to find a new sponsor and reapply in order to continue to argue that she should receive financial relief. To date, the Miller Fund has still not covered any part of the $ 4,000 bill (and none of its previously accrued $ 2,000 debt).

In September, MIT’s healthcare plan unexpectedly changed without notification, removing a previous extension of coverage: The MIT administration claims they had no warning that this change was coming. Unbeknownst to graduate workers and other beneficiaries, coverage for any support provided by a registered dietitian has been reduced to 12 sessions per year with a co-payment of $ 25, after which no additional sessions would be covered at all. Because Alex needed to see a dietitian so frequently, by the time she discovered these changes, she had undergone a Additional $ 3,000 in charges. Initially, MIT declined to investigate whether coverage had actually changed for graduate workers, insisting it was an individual error. After a prolonged fight to get MIT and the insurance provider to recognize the charges were unfair, MIT promised the charges would be covered. Despite these assurances, weeks later, the $ 3,000 costs have still not been reimbursed.

Receiving huge medical bills repeatedly can threaten graduates’ ability to focus on research, fully participate in the MIT community, earn their degrees, or even achieve their goals. basic needs. Graduate workers living with chronic health conditions or facing a sudden medical emergency shouldn’t have the added burden of worrying about their insurance coverage, struggling to find money to cover the cost of treatment, or fight to overturn wrongful accusations or to access relief funds. In addition, all graduate workers always lack coverage in several areas of basic care, and more unexpected changes in insurance policies are always possible without a collectively negotiated contract.

MIT lagging behind peer institutions on health benefits, and in particular behind universities where graduate workers have unionized. For example, University of Michigan graduate workers got dental coverage in their union contract in 1983 and also benefits from vision coverage, which is currently not available to MIT graduate workers. Meanwhile, at MIT, the GSC has demanded that MIT provide dental insurance to graduate workers for decades, to no avail. Instead, many MIT graduate workers either do not have dental insurance or pay more than $ 500 out of pocket each year.

Previous advocacy efforts organized by the GSU have demonstrated the power of collective action to achieve expanded health care coverage for graduate workers. Prior to the GSU’s Mental Health Campaign (then operating as Graduate Students for a Healthy MIT), graduate workers received coverage for only 12 therapy sessions per year, after which they incurred a co-payment. share of $ 25 per session. For anyone receiving weekly therapy, this cost quickly became prohibitive, rising to over $ 1,000 per year. We organized to harness our collective power and were successful in lobbying MIT to expand mental health coverage. We gained 52 fully covered therapy sessions per year, plus increased benefits for antidepressant medications, trans-inclusive healthcare, and more. But there is still a long way to go to ensure comprehensive and affordable health care coverage for all graduate workers, including those with chronic illnesses like Alex.

By coming together to form a union, graduate workers will finally have a democratic voice at the table to advocate for equitable health coverage. To form a union, workers must stand together to ensure that everyone’s needs are met, that is, to ensure that everyone can afford to take care of their physical and mental health and no worker faces panic of a bill they cannot afford in addition to a medical emergency.

With our union, we will have the collective power to fight for the health care we need.

Join us by signing your union card at mitgsu.org/sign.

If you are having similar issues with healthcare as a graduate worker, please contact the MIT GSU at [email protected]

Ethan Baker is a 5th year biology graduate student-worker.
Owen Leddy is a 3rd year graduate student worker in Bioengineering.
Sneha Kabaria is a 2nd year chemical engineering graduate student worker.

All authors are organizers of the MIT Graduate Student Union.

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About Evelyn C. Heim

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