MIT Medical: A Freshman’s Story by Paul B. '11

A few weeks ago, a friend of mine approached me with an idea for a blog entry about MIT Medical: an inside look on their experience with MIT’s medical system, and medical facilities around Boston. They thought that their story was particularly relevant because this is the time when the incoming freshmen and their parents are working on their insurance plans for college, and I agreed. For sake of privacy, though, we agreed that the entry should be anonymous.

It’s a long and detailed entry, but I think it’s worth sharing: after all, MIT has one of the best medical systems in the nation, and I believe incoming (and prospective) students deserve to know exactly what sort of healthcare they’ll be getting at MIT. I’ve also added a compilation of links to some of MIT’s many student health resources at the end of this post. And while I’m no expert regarding MIT Medical, I do have quite a bit of experience with Medical due to my training as a Medlink; so if you have any questions, I’ll do my best to answer them.

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Student ’11: Over the past year, I’ve had more than my fair share of encounters with MIT Medical – such as obtaining a prescription at a decent price in September, mononucleosis in October, vaccinations in November and February, and a series of three major throat infections in February and March that culminated in emergency surgery the week before spring break. (All this, and I hadn’t even declared a major yet.) Of course, medical issues mean medical bills mean medical insurance. Oh joy.

I’ve learned a number of things about medical insurance – and specifically, medical insurance at MIT – since arriving here, most of it the hard way. I know that prefrosh and their parents are choosing a medical plan right about now, so I hope that you will benefit from my experience. I particularly learned about the differences between having the MIT Student Medical Plan, in which all MIT students are automatically enrolled, and the MIT Student Extended Insurance Plan, which costs an additional $1570 per academic year for a single student. Last August, my family elected to not put me on the MIT Extended Insurance Plan, instead depending on the MIT Student Medical Plan that every MIT undergrad gets automatically (call it the Basic Plan), plus my Dad’s insurance for covering the big stuff.

Dad of Student ’11: Since medical insurance decisions are complex, and involve a joint student-parent discussion, we added a parent’s voice to this entry. Long ago I spent a year at MIT (my “junior year abroad” in Boston) so I thought I knew how the place worked (not quite, Dad!). Our family has a comprehensive medical plan that I buy through my employer, who negotiates with providers for a wide range of well-priced choices. Now, since I trained up as an economics major (Course 14, for you Tech types), I used those rusty skills to compare all the plan options from our employers. We had all been robustly healthy the past ten years (minor athletic injuries aside), so I opted to bet against long-tail probabilities and took the so-called High Deductible Medical plan. We then saved the difference versus the lower deductibles plans in a special medical savings account. Our medical plan is flexible, with open access, meaning we can go to any participating in-plan provider anywhere without going through a gatekeeper or getting pre-approval, and it offers good coverage if you need to go outside the network. It was been a good bet for four years running, and we had a nice safety cushion building. Emphasis on the had.

Student: A little bit about MIT Medical: It’s basically a miniature hospital. The building contains Urgent Care, staffed 24/7 with at least one doctor on call; a small pharmacy; a lab; offices for general practitioners; OB/GYN specialists; ear/nose/throat specialists; a bunch of other types of specialists; and even a hospital-style ward, complete with nurses taking your blood pressure at all hours of the day and night. (I lived there for a few days while still in recovery from the surgery described below – the food isn’t bad, and the nurses even have some tolerance for the nocturnal habits of MIT students like me). I’m pretty sure there’s other stuff tucked away in that medical building that I’m missing. The building itself is located in E23, just behind the Media Lab on the east side of campus. It’s also only about a hundred yards from the Kendall Square T-stop on the Red Line. If you hop on the train inbound to Boston, the very next stop is Charles/MGH, just across the Longfellow Bridge and right next to the Massachusetts General Hospital, better known as Mass General or MGH.

Dad: MIT Medical serves the entire Institute population – faculty, staff, post-docs, grad students, undergrads – with a comprehensive medical service delivered primarily through the clinic and hospital-like facilities on campus near Kendall Square. They are a Preferred Provider Organization (PPO) which has formal links to a selection of medical specialists and hospitals near Cambridge. For students on the Extended Plan, they also have some coverage if you study abroad (check their web site for details). But as a PPO – and unlike your local doctor – they do not have the capability to bill an outside insurance company (a special exception is noted below). So MIT Medical can do the whole deal with care end-to-end on the Extended Plan. Or, if you are on just the Basic Plan, they need to send your student to someone who can provide the care and send you a bill. So the student gets to see a local doctor, or a local pharmacy, and you or your plan gets the bill. And apart from MIT Medical’s own pharmacy, the nearest pharmacies are in Central Square (rather a walk from campus) since there are no pharmacies or groceries to be found in offices-only Kendall Square near MIT.

Student: As I learned, the MIT Basic Plan is decent coverage as long as you don’t have any major problems. When I showed up in Urgent Care at MIT Medical with rock-hard lymph nodes and generally feeling like crap, they were able to send me to the lab for a blood test without much trouble, and I had a diagnosis for mononucleosis the next morning. Getting my two remaining vaccinations wasn’t a problem either; they just gave me the shots, and sent a bill to my Dad’s insurance. (Dad: Vaccines strongly recommended for students are the one case where MIT Medical has made arrangements to put charge for the services, either on the MIT Student Accounts invoice, or to bill insurance carriers.) If I’d had no more than that all year, things would have been just fine and dandy. The problems began when I needed more care than just shots and sniffles.

Slightly more problematic was getting a prescription for a long-term medication. Not getting the prescription – I had prescriptions from three separate doctors by the time I was done. The issues were cost and location. I had three options: buy it from MIT Medical, through my Dad’s insurance, or a local provider. My Dad’s insurance plan’s pharmacy was expensive and inconvenient. MIT Medical, under the Basic Plan, was also expensive, but at least convenient. The local provider was less expensive and quite inconvenient; I had to haul across the river and down to the BU area in order to have an appointment with a doctor (which we had to pay for separately) in order to get their prescription from them so that I could buy the medicine from them; they wouldn’t take the prescription my doctor at home had already written for me. There’s an afternoon down the drain. Sigh. Not to mention various annoyances related to buying medications from a very small, very local, very idiosyncratic institution. If I had been on the MIT Expanded Plan, I could have gotten the medication both cheaply and conveniently right on campus. MIT Medical heavily discounts many prescription medications, has a low-ish co-pay, and the pharmacy is right on campus.

Dad: Costs so far: $213.50 total billed, of which $0 was covered by our insurance, and $213.50 was our share.

Student: Now the fun part: infections, abscess drainage, and surgery! One Saturday night in early February, I went to MIT Urgent Care with huge swelling in my throat, from with what turned out to be an abscess caused by an infection near my tonsils. The lone doctor on call sent me over to Mass General, just one T-stop away, where (after much waiting punctuated by intermittent poking and prodding) they hooked me up to an IV, gave me some stuff to relieve symptoms, and ran me through a CAT scan, which confirmed the doctor’s diagnosis of a peritonsular abscess. They put me to bed for a few hours, and finally drained the abscess in the morning. This basically consisted of numbing my throat with the most awful-tasting stuff I’ve ever had to endure (like an acrid, chemical imitation of rotting bananas), shoving a syringe into the abscess to extract a sample of pus for analysis, and then prying open the hole from the syringe and pressing onto the swelling to squeeze out the rest of the gunk. I left with narcotic painkillers and antibiotics to clean out the infection.

Dad: This is not the phone call any parent ever wants to get at 10:00 PM on a Saturday night: “Ah, Dad, I’m in the ER at Mass General, my throat is swollen, can’t talk much, they’re gonna give me a CAT scan, my phone is losing power, bye!”. We’re lucky – we live about 3 hours from Boston, so very early the next morning I hopped in my car and drove to Boston. I arrived in time to catch up with my child in the emergency surgery recovery room at Mass Eye and Ear Infirmary (MEEI), and accompany back to the admitting emergency room at MGH, the eventual point of discharge. We learned that MGH and MEEI are two different institutions, with separate billing and separate parking, connected by a covered passageway, and sharing a prison morphed into a fancy hotel (no really, it used to be a prison). MEEI does eyes, ears, noses, and throats; MGH does everything else.

Going through the bills much later, I had a chance to Google-check the attending ER physician at MGH; she is the holder of an Olympic Bronze medal, awarded as a member of the US Women’s Field Hockey team sometime back in the day. Now she is a specialist in ER and Sports Medicine – how classically overqualified Boston, eh?

We stayed in a Cambridge hotel Sunday night so our Student could recover (in an excess of comfort), and then go back to class Monday morning. Medical costs for this encounter: $11,243 total billed, and $8,233 allowed under our insurance plan’s negotiated rates; of which $3230 was covered by the insurance plan and $5,002 was our share. Ouch. At least we had used up our student’s deductible.

Student: After two weeks of recovery and apparent good health, the peritonsular abscess infection returned, and back I went to MIT Medical. This time, however, it was a Wednesday morning, around 9:30 AM. As it turns out, MIT Medical has the personnel and equipment to drain an abscess like that, no problem. Because I was on the Basic Plan, not the Extended Plan, the procedure to drain an abscess was not covered, and MIT Medical could not bill my family insurance plan. So once more they sent me over to the Mass Eye and Ear (by cab). I spent the day waiting in the MEEI ER, getting the procedure performed, recovering a bit, then coming home and taking a narcotics-induced nap while my peers took the semester’s first 18.03 exam.

Dad: Costs for this set: $1,095 total billed, and $556 allowed under our insurance plan negotiated rates, of which $367 was covered by our insurance plan and $189 was our share. Not as bad as the last one.

Student: It was a Monday morning when I went to MIT Medical 17 days later for the second relapse – the third round with my peritonsular abscess. They spent a long time fussing over me (still not sure why) before sending me over to Mass Eye and Ear again for drainage. Didn’t come back till Friday, though, as the doctor there decided I needed surgery immediately to remove the apparent cause of the recurrent infection. The doctor (named Dr. Song, appropriately enough for a throat specialist) figured that the bacterial infection was hiding in the labyrinth of tissue that comprise my tonsils, as the little bacteria could hole up in there and lie low until the nasty antibiotics went away, and then attack my throat once more. Though a tonsillectomy is a relatively common procedure, my case was a little unusual because they would be performing surgery on an infected area; this made the procedure a quincy tonsillectomy. For kids, a tonsillectomy is not a big deal; for adults (in body if not in mind), it is a distinctly non-trivial case.

I was moved upstairs, from the emergency area on the ground floor to the inpatient unit on the 11th floor, where I lived for the rest of the week. They did a bunch of diagnostics on me Monday afternoon, including a lot of blood samples and another CAT scan. Dr. Song wanted to do the surgery as quickly as possible, but first they ran into some (ultimately groundless) concern about my blood not clotting enough. (I must have looked like a heroin addict by the end of the week: the insides of my elbows were just covered in needle tracks. The IV in the back of my hand also left several blood vessels mushed into weird but harmless misalignments.) There were also some delays with scheduling time in the surgery room, but on Wednesday afternoon, just as my peers were taking their second 18.03 test and/or the 6.01 midterm, the nurses loaded me onto a big fancy surgery bed and took me down to the surgery floor. Interestingly enough, between the 6th and 7th floors (I think) there are 2 floors that are labeled only by letters in the elevator: S and R, presumably for Surgery and Recovery. (Platform Nine and Three-Quarters, anyone?)

Once in surgery, the anesthesiologist put a mask over my face and probably something in my IV, and then I woke up a few hours later in the recovery room feeling thoroughly muzzy. It probably took me a good 15 or 20 minutes to go from aware to engaged, so it was nice that the recovery room was very quiet and the nurse didn’t even approach me until it was clear my brain was functioning enough that I could respond to her. Another nurse wheeled my surgery bed back up to the 11th floor, where I am proud to say I got out and walked to my hospital bed on my own two feet.

I spent Wednesday night and Thursday in my hospital room, sleeping (as much as can be done when a nurse wakes you every other hour to check your vitals), eating really soft foods, reading, occasionally speaking in a very soft voice, and taking lots of narcotics to dull the pain of the worst sore throat you could ever imagine. By Thursday I was itching to get out; hospital stays are the epitome of “hurry up and wait,” and the only reason I wasn’t bored stiff was that a wonderful friend contrived to get into my room, grab some books, and run them over to me at MEEI when I learned Monday that they’d be keeping me all week. And I’d had absolutely no Internet access all week (horror of horrors for an MIT student!). I kept in touch with my friends mostly via text message; a few even came to visit. I was quite happy to be discharged at last on Friday, when the doctors decided I’d gotten through just fine and it was safe for me to leave. My parents loaded me and my dirty laundry into the car and drove home. The following week was MIT spring vacation, so I spent it at home recovering and enjoying some of Mom’s mushier dishes. I even managed to dig up enough energy near the end of the week to start catching up on schoolwork.

Dad: Once again, I was able to hop in the car and head to Boston, to be advocate and companion for my kid during the whole long stay in the hospital, and then provide transport home for initial recovery. One very small side benefit: The view from the 7th floor MEEI cafeteria is a spectacular sweep of Boston, Cambridge, and particularly MIT – perhaps the best views of the MIT campus I have seen from any vantage point in Boston or Cambridge. Lunches were wonderful, and sunsets were stunning. I was going nuts not being able to check e-mail from work – major Internet withdrawal. But in the MEEI cafeteria I spotted an MIT student (the T-shirt and laptop is always a giveaway) – he was doing research on kinesthesiology, something about testing middle ear disturbances for a project funded by NASA. He sent me to the library, which got me wired up in a jiffy. Nights, we stayed at the hotel in Cambridge, leaving our student to the tender ministrations of the night nurses.

Much later came the reality check (literally). Getting billed for a hospital stay with major surgery is like watching an avalanche on one of Saturn’s moons fall down in slow motion on your planetary lander from a control room on earth; it happened a long time ago because of transmission delay, and by now there is not a darn thing you can do about it. Costs for this set: $26,261 total billed, and $6,186 allowed under our insurance plan’s negotiated rates; of that $4,345 was covered by the insurance plan, and $1,840 was our share. Wow.

Student: After my week of convalescence at home, my parents drove me back up to Boston as classes resumed. I spent my first few days back living on the inpatient ward in MIT Medical, where the medical staff could keep an eye on me and provide me with nice soft food. After about two days the doctor declared me thoroughly stable, and I returned to living in my dorm room. About a week later, I went back to MEEI for a follow-up with Dr. Song, who concluded I was healing fantastically and requested an additional follow-up in late May. So, after finals (by which time my stay in MEEI seemed like a lifetime ago) I returned for that last follow-up, which included yet another CAT scan (I think we’re at #3 now?); Dr. Song declared me completely recovered and released me from his care.

Dad: Costs for this set: $2,430 total billed, and $1,612 allowed under our insurance plan negotiated rates, of which $1,137 was covered by the insurance plan, and $475 was our share.

Student: So here’s my take. The Basic Plan is sufficient for:

• Shots and vaccinations
• Sniffles and sneezes
• Common diseases – mono, strep, bronchitis, etc.
• STD testing
• Medical documentation and patient advocacy within the Institute
• BUT you’ll need to understand your insurance plans to do your own math for prescriptions, vaccination co-pays, your other needs and stuff.

The MIT Extended plan is really helpful for:

• Uncommon or complicated medical problems
• Chronic problems
• Anything that requires a specialist
• Easy access to the local hospitals with which MIT Medical has contracts.
• Avoiding MIT Medical’s limitations on charging outside insurance agencies for anything beyond vaccinations.

From my experience, MIT Medical will send you to the hospital regardless of your insurance plan if you need something they cannot deliver, such as surgery, or if it is outside business hours (~8-5, Mon-Fri). Ultimately, you will get care, somewhere.

Dad: Well, all is well that ends pretty well. My child was able to finish out the semester successfully, and did anywhere from well to very well in the spring semester courses. And we had quite a lesson in medical billing and insurance reimbursement – and in the sheer time it can take to get medical care, time that should be weighed against the costs involved in the Extended Medical coverage. Total costs across all that happened this year was: $41,123 total billed, and $16,672 allowed under our insurance plan’s negotiated rates; of which $9,147 was covered by the insurance plan, and $7,524 was our share. We would have paid out less – likely quite a lot less – under the lower deductible and smaller co-pays of the MIT Extended plan. We’ll be taking the MIT Extended plan for our student in the new academic year – with hopes that all needed care can be delivered on the campus. Stay well, kid!

Student: One final thought: Whatever happens, if you know you need serious medical help, always go first to MIT Medical. Any Medlink will tell you the same thing. I don’t care what plan you’re on, just go to Urgent Care. Even if all they can do is take a look and then pay your taxi fare to get you to Mass General, GO TO MEDICAL. I can’t stress that enough. Why? Because then Medical has on record that you came in with a medical problem. That means everyone you are accountable to – your professors, your research supervisor, your employer, anyone – can verify that you went to Medical on a given day with a call to the Dean in Student Support Services (better known as S³). That way, you have some footing for negotiating with your professors about things you missed, like the two 18.03 exams I missed while getting treated for those infections. (One I made up after the surgery; the other the professor replaced with the average of the rest of my exams.)

Even better, if you have a case that drags on – such as my week-long visit to the hospital and subsequent three-week recovery – someone in MIT Medical (a “Patient Advocate”) will keep in touch with you, following your case and making sure that you’re getting the care you need, that your professors are giving you sufficient leeway to recover and catch up, and the deans and your advisor are kept in the loop.

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Helpful Links from MIT Medical:
MIT Medical Homepage
Student Quick Links
Student Health Plans Overview
Student Health Plans Overview (pdf)
Summary of Student Medical (Basic) Plan (pdf)
Summary of Student Extended Plan (pdf)
Insurance Enrollment Form
Waiving the Extended Plan FAQ

Other Helpful Links:
Student Support Services
MIT Medlinks
MIT Emergency Medical Services (EMTs)
MIT Police Homepage
MIT Nightline: 617-253-8800 (anonymous peer-listening service run by student volunteers)
Boston Area Rape Crisis Center: 1-800-841-8371

MIT Emergency Phone Numbers

• 24/7 Emergency Hotline: 617-253-1212
• MIT Medical (24-hour Urgent Care): 617-253-1311