Student Medical Insurance Plan Benefits
Duke’s Student Medical Insurance Plan (SMIP) is a robust, high quality plan that provides excellent and affordable benefits for our students. This Affordable Care Act (ACA) compliant plan is designed specifically for students to help support their health and well-being needs while at Duke.
For students looking to compare the Duke SMIP to other plans, our plan is designated as a Platinum level plan under the ACA rating system.
Coverage Period for 2025 - 2026
| Annual Plan | August 1, 2025 - July 31, 2026 |
| For Spring incoming students | January 1, 2026 - July 31, 2026 |
Plan Benefits
There are a number of documents and resources to help you understand all the benefits that come with your Duke student medical or dental plan.
Medical Plan In-Network Benefit Highlights
| Blue Cross Blue Shield Provider Network | A robust healthcare provider and pharmacy network that provides access to a wide range of providers in North Carolina, access to a nationwide network, and worldwide coverage. |
| Deductible | $0 |
| Out-of-pocket Limit | $2000 (individual) / $4500 (family) |
| Preventative Care | No charge-Includes services such as gynecological exams, cervical cancer screening, ovarian cancer screening, screening mammograms, colorectal screening, bone mass measurement, prostate-specific antigen tests, and newborn hearing screenings. |
| Primary Care Provider Office Visits | $25 office visit copay, 20% coinsurance for all other services |
| Specialist Office Visits | $35 office visit copay, 20% coinsurance for all other services |
| Mental Health Office Visits | $10 copayment |
| Physical, Speech, Occupational Therapy, Chiropractic Services | 20% coinsurance 30 covered visits |
| Urgent Care | $45 copayment for visit 20% coinsurance for other services (x-ray, lab, other services) |
| Emergency Department | $150 copayment, then 20% coinsurance |
| Ambulance Transport | 20% coinsurance |
| Hospitalization | 20% coinsurance |
| Labs / Tests/ Xrays | 20% coinsurance |
| Prescription Drugs | Tier 1: $10 copayment Typically generic medications Tier 2: $20 copayment Typically mid-range cost drugs, typically generic, but some brand-name Tier 3: $35 copayment Typically high cost brand-name prescription drugs Tier 4: $70 copayment Typically high cost prescription drugs, brand-name, and some specialty drugs Tier 5: 25% coinsurance Typically specialty drugs |
| Insulin | $10 copayment |
| Lenses & Frames | $100 reimbursement for glasses, hard, soft, or disposable contact lenses |
The benefits listed above are for in-network services per plan year (August 1 - July 31 each year). For full details on in-network and out-of-network coverage, including exclusions, please review the plan documents linked on this page.