Student Health Insurance

STUDENT  HEALTH INSURANCE PLANS

During my career as a health insurance broker I have been asked if purchasing a student health insurance plan is a prudent decision. The answer is if I can review the benefits and the premiums I can help my clients make the best decision. The reality is that in twenty- nine years of reviewing student health plans I have only seen a handful of plans that will adequately cover someone in the case of a severe catastrophic illness or injury. This is the time of year when many are reviewing student health plans.

A  Los Angeles Times article dated 8/11/2013 follows my discussion.

For the most part this is a good article. It is important to understand the significance of several areas of health coverage, the per illness maximum, the annual maximum and the lifetime maximum. As part of the discussion one has to first understand that there are benefits that will always be limited for the most part by medical necessity such as chiropractic and all the therapies (physical, psychological, occupational, speech, etc.) Coverage for illness requiring hospitalization, doctors visits, imaging and most outpatient procedures which are also determined by medical necessity should NEVER be limited by a per illness, annual or lifetime maximum. This is the area that most student health plans in my opinion fall far short of being acceptable. Policies on the regular open market which must comply with Health Care Reform do not have limits that I have described above.

Assume that a student health plan provides $500,000 as a lifetime maximum. I see this in many student health plans. A severe accident, injury or medical condition can result in medical bills which exceed $1,000,000. The student plan will cover the first $500,000 and the patient is responsible for the remainder of the bill. An unlimited lifetime and per illness maximum will pay the entire bill. The Times article states “These caps have been a common cause of financial hardship…”

The article continues “Regardless, student health plans can be a cost effective option for good coverage , experts say”. I say this statement is inappropriate unless a student has a pre existing condition and cannot purchase a plan on the open market. Pre existing conditions will not be a factor as of January 1, 2104 due to Health Care Reform. Today  many open market policies with excellent coverage are about the same premium as a student policy.

When I was a college student I paid the inexpensive annual fee to access the student health center which was free and convenient but I kept my regular health insurance policy for care that could not be obtained at the health center. This is the approach I recommend.

As I have mentioned in my previous blogs the health insurance premiums that will be a result of Health Care Reform are uncertain at this time. When it comes to student health policies we should reevaluate in the summer of 2014.

The Los Angeles Times article follows;

HEALTHCARE WATCH

 

Take note, college students

There are myriad insurance options at different costs. Find one that’s best for you.

 

BY LISA ZAMOSKY

Noel Carrillo was nervous this summer about his lack of health insurance.

“I was a little bit scared because things happen all the time,” said the 26-yearold Westwood resident.

But now that he’s headed to medical school at UCLA, help has arrived. Like millions of other students across the nation, he’s covered by a university health plan.

Insurance coverage for young adults has been in the news as provisions of the Affordable Care Act have begun to take effect, including the option for young adults to remain on their parents’ policies until age 26. In addition, there are federal regulations taking effect next year requiring nearly all Americans to have health insurance.

Though health insurance is often last on students’ lists of things to think about, experts say they and their parents need to carefully consider a variety of options to make sure they’ve got the best coverage for their circumstances and their wallets.

8 Student health plans. As many as 1.5 million undergraduate and graduate students are enrolled in a health insurance plan offered through a college or university, according to the U.S. Department of Health and Human Services. Many schools require students to either buy the health insurance policy they offer or show proof of other coverage.

The Affordable Care Act provides new advantages for students covered by their school’s health insurance plan. Among them is the requirement that the plans provide preventive health services and access to contraception at no additional cost.

Overall, the greatest benefit of the law “is free preventive services,” says Tamika Butler, the California director of Washington-based Young Invincibles, a national organization that seeks to represent the interests of 18- to 34-yearolds. “Even with a college plan, students sometimes can’t afford to go to the doctor.”

Many student health plans aren’t required to comply with some of the law’s protections, including one that eliminates caps on annual or lifetime benefits. These caps have been a common cause of financial hardship when students suffer injuries or illnesses.

Regardless, student health plans can be a cost-effective option for good coverage, experts say. “The other advantage of a student plan is you can fold it into your financial aid package so you don’t have to put cash on the barrel,” says Jenny Haubenreiser, immediate past president for the American College Health Assn.

8 Care on campus. No matter whether you buy into your school’s health insurance plan, you may be required to pay a fee to help support an on-campus health clinic.

Although the fees vary, Haubenreiser says it’s safe to assume a charge of $100 to $200 per semester. This is not a health insurance policy, but the clinics are a good source of primary care for students.

It’s important to understand, however, that this typically doesn’t cover hospital stays. “Most student health service is only for outpatient care,” says Martin Rosen, co-founder and executive vice president of Health Advocate, a patient advocacy organization based in Plymouth Meeting, Pa.

8 Stay on Mom’s or Dad’s plan. Under the health law, most young adults can now stay on their parents’ insurance plan until age 26.

This part of the law has helped about 3.4 million young adults nationwide gain insurance coverage. In some cases, it costs nothing to add adult children to a policy. Other plans charge at most $150 a month, which can still be cost-effective, says Mike Thompson at consulting firm PricewaterhouseCoopers’ human resources services.

Pay careful attention if the student attends school out of state. Many health plans require you to use a network of healthcare providers within the geographic area in which the policy is issued.

If the plan is a preferred provider organization, typically you can see out-of-network doctors, although costs will be higher if you do. But experts say this can work if a healthy student visits the doctor only when home on break, as long as there is a health clinic on campus that can meet the student’s primary care needs.

8 Get an outside policy. For students who also work full time, particularly those at community colleges that may not offer a health plan, it’s a good idea to explore insurance options on the job.

There’s also the private health insurance market. Although it may be tougher for someone to qualify for a health plan right now, next year the Affordable Care Act guarantees coverage to everyone who applies for a policy.

New private insurance options are coming. And on Oct. 1, Californians can begin shopping for a plan on Covered California, the state’s new health insurance marketplace. Coverage purchased by Dec.15 will take effect Jan.1. In addition, subsidies will be available to reduce the cost of coverage for lower-income adults.

Carrillo says he’s thankful to have his student health plan, which kicked in last week. Without it, he’d be a doctor in training with no health benefits, he said.

“I don’t really have money, so if I didn’t have student health insurance I would have to wing it,” he said.

Resources and links

Information about college health plans: American College Health Assn., acha  .org

Comparing insurance options: Federal government’s website healthcare  .gov

Shopping for insurance coverage: Covered California, coveredca.com  , starting in October

Zamosky writes about healthcare and health insurance. business@latimes.com

 

GENARO MOLINA Los Angeles Times

NOEL CARRILLO, a first-year student at UCLA’s medical school, is thankful for the school’s health plan. “I don’t really have money,” he said.

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