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Health Coverage Often Stops at the Campus Gate

Discussion in 'Parents of College Kids and Young Adults with Type' started by Ellen, Feb 25, 2008.

  1. Ellen

    Ellen Senior Member

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    NYTimes.com

    Health Coverage Often Stops at the Campus Gate

    By TANYA MOHN




    February 23, 2008

    PARENTS often do not think twice about health coverage when their children head to college, but it might be to their advantage to take a second look before doing a double-take when they see their bills.
    They may wind up paying double or triple for campus health care, said James A. Boyle, president of College Parents of America, a nonprofit group based in Arlington, Va., that provides support and advice for parents of college students.

    On most campuses, a family’s insurance plan “is effectively worthless,” Mr. Boyle said. It goes unused, he said, because most colleges do not process standard health insurance.

    Andrew Menter, founder of the Highland Campus Health Group, a company that bills and collects third-party insurance for college health centers, estimated that only 2 percent to 3 percent of centers nationwide are in-network providers with the large insurance carriers.
    Campus health centers traditionally have been financed through tuition, general fees or specific health fees, allowing the same access for all students. More recently, a fee-for-service approach has become increasingly common. As a result, parents who are already buying their own insurance may have to pay substantial health fees and out-of-pocket costs for lab tests and X-rays.

    Students could pay for health services themselves and then file for reimbursement from their insurance companies, but Mr. Menter said only about one in eight claims is reimbursed for out-of-network providers. And when they are paid, he said, it is sometimes for a fraction of the charge.
    All this can leave students confused. Last April, Michael Feuerstein, 19, a sophomore at the University of Virginia, wrote a letter to the editor of The Cavalier Daily, the student newspaper, stating that the health center did not make it clear how billing was handled. “I feel it is a very deceptive process,” he said. “It should be easier for students who are sick and away from home.”

    His views are supported by Glenn Egelman, director and physician in chief of the student health service at Bowling Green State University in Bowling Green, Ohio, which began billing the health insurers of students rather than increase fees or reduce services several years ago. “If you think about it, it doesn’t make any sense,” he said. “We saw that many students had insurance; they were paying for it but weren’t using it.”
    The change, he said, “has been a very positive thing for us.” Revenue from direct billing has provided money for better services and increased access at the health center.

    At Kent State University, more students are seeking care because they know it is covered by insurance, said Mary D. Reeves, director of university health services. “Also, they don’t delay care. We have diagnosed some serious things — breast cancer, cervical cancer and severe mental illness.”

    Health care costs have risen in recent years, putting a strain on university budgets, and more colleges are looking for ways to preserve the quality of care by collecting payments for services rather than raising tuition and fees, said Dana Mills, director of the student health service at Marquette University in Milwaukee and chairman of the student health insurance task force at the American College Health Association.
    “It’s the wave of the future,” Mr. Mills said.

    Karen Allen, an Austin, Tex., mother of three, has had experience with a college that bills insurance and one that does not. When her daughter Kaitlin became ill twice as a college student she had to decide whether to make a two-hour trip home or go to the emergency room because the nearby hospital accepted her insurance but the campus health center did not.

    “I was surprised and shocked that they have to make choices they shouldn’t have to make,” Mrs. Allen said.

    But when her son Mack, a student at Baylor University, which accepts insurance, developed pneumonia last fall, he went directly to the campus heath center. “He knew all he had to do was show his insurance card, just like at home.”

    Nevertheless, the traditional system has its advocates.
    Stephen C. Caulfield, chairman of the Chickering Group, a unit of the Aetna Company that provides university-sponsored plans at 170 colleges and universities, said uninsured and underinsured students are a major concern.

    “A significant number of college students (nearly 4.5 million, including many graduate students) do not have coverage, and many more do not have adequate coverage,” he wrote in an e-mail message. The reason colleges and universities have sponsored health insurance programs, he added, “is to promote adequate access to quality health care at a reasonable cost for all students.”

    Washington University in St. Louis requires that all students buy the university-sponsored plan because it found that underinsured or uninsured students were not seeking care, putting themselves and other students at risk. For $686 a year, all students receive full access to the center and a 12-month insurance policy.

    Jim Mitchell, director of the student health service at Montana State University in Bozeman and a former president of the American College Health Association, is an advocate of the old system but acknowledges that insurance billing is likely to increase in the years ahead. “In my opinion, it’s not the most desirable method for providing accessible, convenient health care to students,” Mr. Mitchell said. “My sense is that universities are going there out of necessity, not because they want to.”
    Dr. Richard P. Keeling, founder of Keeling & Associates, a higher education consulting firm in New York, sees both sides.
    “It’s not a black-and-white issue,” he said.

    Dr. Keeling, also a former president of the American College Health Association, called insurance billing a “good and very reasonable” step for college heath centers. But there still has to be a way for centers to cover some medical services and nonclinical expenses, like wellness and counseling programs, he said.

    The origins of campus health centers help explain the traditional system, Dr. Keeling said. Centers were established to provide health care on campus to support the academic mission of the college and help keep students in school.

    “It is still the reason colleges and universities do this,” he said.
    The trend toward accepting insurance has already given rise to Mr. Menter’s business, the Highland Campus Health Group, which handles paperwork and credentials for universities that want to bill insurance companies.

    Highland takes a percentage of the insurance reimbursement and sends the rest to the college, typically increasing a health center’s annual budget by 10 percent to 15 percent, Mr. Menter said.
    Insurance companies like the system as well, he added. If students go to the emergency room or put off care until returning home on break, it can ultimately cost the companies more money.

    So what’s a parent to do?
    Mr. Boyle suggests that parents ask college administrators: “Do you accept the health insurance our family has? If the answer is no, one question should be ‘why not?’” If enough parents ask, Mr. Boyle said, it will pressure universities to consider accepting their private health insurance.

    “College health centers are not above being responsive to parents,” said Dr. Allan L. Markus, director of the campus health service at Arizona State University. Dr. Markus suggests parents handle it like any other consumer issue, and ask college administrators, ‘Tell me, what am I getting for the health fee? Can I waive out, and why not? ’ ”

    At orientation sessions for new students, he said, parents frequently ask “ ‘Do you take Blue Cross, Aetna?’ I say ‘Yes, yes, yes. We take them all.’ They say to themselves ‘that’s one less thing I have to worry about.’ I’ve not had one parent say to me, ‘It’s not the right thing to do. ’ ”
     
  2. Brensdad

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  3. funnygrl

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    NY here and I'm covered til I'm 25 on my parents' insurance as long as I'm a full time student. Thankful for that.
     
  4. OSUMom

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    Interesting, I didn't know it was a state by state thing. Our insurance is through Delaware because that's where my husband's company has it's main office. I know our sons are covered as long as they stay in school until they are 25. It is so so so key to know the deal with the coverage!!!

    You do not want your coverage to stop ever and be uninsured if you can help it. I am close with a Type 1 young adult dealing with this now. She stopped college and didn't get right on the employer's coverage. We are fundraising to get her an insulin pump.
     
  5. faithe113001

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    MI...I have special insurance because of the D, so I'm covered until 21. Otherwise, it stops at 18.
     
  6. Ellen

    Ellen Senior Member

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    Thanks Emma's Dad. I wish I could get Florida on that list:rolleyes:. On the positive side, I can encourage my children to stay in college until age 25.

    If anyone is interested in what employers are thinking about re health care in the future, here's an IBM paper:

    Healthcare 2015 and U.S. health plans: New roles, new competencies

    http://www-935.ibm.com/services/us/gbs/bus/pdf/g510-7582-00-hc2015.pdf
     
  7. Brensdad

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  8. SamsMom

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    My non-d kid will graduate college in the middle of June. She will no longer be a student but who knows how long before she gets a job and/or if there is a waiting period before she will receive benefits with an employer. Does anyone know how this works? Should we just get some sort of catastrophic coverage for her? Or can we do cobra on our plan? We probably need to contact our health insurance provider and see what options we have. What did you parents with college graduates do? Does the college kid automatically drop off your plan since they are no longer students? I want to have my ducks in a row before June sneaks up on us!
     
  9. lilituc

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    Generally as soon as they graduate, they are dropped. I think some plans can do COBRA, but I'm not sure. If she doesn't have any health issues, she can probably apply for an individual plan, though. If she does, it looks like Texas has a high risk pool http://www.diabetes.org/advocacy-and-legalresources/insurance/texas.jsp so she could apply for that instead, assuming she's not eligible for COBRA.

    I think the usual procedure is to just not have health insurance, since that's kind of the invincible age. ;) I don't recommend it, though.
     
  10. Ellen

    Ellen Senior Member

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    If nothing else, it may be worth it to take a night class or two after graduating in order to purchase the school's health insurance plan. The local university here offers one that is very affordable. It's very important not to lose the chain of coverage.
     
  11. bgallini

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    Here's an article I found about this issue. It's still something you have to ask your insurance company about though.

    http://www.nextstudent.com/NextPath...-keeping-your-graduate-medically-insured.aspx

    Another thought is for your daughter is for her to line up a job now, even if it's not her dream job, and make sure it's one that has insurance coverage. She can then take her time finding her dream job (with insurance).
     
  12. SamsMom

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    Thanks for that link, Barbie. I printed it out and will have dh take a look at it with me. I agree, I want her employed and she does, too, I am just hoping she is willing to take less than the ideal job for coverage.
     
  13. livacreature

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    This issue, as a senior getting married in May has caused me so much grief. I have had to COBRA with the rest of my family due to job switches/lay offs before (you think insurance for a diabetic is bad, my dad has multiple myeloma...WOWZA!), and am lucky enough (though there goes my savings) to COBRA for a few months before my soon-to-be husband's insurance will kick in. Before we knew I could get on his insurance at his graduate program I was really panicked.

    I now have the luxery to take jobs that I really want regardless of health insurance, but I was looking at everything that had benefits before which unfortunately were mostly in positions that were not my thing.

    To prevent huge issues, I went ahead and got a new pump, am filling all of my prescriptions monthly to stock pile, etc. just in case their are any issues with the switch.
    I'm in NC, BlueCross BlueShield, currently.
     
  14. Brensdad

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    This is all kind of ridiculous isn't it? On top of all the stress a new college graduate has, they also have to worry about this crap.:mad:
     
  15. moco89

    moco89 Approved members

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    Starbucks, Costco, and UPS allow part time workers to have benefits

    I think at starbucks you must work a minimum of 20 hrs. At UPS, it's 25 hours. It's all reasonable insurance, too.

    COBRA sucks! It's costs too much $$$$. However, COBRA is a must.

    If you go 63 days without any insurance (cobra counts as insurance) coverage, you are subjected to the pre-existing condition clause. You can expect to not have any insurance coverage for D for approximately 12 months, if youre lucky-6
     
    Last edited: Jun 20, 2008
  16. Brensdad

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    This, unfortunately, seems to be the diabetic professional mantra.
     
  17. TerpSteph

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    We have a bit of time to figure things out this since my son will be a HS senior this year, but I've definitely had concerns over the major he selects since health insurance will be a must for him. We do feel lucky that my husband's employer (MD State government) changed its rules this year and we can carry Matt on our health insurance until he is 25 regardless of his student status.
     

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