College student health insurance costs can blind families

College student health insurance costs can blind families

Hawley Montgomery-Downs was thrilled when her daughter got a scholarship to cover half of USC’s tuition.

But just as Bryn Tronco was starting school in August, the West Virginia mom was shocked to receive a nearly $3,000 bill from USC to cover a student health insurance premium and fees for students to access on-campus clinics and other services.

The fees seemed to duplicate Montgomery-Downs.

“It would be nice for her to go to the student health center, but with buying insurance to go to a primary care provider, I feel like I’m paying twice,” he said. she declared.

Compulsory medical insurance and health service fees are common in colleges as a condition of enrollment. But the big bill might come as a surprise, making a barely affordable education even less. Costs vary by school, but can often add up to several thousand dollars a year – costs that health care advocates say should be carefully considered by parents and students to ensure that they understand their options while meeting academic requirements.

Stephen Beckley, a Fort Collins, Colo. consultant for college health and benefits, said healthcare costs can help reduce student insurance premiums. But he can understand how parents can feel like they’re paying double. “It’s a big enigma for our field,” he said.

Students can apply for a waiver of university health insurance by demonstrating that they have their own insurance or that they are covered by their parents’ insurance that meets specific university criteria. Schools generally want to see that the student’s own insurance covers local doctors and hospitals for a low cost. However, student health costs generally cannot be waived.

USC, a private university, charges $2,273 per year for its Aetna student health insurance plan. The average for public colleges is $2,712 and $3,540 for private universities, according to a 2022 survey by the firm of Beckley, Hodgkins Beckley & Lyon.

Other top colleges charge significantly more, such as $6,768 at Stanford and $4,163 at Dartmouth College. The University of Colorado charges $3,976.

The easiest way to avoid these fees would be for students to stay on a parent’s health policy — which the Affordable Care Act allows until age 26. But that only works if the student’s parent has a policy that meets the school’s comprehensive requirements and offers in-network coverage where the college is located.

If not, parents may want to shop around among ACA Marketplace plans to see if they can find a good deal. If their income is low enough, students can sometimes enroll in Medicaid or a Children’s Health Insurance Program (CHIP) in the states where they attend school. But this strategy also has limits. Students must meet the residency requirements of the state where they attend school and parents cannot claim them as a dependent on tax returns. CHIP coverage also expires once the student turns 19.

Schools that charge student health fees and require insurance coverage say the funding helps cover services at campus health clinics that would otherwise cost students hundreds of dollars a year or more.

USC’s student health fees — which cover primary and preventative health services — also help the school pay for services not usually covered by insurance, such as on-campus epidemic monitoring.

Dr. Sarah Van Orman, director of health at USC Student Health, noted that the student health fee provides funding for additional on-campus mental health providers and a team focused on prevention and education. sexual assault – services available to students with no co-payments. She said these additions are essential because, even with insurance, students might struggle to find private counselors to provide timely help and, if they do, students would have costs to share.

“Student healthcare costs support our on-campus public health infrastructure,” Van Orman said.

Because students can get primary health services on campus at the student health center, fewer of them seek care outside of it paid for by insurance, she said, and that helps. to keep the monthly premium for the Aetna Student Health Insurance Plan lower. “These things work together and don’t duplicate at all,” Van Orman said.

USC student health insurance has an annual in-network deductible of $450 and a $20 co-pay for doctor visits. It also provides comprehensive nationwide services, so students are covered while at school and at home, even if it’s nationwide. About half of USC students buy Aetna student insurance, Van Orman said.

Other colleges have a different strategy. For example, George Washington University’s mandatory health insurance covers on-campus health center services. Unless they get a waiver, undergraduates must enroll in the Student Health Insurance Plan, which costs $2,700 a year. The health plan premium entitles students to many free services at the student health center, including doctor’s office visits, certain prescriptions, and routine screenings for sexually transmitted infections.

Beckley said college rules vary in whether they allow students to choose insurance plans other than those offered by the school.

USC allows students to purchase an alternative insurance policy through their parent’s plan or on the ACA Marketplace as long as it meets the school’s requirements which include comprehensive health coverage in the Los Angeles area and preventive care coverage without cost sharing. Out-of-state Medicaid or CHIP plans do not meet the university’s criteria because they do not have provider networks for routine care in California.

This was bad news for Montgomery-Downs.

“It’s not something we budgeted for,” she said of USC’s healthcare costs.

Montgomery-Downs, a former associate professor at West Virginia University who now works as a freelance writer, said she didn’t know what to do when she received the USC health bill. She had thought Bryn, who turned 19 in December, would initially be covered because her CHIP plan provides coverage for treatment in emergency rooms and out-of-state urgent care centers. And Montgomery-Downs wanted to make sure her daughter had health coverage during summer break and vacations at home.

Unsure of market coverage options that would meet school rules and deadlines, she decided to opt for the Aetna student plan offered by USC.

A look at the market options on Covered California shows that the $2,200 for the USC Aetna student plan is a competitive rate. The cheapest comparable PPO plan offered by California Blue Cross that would provide Bryn with a national network of providers costs about $2,400 per year, taking into account a government subsidy based on family income. PPOs provide some coverage for out-of-network doctors and hospitals.

Montgomery-Downs gets her market coverage and said she will buy a market plan for Bryn for the next school year. She said she wished they had been aware of all health costs at the time of admission rather than just before classes started.

“It’s a nightmare, even for someone who is privileged to have the time and some understanding of these bureaucracies — higher education and medical insurance,” Montgomery-Downs said.

This report was produced by Kaiser Health News, one of three major operating programs of the Kaiser Family Foundation.

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