A step up from nothing
For students who don’t have any other options, the university offers a health insurance plan called the Student Sickness and Injury Insurance Plan. The health center functions as a primary doctor for referrals, and it works like most insurance plans.
After being without insurance for about four months, Andrew Aulino, a modern and classical language studies graduate student, opted for the university health insurance plan rather than leaving himself vulnerable to threatening letters from doctor’s billing offices. He hasn’t used the plan for anything more than medications, but he says he hasn’t seen any flaws in it yet.
“There is a $500 cap on how much you can spend on prescriptions,” Aulino says. “If I hadn't changed things around in terms of medications that I was taking when I didn’t have insurance last fall, I would have gone broke during the fall semester, and I would have been screwed.”
As his medical bills accumulated from not having insurance, Aulino says he got on the university plan to save him from debt.
“I felt like I was getting pneumonia, so I went to the emergency room without insurance, and then I started getting bills from tests that I had performed when I still had insurance, as if I were uninsured during the tests,” he says. “So I keep getting bills for like $600, and I’m not responding to them.”
The price for the premium of the university's offered policy is $1,100 a year for undergraduate students. The price can vary for graduate students, where a stipend may be involved, like Aulino, who says he pays about $100 a month.
For students who think heath insurance is an unnecessary expense, it’s appropriate to think of it as investing for something that will happen.
“It is important to have health insurance because of unexpected occurrences,” says Jaime Lebron, Northern Ohio regional sales manager for individual programs at Anthem Blue Cross Blue Shield. “You want to have the protection that they need. Not only being a student, but beyond college.”
Insurance companies save money in ways that aren’t usually seen. Doctors can charge whatever they want for a service, but insurance companies don’t have to pay that much.
“Usual, customary and reasonable are the industry average between different professionals for a particular service,” Lebron says. “If one doctor charges $1,000 and the other $600, they take an average for that particular service, and that serves as a guideline.” And insurance companies have contracts with health care providers to optimize negotiated rates.
“Students without health insurance could be paying whatever the doctor wants to charge because they don’t have that service,” Lebron says. “Insurance companies get the better rate because they can negotiate.”
Michelle Watson, a 2003 Kent State graduate with a degree in human development and family studies, has experienced the full circle of health insurance options. Switching from no insurance to the university plan and, as a last resort, Medicaid in the past two years has taught her a lot about health insurance.
“I have a college degree, and getting on Medicaid was hard and confusing to me.”
“I graduated in December; I found out I was pregnant in January,” Watson says. “My husband was still a student, and I couldn’t get insurance through my job. I tried to get an individual plan, but pregnancy is a pre-existing medical condition, and most individual plans won’t cover pregnancy if you are pregnant when you get on it. Even when you get on an individual plan, you have to be on it for nine months before you get pregnant for it to be covered, and in most cases, you need to buy a rider to your plan for pregnancy to be covered by your insurance. So I turned to Medicaid.”
Getting an individual plan with a pre-existing condition is difficult.
“If they are pregnant in advance, we don’t cover them until after the baby is delivered,” Lebron says. “For the most part, that is an industry standard. Some companies can cover the person, but not the pregnancy and the delivery. If they came in with a group, they are automatically covered for the most part.”
To be eligible for Medicaid coverage, Watson had to quit her job. Filling out the forms and writing all the letters needed to get coverage was difficult.
“I have a college degree, and getting on Medicaid was hard and confusing to me,” she says. “Medicaid is different from Medicare. To get on Medicaid you have to be under 19, pregnant or have a family and be poor. It does not cover most college students, which is really sad because college students are the ones getting into the most debt spending with tuition, housing and first time managing their funds.”
Watson was on Medicaid from February to December 2004, and her son was born on Sept. 27.
“Medicaid only covers pregnancy for three months after the child is born,” Watson says. “My husband, who finished his master’s this past December, got a job with benefits in August, and we are on a plan through him now. But Medicaid is the best insurance ever. It covered everything. I paid like nothing. If I paid anything, it was like 80 cents for a prescription.”
The Student Sickness and Injury Insurance Plan, which she started when she got married before she graduated, didn’t offer enough coverage for her. Watson says she went over the allowed lab coverage in a month.
“I have a thyroid condition, and I have to get blood work done every month,” Watson says. “When I get my thyroid checked every month, it costs a lot of money, and when I have extensive work, it’s like $1,500.”
The Burr is produced by students at Kent State University twice per academic year.No part of The Burr may be reprinted without permission.