College student health insurance costs can blindside families

Hawley Montgomery-Downs was thrilled when her daughter received a stipend 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 a fee that enables students , clinics and other services on campus.

The charges appeared to be double Montgomery Downs.

“It would be nice for them to go to the student health center, but when I buy insurance to go to primary care, it feels like I’m paying twice,” she said.

Compulsory health insurance and health service fees are common at colleges as a condition of enrollment. But the big bill might surprise, making a barely affordable education feel even less. Costs vary by school but can often run into thousands of dollars a year — costs that health care advocates say parents and students should carefully consider to ensure they understand their options while meeting university requirements .

Stephen Beckley, a college health and benefits advisor in Fort Collins, Colorado, said the health fee can help lower student insurance premiums. But he can understand parents feeling like they’re paying twice. “It’s a big mystery for our field,” he said.

Students can apply for an exemption from college health insurance by proving they have their own insurance or are covered by their parents’ insurance that meet certain college criteria. Schools typically want to see a student’s own insurance cover local doctors and hospitals for a small out-of-pocket cost. In principle, however, the student contribution cannot be waived.

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

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

The simplest solution to avoiding these fees would be for students to remain on a parent’s health plan – which the Affordable Care Act allows until they are 26. However, this only works if the student’s parents have a policy that meets the school’s comprehensive requirements and offers coverage where the college is located.

Otherwise, parents might want to shop among the ACA Marketplace plans to see if they can find a bargain. If their income is low enough, students can sometimes enroll in Medicaid or a children’s health insurance (CHIP) program in states where they attend school. But even this strategy has its limits. Students must meet state residency requirements where they attend school, and parents cannot claim them as dependent on tax returns. CHIP coverage also expires when a student turns 19.

Schools that charge a student health fee 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.

The USC student health fee, which covers primary and preventive health services, also helps the school pay for services not typically covered by insurance, such as: B. Surveillance of disease outbreaks on campus.

dr Sarah Van Orman, chief health officer of USC Student Health, noted that the student health fee funds additional on-campus mental health providers and a team focused on sexual assault prevention and education — services that provide students with no co-payments be available. She said these additions are crucial because even with insurance, students could face the challenge of finding private advisers to provide timely assistance and if they do, students would face cost-sharing costs.

“The student health fee supports our public health infrastructure on campus,” said Van Orman.

Because students can get primary health care at the student health center campus, fewer of them are seeking insurance-paid medical care, she said, and that helps keep the monthly premium for Aetna student health insurance lower. “These things work together and aren’t duplicated at all,” said Van Orman.

USC student health insurance has an annual deductible of $450 and a $20 co-payment for doctor visits. It also offers comprehensive services nationwide, so students are covered at school and at home – even if that is across the country. About half of USC students buy Aetna student insurance, Van Orman said.

Other universities have a different strategy. For example, George Washington University’s compulsory health insurance covers on-campus health centers. Unless they receive an exemption, students must enroll in student health insurance, which costs $2,700 per year. The health plan premium allows students to enjoy many free services at the student health center, including doctor visits, some prescriptions, and routine screening for sexually transmitted infections.

Beckley said college rules differ on whether they allow students to choose insurance plans other than the school’s.

USC allows students to purchase an alternative insurance policy through their parents’ plan or on the ACA marketplace as long as it meets the school’s requirements, which include comprehensive Los Angeles-area health insurance and preventative coverage at no cost. Out-of-state Medicaid or CHIP plans do not meet the university’s criteria because they do not have routine care provider networks in California.

This was unwelcome 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 editor, said she wasn’t sure what to do when she received the USC health bill. She had figured Bryn, who turned 19 in December, would initially be covered because her CHIP plan covers treatment in out-of-state emergency rooms and emergency centers. And Montgomery-Downs wanted to make sure her daughter had health insurance at home during the summer and holiday breaks.

Unsure what market coverage options would meet the school’s rules and deadlines, she settled on the offered Aetna student plan USC.

A look at the marketplace options on Covered California shows that the $2,200 USC Aetna student plan is a competitive price. The lowest-cost comparable PPO plan offered by California Blue Cross, which would provide Bryn with a national network of providers, costs about $2,400 per year, allowing for a government subsidy based on her family income. PPOs provide some insurance coverage for off-network doctors and hospitals.

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

“It’s all a nightmare, even for someone with the privilege of time and some understanding of these bureaucracies – higher education and health insurance,” Montgomery-Downs said.

This report was produced by Kaiser Health News, one of the three main operating programs of the Kaiser Family Foundation. College student health insurance costs can blindside families

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