This is the first installment of a quarter-long series on student health care, the second of which will be published November 4.
With the implementation of the Affordable Care Act (ACA) and changes to Student Health and Counseling Services, health care is in a dynamic state both nationally and right here on campus. In a quarter long series, the Maroon will take a look at the clinical services, counseling, and mental health services, as well as the efficacy of preventative services provided to students.
The University is currently entering a “bid year,” in which the Student Health Advisory Board will re-evaluate the current student insurance plan, U-SHIP, and consider other plans. The University bids every three to four years.
In 2009, the University switched from its old provider Aetna to Student Resources, a provider under the UnitedHealthcare network. At that time, the premium, or upfront cost, of U-SHIP was $2,025 per year. Last year, the premium was $2,757. It is $3,021 for the current academic year—a nine-percent increase from last year. In a survey released in August by the Kaiser Family Foundation, the average annual premium for an individual who purchased through an employer increased by five percent.
“[The rise in cost] does go with the rise in the [general] cost of health care,” said Executive Administrator of Student Health and Counseling Services Melva Hardy.
Students are automatically enrolled in U-SHIP but can waive the plan if their health care coverage meets certain guidelines, such as at least coverage of 80 percent of most costs and a $1,000,000 policy maximum.
According to Hardy, about half of the student population, or 6,500 students, are enrolled in U-SHIP this year, and 6,700 were enrolled last year.
U-SHIP is a PPO, or preferred provider organization, meaning that students have access to a network of hospitals and health care providers across the country, including the University of Chicago hospitals and 35 other providers in Chicago.
The plan covers students for a full year from September 1, 2013 to August 31, 2014. U-SHIP is a co-insurance plan, meaning students pay for a percentage of costs rather than flat-rate fees for particular services. After meeting a $200 deductible, U-SHIP covers 90 percent of most costs for hospitals in the preferred network, leaving students left to pay the remaining 10 percent—though a student will not pay more than $1,500 per year. Peer institutions Northwestern University and Columbia University offer similar plans, with premiums around $3,000 and 80 or 90 percent of costs covered.
Student Health and Counseling Services (SHCS) serves as a first point of contact for students enrolled in U-SHIP on campus. Students must go to SHCS for outpatient services first before going to other health care providers. All students, whether on U-SHIP or not, have access to services provided by SHCS through the mandatory Student Life Fee.
Before seeking treatment from another provider, students must obtain a referral from Student Health Services and are subject to a $50 deductible per service if they fail to obtain a referral first.
Students trying to understand the details of their insurance have two main sources to go to for their questions. As a part of the University’s contract with UnitedHealthcare, two representatives from United are required to be present on campus. The current representative is Sue Williams; the second coordinator has yet to be announced. In addition, in June, Marcy Hochberg was appointed as the University’s Student Health Insurance Coordinator as a resource for students who want guidance from someone not affiliated with an insurance company.
“If there’s been an issue with claims being denied, or [if students have] gone through an appeals process and they feel frustrated by how they’ve been dealt with by the UnitedHealthcare representatives, I’m here to serve as an advocate to assist them in working with our insurance company,” Hochberg said.
Hochberg also serves as a general point person for questions about health insurance.
“This isn’t student-specific, but in a lot of cases, most of us don’t look at our policy guide until we’re in a position of utilizing our insurance, and then we start to look at what’s actually covered, so I think there’s always a need for better education, better outreach in a topic like this,” she said.
The Affordable Care Act will ultimately prevent policies from having policy maximums or annual limits. U-SHIP currently does not have a policy maximum but has an annual limit of $1,000,000.
As a part of the ACA, the federal government created the health insurance marketplace, which aims to help the uninsured find health coverage. The law requires most people to have health insurance by 2014 or pay a fee, but the University already requires students to have insurance.
Social Service Administration professor Colleen Grogan, who researches health policy and health politics, believes that students should look at plans offered in the marketplace as an alternative to U-SHIP.
“I think it is important for students and all citizens to understand what’s being offered on the exchange,” she said. “Rather than just taking the student health insurance, it is a good idea to look on the exchange and see whether that’s something they should advocate for.”
The Maroon is committed to understanding all aspects of student health care. If you or someone you know has experiences relating to health care on campus, please contact firstname.lastname@example.org.