Health insurance often inaccessible

If someone asks Jean Brown why it’s important for students to have health insurance, it’s not hard for her to come up with a number of reasons.

Brown, the director of Student Health Services, recalled an SPU student a few years ago who had no health insurance and found a suspicious lump. Diagnostic testing couldn’t rule out cancer, so more expensive tests had to be run.

Student Health Services was able to find the student some insurance, but because the condition was pre-existing, the insurance wouldn’t cover the tests.

Finally, the student’s family had to pay cash for a biopsy and lumpectomy. The student, whose identity Brown could not disclose for confidentiality reasons, had to drop out of school because of finances after that.

"It is vital for students to understand that they need health insurance and to explore their options to get it because life gives you all kinds of unexpected obstacles," Brown said.

Only 34 percent of freshmen entering SPU in the fall were insured through their parents, said Brown.

Although this number isn’t unusual compared to the 40 to 60 percent of college students who do not have health insurance in any given year, it is unacceptable, Brown said.

Some students try to get health insurance through their jobs, but it isn’t always an option.

"I actually worked at a job that kept me at its maximum of 29 hours a week before they would have to pay for my benefits," said senior Stacey Froelich. "Thank God I don’t get sick very often."

Even students who do have insurance can encounter problems when their health maintenance organizations (HMOs) are outside of Washington and won’t cover treatment in this area.

When sophomore Lynn Jansen headed off to college, her mother made a small request.

"My mom told me, just don’t get sick," Jansen said.

Jansen is covered by her parents’ health insurance in Illinois, but it doesn’t cover care outside of the state.

According to Brown, one student with a fracture was told by an insurance company to fly home with the fracture in order to be treated or they wouldn’t cover the cost.

"That’s when we got a little nasty," Brown said. "We sent them a letter and said that if this student died of an embolism, they were responsible."

The insurance company gave Health Services permission to administer modified treatment, but the student still had to fly home to have a surgery needed for complete recovery.

"College students may statistically be the healthiest age group, but they are also the group that has the most injuries and accidents," Brown said.

University officials are trying to figure out how to convince all students to have health insurance. Other universities have solved this problem by requiring their students to have health insurance, but SPU is one of the only private universities in the state of Washington that only strongly recommends that its students have health insurance, Brown said.

"There are substantial benefits to getting a mandatory health insurance plan, such as lower premiums," Brown said.

"Nobody wants an extra fee, but with the high cost of health care and the amount of students who don’t have health insurance, SPU just might have to require it," Brown said.

SPU’s current plan is underwritten by United Healthcare. It offers a $50,000 aggregate max in a calendar year and costs $974. This plan includes the summer months to insure that students are covered even when they are not registered for summer courses. Students are allowed to sign up for the insurance at any time of year, but the premium they must pay stays the same. Once a premium is paid, it can only be refunded if a student is called to active duty.

SPU’s plan covers illness and injury. Illness involves any flu or disease that a student may contract during the year. Yearly checkups and physicals are not covered because students are considered "healthy" when they go in to receive them. Some surgeries are covered if they are related to illness because it is considered treating an illness.

Injury involves bodily injury that occurs because of an accident. Pre-existing conditions can be treated three to six months after a student buys the insurance plan, depending on the condition.

Prescriptions are also covered, up to $600 a year.

"It’s not a full spectrum insurance, but it’s a good stopgap between what your parents have and nothing," Brown said.

Brown admitted that there are limitations to the insurance plan.

"One thing I particularly don’t like is that the emergency room only covers $150," Brown said.

The plan also doesn’t cover dental or vision checkups either.

If a student needs a medication that costs more than $50 a month, SPU’s plan doesn’t cover it.

The plan can also pose monetary problems if a student has a child or spouse. It annually costs an extra $3,043 to insure a spouse and $1,217 for each child.

"I would recommend Washington Basic Healthcare if you have a child or spouse," Brown said.

If paying for an SPU health plan is a problem, Brown also advised students to look at minute clinics for simple things.

"Their prices are set, so you know what you are going to get before you go in. They also have expanded hours," Brown said. Two minute clinics close to SPU are located inside QFCs in the University District (2746 NE 45th St.) and Northgate (11100 Roosevelt Way NE).

Brown also recommended urgent care clinics over the emergency room (ER) if money is an issue.

"With urgent care clinics, they can make you a quick appointment, and that is usually more affordable than ER fees."

SPU will continue its discussion and investigation of whether the university should require students to have mandatory health insurance, said Brown. Until then, she encourages students to explore their options, because not having insurance should not be a choice.

"Be good consumers and check out the best deal," Brown said. "Make a list of what you need to have covered, and then go shopping."

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Title: Health insurance often inaccessible | Author: Christina Petitfils | Section: News | Published Date: 2008-04-30 | Internal ID: 6477