After tuition, books, and room and board, rising college healthcare fees hit a nerve | News
Have you compared the license plate? Reviewed the costs of housing on campus. Even the student meal plan prices digested.
But have you thought about how much your son or daughter’s dream school will charge for health coverage?
You could be in for a shock.
Hawley Montgomery-Downs was thrilled when her daughter Bryn Tronco won a scholarship that pays half of her $63,000 annual tuition to the University of Southern California. But just as classes were starting in August, she was shocked to receive a bill from USC for $3,000 to cover both the students’ health insurance premium and a fee that allows students to access on-campus clinics and other services. . At her West Virginia home, she had paid nothing for her daughter’s health insurance through the state’s Children’s Health Insurance Program, which serves lower- and middle-class families.
Montgomery-Downs, who lives in Morgantown, West Virginia, was especially upset that USC billed her for not only health insurance, but also a $1,050 annual medical fee. “It would be nice for her to go to the student health center, but by buying insurance to go to a primary care provider, she feels like she’s paying twice,” she said.
Mandatory health insurance and health service fees are common at universities as a condition of enrollment, said Stephen Beckley, a health and benefits consultant for universities in Fort Collins, Colorado. While the health fee can help lower student insurance premiums, parents may feel like they are paying twice as much. “That’s a big puzzle for our field,” he said.
For parents, these large payments can come as a surprise, making a barely affordable education feel even less. After all, students can save money by choosing a small meal plan and cooking their own dinners or buying used textbooks, but there’s no way around mandatory health fees.
Costs vary by school, but can often run to several thousand dollars a year, costs that health care advocates say parents and students should review carefully to make sure they understand their options while abiding by with college requirements.
Students can apply for a college health insurance waiver by showing they have their own insurance or are covered by their parents’ insurance that meets specific college criteria. Schools generally want to see a student’s own insurance cover local doctors and hospitals for minimal out-of-pocket cost. However, student health fees generally cannot be waived.
USC, a private university, charges $2,273 a year for its Aetna student health insurance plan. The average for public universities is $2,712 and $3,540 for private universities, according to a 2022 survey by Beckley’s firm, Hodgkins Beckley & Lyon.
Other notable colleges charge much more, like $6,768 at Stanford and $4,163 at Dartmouth College.
The University of Montana charges $4,700 and most services at their school health clinic are fully covered by their health plan. The University of Colorado charges $3,976.
At Harvard, students who buy school insurance pay $4,080 a year and $1,304 for the student health fee.
The easiest solution to avoid these charges would be for students to stay on their parents’ health policy, which the Affordable Care Act allows until they turn 26. But that only works if the student’s parents have a policy that meets the comprehensive requirements of the school and offers in-Network coverage where the school is located.
Otherwise, parents may want to shop 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 CHIP plan in the states where they attend school. But this strategy also has limitations. Students must meet the residency requirements of the state where they attend school, and parents cannot claim them as dependents on tax returns. CHIP coverage also ends once a student turns 19.
Schools that charge a health fee to students and require insurance coverage say the funds help cover services at campus health clinics that would otherwise cost students hundreds of dollars a year or more.
Covering primary and preventative health services, USC’s student health fee also helps the school pay for services not normally covered by insurance, such as managing disease outbreaks on campus.
Dr. Sarah Van Orman, director of health for USC Student Health, noted that the student health fee provides funding for additional on-campus mental health providers and a team focused on sexual assault prevention and education, services available for students without copays. She said these additions are vital because, even with insurance, students could face challenges finding private counselors to provide timely help, and if they do, students would have shared costs.
“The student health fee supports our public health infrastructure on campus,” Van Orman said.
Because students can get primary health services on campus at the student health center, fewer of them seek care paid for by insurance, he said, and that helps keep the monthly health plan premium lower for students. Aetna students. “These things work together and are not duplicated at all,” Van Orman said.
USC student health insurance has an annual in-network deductible of $450 and a $20 copay for doctor’s office visits. It also provides comprehensive services across the country, so students are covered when they’re at school and at home, even if it’s across the country. About half of USC students buy student insurance from Aetna, according to Van Orman.
Other universities have a different strategy. For example, George Washington University’s mandatory health insurance covers health center services on campus. Unless they get a waiver, college students must enroll in the student health insurance plan, which costs $2,700 a year, unless they can show they have another insurance plan that meets the school’s criteria. The health plan premium allows students to get many free services at the student health center, including doctor’s office visits, some prescriptions, and routine screenings for sexually transmitted infections.
Beckley said university rules vary on 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 in 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. no cost share. 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.
That was bad news for Montgomery-Downs.
“This is not something we budget for,” he 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 got the USC health bill. She had thought that Bryn, who turned 19 last week, would initially be covered because her CHIP plan provided coverage for treatment in out-of-state emergency rooms and urgent care centers. And Montgomery-Downs wanted to make sure her daughter had health coverage during summer vacations and vacations when she was home.
Not sure which coverage options in the marketplace would meet the school’s rules and deadlines, she decided to go with the Aetna student plan offered by USC.
A look at the market options at Covered California shows that the $2,200 for the USC Aetna student plan is a competitive rate. The lowest-priced comparable PPO plan offered by California Blue Cross that would provide Bryn with a national network of providers costs about $2,400 a year with a government subsidy based on family income. PPOs provide some coverage for out-of-network doctors and hospitals.
Montgomery-Downs gets her coverage on the Marketplace and said she will buy a Marketplace plan for Bryn for next school year. She said that she wishes they had been aware of all the healthcare costs at the time of admission instead of just before classes started.
“Everything is a nightmare, even for someone with the privilege of time and some understanding of these bureaucracies: higher education and health insurance,” Montgomery-Downs said.
KHN (Kaiser Health News) is a national newsroom that produces detailed journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three main operating programs of the KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization that provides information on health issues to the nation.