Students, do you know what your health insurance covers?

By Keegan Garrity

October 24, 2006 | Health care may not be found on the top of most students' spending lists. After tuition, gasoline, textbooks, and iPods there just doesn't seem to be enough left for health care.

At $837 a semester, it may be easier to understand why students choose not to cough up the dough when they aren't even coughing up phlegm. Many Aggies realize that not having a health plan can be a big risk. They are not happy about their lack of insurance, but feel they are forced to take this risk because of tight budgets.

"[My wife and I] don't even have health care right now." says recently married student Darrell Cropper, "We just hope we don't get sick."

Others may just be naïve or ignorant to the fact that they have no coverage. There's no need to worry about health care when I am covered under my parents' health insurance, right? Not exactly; many health plans extend coverage only to dependants under age 23. Utah State enrolls many students who exceed this age, largely due to the fact that many put their education on hold to pursue religious service.

Why the high cost? Regence BlueCross BlueShield of Utah gives 10 reasons why health care is so expensive. One large factor responsible for the increase in health insurance is the inflation of prescription drug prices. For example, amoxicillin is a prescription drug commonly used to treat strep throat. One could expect to pay around $50 for the generic drug. University health insurance policy holders are charged a co-pay of $15 for the drug.

Even if one provider advertised significantly lower rates than their competitors, would students be interested? Students may not feel the same way about health care as they do about a Wendy's dollar menu. Does a person really want to get "the best deal" on heath insurance? One may not feel boastful about the great bargain they received on their health insurance.

Not every medical service on campus is costly though. Students are entitled to a free examination from a licensed doctor at the Wellness Center. If it's free who pays for it? Well, it's not exactly free. Each semester students pay a $30 fee incorporated into tuition to cover these costs. An office visit to the doctor typically costs somewhere around $120-$170, so stopping by USU's Health and Wellness Center may be a reasonable value.

Katherine Berg, a senior majoring in mechanical engineering continually experienced a sore throat and decided she ought to get checked out. She also noticed small white bumps in the back of her throat so she visited the Health and Wellness Center. There, she informed the doctor at the facility about these symptoms. She was assured that her condition was normal, that she was overreacting, and just needed to get some sleep.

A few months later, because symptoms persisted, she saw an ear, nose, and throat specialist. Under a health care plan provided by her employer, Berg covered the $20 co-pay fee for this visit. During the examination, she was told that the small white bumps were known as chronic debris, a symptom of tonsillitis, and that her tonsils needed to come out immediately. She, of course, agreed to the surgery rather than risk the chance of liver failure, heart failure, or rheumatic fever.

"It wasn't very comforting to know that during those months [my condition] could have developed into something more serious," said Berg.

She has not yet received the bill for the procedure, but can probably expect it to exceed $4,000. The plan she currently is on will cover 80 percent of the cost.

The need for a tonsillectomy is just one of the many possible procedures a student may need to go through during their college experience. Let's say you have a severe stomach ache for a few days, and after asking a few friends you feel you should look into the possibility that it may be caused by an infected appendix. To obtain a diagnosis, you could set up an appointment with the Wellness Center and probably be seen the same day. Suppose the diagnosis is affirmative and you learn you must receive an appendectomy. The typical bill for fees involving this type of condition may total around $17,000. Most Utah State students are not likely in possession of such funds. If the student was insured under the school, this cost after the 70 percent coverage and cost of initial insurance would comparatively be about $7,200.

Another hypothetical situation might be if you were out on Mt. Beaver snowboarding and had an accident in which you hit your head on the ground. If you wanted to make sure you were OK, a CAT scan could cost anywhere from $300-$600. Keep in mind that is just for the scan, and doesn't include staying in the hospital, pain medication, etc. Under the university's health insurance plan you would be charged $100 for a co-pay visit. On top of that you would be charged 50 percent of the CAT scan fee or 30 percent if you visit a preferred provider under the plan.

If the above mentioned injury occurred while participating in an interscholastic or intercollegiate event or competition, it would fall under the exclusions and limitations section of the policy. Therefore the injured party would assume all costs. This is just one of the many exclusions of the policy.

Does the pollen in Cache Valley have you sneezing? If your allergies are to the point where prescription drugs or allergy testing is necessary for relief, count on paying for all costs out of your own pocket. The plan doesn't cover this ailment. Are you squinting to see the PowerPoint presentation displayed on the screen as you sit in class? Don't look to the university to provide you with an eye exam, glasses, or contact lenses because they aren't covered either.

"There are only about 200 students currently enrolled in the plan available from the university," says Noell Hansen, Student Health Insurance Specialist, "and many of them are high-usage participants of the plan."

This number has decreased from 1,800 students a few years ago. Knowing this it may be easier to understand why many health care providers are reluctant to submit their services to Utah State. Unless changes to the health insurance policy of the university are made, the downward spiral will continue. If the only students purchasing the health insurance policy are those who consistently take advantage of it, then insurance companies will be driven away one by one.

Perhaps if the university required all students to have health insurance, there may be more incentive for health insurance providers to offer premiums at more affordable rates.

If every student at USU enrolled themselves in the school's health care plan, the percentage of policy holders that actually used their insurance would go down. With the pool being larger, the cost of health insurance per student would, in turn, decrease. Unless students feel a push to make health care a priority, reasonable coverage is likely to become further and further out of reach.

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