Health Insurance

[sweetpearl16]

I'm 24 and I have always been on my parent's health insurance plan. I'm asthmatic and have two types of inhalers (One I take daily and the other is as needed), so health insurance is important to me. At my current institution, where I am finishing up a terminal MA, most departments do not include health insurance in their funding packages.  However the school requires health insurance, so most PhD students end up purchasing the school's health insurance for $1600 a year. Many students argue that the school looses strong students due to program's failure to provide insurance in the funding package. Students are also very vocal about their hatred of the insurance plan but tend to purchase it due to low cost. The plan does not include vision or dental and charges a lot for medication (my daily medication would cost me $65 for a one month supply. Currently I pay $65 for a three month supply).

 

When looking at PhD programs, I was really surprised at the range in quality of insurance plans schools provide. One school I applied to provided a health insurance plan similar to my current institution, but it was covered in the funding package. Another school had a plan where my medicine cost $20 a month and included dental and vision. It also covered the cost of new glasses or contacts every year. My new institution's health plan does not include vision, dental, or prescription benefits. I could purchase my medicine for a small co-pay at the school's health center. The school provides a supplementary program that provides discounts on glasses, contacts, and prescriptions  The school provides grad students with a separate vision and dental plan, which cover yearly checkups.

 

For those of you currently in grad school, what do you think of your school's health insurance? Is it covered in your funding package? Does it provide adequate coverage? What would you change about it? For those of you entering graduate school, did health insurance at all factor into your choice of schools?

[msocean]

One would provide a very nice medical plan at a very reasonable cost.  The other offers nothing.  However, the one with the better medical accepted very few students this year due to funding.  So it's nice for the very few who got it.

 

I would compare the cost of health care offered and the cost to your parents to keep you on their policy until you are 26.  Be sure to compare things like routine office visit costs, prescriptions, and availability of in-network providers for both policies...especially if you are moving out-of-state from your parents.

[TakeruK]

My school's current health insurance is pretty great. I pay $500 per year for health insurance. It includes standard routine checkups, vaccinations etc. within the right health network. Doctor visits are $15 copay, but free if I go to the student health clinic on campus. Prescription drugs are 20% copay, generic brand drugs are free in some cases. I think this is a great deal, much better than most other plans at other schools. It's about comparable to my plan in Canada and overall, more value for the cost! 

 

However, dependent health coverage on this plan is really expensive! The school doesn't subsidize the dependent's cost, so it's something like $7000 per year. I've only seen one school where the health plan is subsidized for dependents! I've also seen a lot worse plans -- one school doesn't even cover prescription drugs at all, which is probably the most common expense.

 

My school's dental insurance is also really great. It's about $120 per year for 1 person, or $200 per year for two. Basic stuff (cleaning etc.) are 0% copay, minor treatments are 20% and major treatments are 50%. Some important things aren't covered though, e.g. nightguards are 100% copay. Maximum annual coverage is $1500. However, this is still the best plan I've ever had -- at my grad school in Canada, the plan cost twice as much and covered half as much! ($750 annual maximum).

 

The two things I would change about the plans are (however I'm still very happy with them as is):

 

1) Decrease the cost of adding dependents! The high cost is cited due to low dependent subscription but I think most people enroll their dependents elsewhere because the cost is so high. International students don't have the luxury though, since it's hard to get health insurance elsewhere before you arrive and you can't get a J-1/J-2 status/visa without proof of insurance. Also, the school plan is nice because it's no-questions-asked.

 

2) Cover white fillings (for cavities) in the dental plan! More and more dentists are only doing white (instead of silver) fillings and our plan only covers these up to the silver filling cost. I'm not sure if these dentists are just trying to make an extra buck or they are being honest when they say white fillings are much better for our teeths. Either way, we have to pay the extra cost so it would be nice if our plans could cover it.

 

I definitely factored health insurance into the school decision process last year. I counted it as part of "cost of living" -- basically, I took the stipend, subtracted average annual rent, food, and health insurance (as they are the three biggest expenses we have) and then compared these adjusted values when I wanted to compare stipends. 

[rising_star]

My school's insurance kinda sucks but, we get it for free for TAing. So, I can only sorta complain. The prescription drug benefits don't kick in until you're out of pocket something like $1000. We don't have dental. For vision, we can get a discounted (or it might be free) eye exam but only for glasses, not for contacts. And I don't think there's any coverage for actually purchasing vision correction if you need it. I've heard it's good if you have a serious emergency or injury, but otherwise it's just not that great.

[abeilles]

I'll be paying 5% of the cost of my health insurance, but there's no vision or dental and (for someone with terrible vision and crappy teeth) that's extremely frustrating!

[sweetpearl16]

Does anyone know how Obamacare will impact student health insurance plans? I know that prescription benefits is considered an essential benefit under Obamacare. Does that mean all student insurance plans will have to include prescription benefits? 

[1Q84]

The school that I'm going to doesn't offer dental or vision either.

 

I believe they said I can find my own private health care to replace theirs. Anyone think that sounds like a good idea?

[msocean]

The school that I'm going to doesn't offer dental or vision either.

 

I believe they said I can find my own private health care to replace theirs. Anyone think that sounds like a good idea?

 

 

Some differences between group coverage (university) and private polies that you need to consider.  Group policies have to take you no matter what past medical problems you may have, with no upcharge for covering you for those conditions.  Remember things such as asthma, parents with heart problems, any genetic problems are all covered under group health.

 

If you choose to purchase a private policy, the insurance company underwriters can advise that your premium be rated higher for past medical issues or family history of heritable disorders.  Also, most private policies that I've seen lately have pre-existing clauses.  So if you have been treated for something in the past, let's say kidney stones, you will have to wait usually one year after paying premiums until they will cover you for kidney stones.  If you saw your doctor last year for allergies and now that you have a private policy insurance coverage, the doctor wants to do a CT of your sinuses, the insurance company is probably deny payment until you wait for at least one year.  Also many inexpensive private policies have low maximum lifetime coverage.  I saw one policy that had an annual limit of $10,000.  Honestly, in today's market that's not much.  It may not even cover a complicated ER visit in full.  Neighbor had kidney stones a few years ago, no surgery just the laser thing to break up the stones, overnight in the hospital, $60, 000.  Also look at the lifetime maximum carefully.  If anything catastrophic should happen and you can't ever change policies (now you are basically uninsurable because the underwriters are going to only ofer you coverage at a price you can't afford), stuck with this current policy for a long time...you want the lifetime max to be more than $50,000 - $100,000.

 

Be an informed consumer, read the policies carefully, ask lots of questions, know what you are paying for.

[sweetpearl16]

If your school provides a health plan but no vision or dental, you could also look into buying your own dental and vision plans. I know some PhD students at my school have done that. Also in answer to my own earlier question, according to the insurance office at my new school, the Affordable Healthcare Act will impact student health insurance plans, which may improve some of the worst plans. For example, I think that all health care plans will now have prescription benefits, which is definitely great news for me. 

[queenleblanc]

The university health plan, which in my university you either waive out or you're in, is actually way better than my current employer plan right now. There should be a way to find out what exactly it covers through the campus health website. Mine covers medical and vision while dental is separate. My medical coverage is pretty awesome. The copay to see a physician, or a specialist, is the same. The only difference is the cost of the visit- fully covered with regular physician, and 80% covered with specialist (like my foot doctor for an ongoing foot issue). I also don't have to pay as much for urgent care, and more of the ER visit would be covered as well. Vision is fully covered, which is crazy good! Currently, I work as a teacher (state employee) and the state covers part of the health insurance cost, which to my estimation, is about $5000-$6000 per academic year. The cost of the university health plan? $1471 per academic year. Dental is less than $500 a year, and that covers two visits plus x-rays and more, and lots of dental work that may be necessary. I dont like to gamble with my teeth, we only get one set! Pretty freaking amazing uni health plan! if you are a doctoral student and have a Ta stipend (whatever they are called), the health insurance is included at no extra cost because the university pays you like an employee.

Out of pocket, private insurance, would run close to $200 or more a month at least, and the coverage is not great, there is a it more to pay for when you go to just a regular physician. I don't know about you guys, but if you think the university plan is terrible, compare that what a lot of employers offer. Vision, dental, etc, is usually separate and very expensive. The plan at all NC public universities just can't be beat.

[1Q84]

Some differences between group coverage (university) and private polies that you need to consider.  Group policies have to take you no matter what past medical problems you may have, with no upcharge for covering you for those conditions.  Remember things such as asthma, parents with heart problems, any genetic problems are all covered under group health.

 

If you choose to purchase a private policy, the insurance company underwriters can advise that your premium be rated higher for past medical issues or family history of heritable disorders.  Also, most private policies that I've seen lately have pre-existing clauses.  So if you have been treated for something in the past, let's say kidney stones, you will have to wait usually one year after paying premiums until they will cover you for kidney stones.  If you saw your doctor last year for allergies and now that you have a private policy insurance coverage, the doctor wants to do a CT of your sinuses, the insurance company is probably deny payment until you wait for at least one year.  Also many inexpensive private policies have low maximum lifetime coverage.  I saw one policy that had an annual limit of $10,000.  Honestly, in today's market that's not much.  It may not even cover a complicated ER visit in full.  Neighbor had kidney stones a few years ago, no surgery just the laser thing to break up the stones, overnight in the hospital, $60, 000.  Also look at the lifetime maximum carefully.  If anything catastrophic should happen and you can't ever change policies (now you are basically uninsurable because the underwriters are going to only ofer you coverage at a price you can't afford), stuck with this current policy for a long time...you want the lifetime max to be more than $50,000 - $100,000.

 

Be an informed consumer, read the policies carefully, ask lots of questions, know what you are paying for.

 

Thanks! I totally didn't think about the previous condition stuff for private insurers. I'm definitely going to go with the school group policy, especially considering their maximums are $250,000. From what I can tell, even that's not going to do much in the US.

 

If your school provides a health plan but no vision or dental, you could also look into buying your own dental and vision plans. I know some PhD students at my school have done that. Also in answer to my own earlier question, according to the insurance office at my new school, the Affordable Healthcare Act will impact student health insurance plans, which may improve some of the worst plans. For example, I think that all health care plans will now have prescription benefits, which is definitely great news for me. 

 

Also a good idea! I think I read something about supplementing student healthcare with extra plans. Now to see how much it's going to cost...

[sweetpearl16]

Out of pocket, private insurance, would run close to $200 or more a month at least, and the coverage is not great, there is a it more to pay for when you go to just a regular physician. I don't know about you guys, but if you think the university plan is terrible, compare that what a lot of employers offer. Vision, dental, etc, is usually separate and very expensive. The plan at all NC public universities just can't be beat.

 

True, the plan at NC and I think SC public universities are great (I've seen them before), but many university health insurance plans are awful, even when compared to what other employers offer. Many plans don't provide any coverage of specialists. Also I think plans lacking, essential benefits, such as prescription drug coverage, do qualify as terrible although hopefully these plans will be eliminated in the coming year. 

Edited April 20, 2013 by sweetpearl16

[TeaGirl]

My program won't be paying for my health insurance either. My TA only covers tuition+stipend. Health insurance alone is around $1045 per year. But between health insurance premiums, required dental insurance, and health center fees, it comes up to just under $1800 per year. I'd have to copay $20 for doctor/specialist visits outside the student health center (in would be free) and $10 copay for generic prescription medication per drug on supplies for 30 days ($30 for brand names). All in all, I have to pay almost $2000 total in fees per year.

I guess the dental insurance would be nice. I get 100% coverage on most services so no freaking out over a toothache like that one time during my MS when I didn't have dental, and I don't have to wait for yearly visits home to check my teeth. No vision coverage though.

[RubyBright]

Some differences between group coverage (university) and private polies that you need to consider.  Group policies have to take you no matter what past medical problems you may have, with no upcharge for covering you for those conditions.  Remember things such as asthma, parents with heart problems, any genetic problems are all covered under group health.

 

If you choose to purchase a private policy, the insurance company underwriters can advise that your premium be rated higher for past medical issues or family history of heritable disorders.  Also, most private policies that I've seen lately have pre-existing clauses.  So if you have been treated for something in the past, let's say kidney stones, you will have to wait usually one year after paying premiums until they will cover you for kidney stones.  If you saw your doctor last year for allergies and now that you have a private policy insurance coverage, the doctor wants to do a CT of your sinuses, the insurance company is probably deny payment until you wait for at least one year.  Also many inexpensive private policies have low maximum lifetime coverage.  I saw one policy that had an annual limit of $10,000.  Honestly, in today's market that's not much.  It may not even cover a complicated ER visit in full.  Neighbor had kidney stones a few years ago, no surgery just the laser thing to break up the stones, overnight in the hospital, $60, 000.  Also look at the lifetime maximum carefully.  If anything catastrophic should happen and you can't ever change policies (now you are basically uninsurable because the underwriters are going to only ofer you coverage at a price you can't afford), stuck with this current policy for a long time...you want the lifetime max to be more than $50,000 - $100,000.

 

Be an informed consumer, read the policies carefully, ask lots of questions, know what you are paying for.

 

My understanding was that, per new insurance laws, all insurance plans must cover pre-existing conditions, as long as there is not a gap in coverage (i.e. between your old plan, and starting the new one). Perhaps I am misinformed, but I looked this up specifically because I am on prescriptions that I could not afford out of pocket, and a lapse would be... dangerous at best. 

[msocean]

My understanding was that, per new insurance laws, all insurance plans must cover pre-existing conditions, as long as there is not a gap in coverage (i.e. between your old plan, and starting the new one). Perhaps I am misinformed, but I looked this up specifically because I am on prescriptions that I could not afford out of pocket, and a lapse would be... dangerous at best. 

Check with the prospective insurance company you are considering.  They all seem to interpret things differently.  If you are going from one group policy to another group policy, I am confident that the proof of continuous coverage is sufficient.  However, I am not sure if it works with private policies...until 2014.