Many colleges won't honor private health insurance

The Baltimore Sun

College is expensive enough without having to pay for something you're already getting. Yet many parents are spending hundreds of dollars more than necessary each year on health care for their student.

Most students are covered under a parent's insurance. That's good, because even young adults can be hit with a medical emergency. Problem is, campus health centers rarely accept that insurance.

"So parents are paying for insurance they're not able to use for their son or daughter," says James A. Boyle, president of the advocacy group College Parents of America.

At the same time, parents are paying an annual student health fee that can run a few hundred dollars a year. And colleges promote student insurance policies that are accepted at campus clinics but cost hundreds of dollars.

This issue isn't on the radar screen of many families. But more students and parents are asking student health centers to accept their insurance. And some schools, including Towson University, are starting to do that.

The obvious winners of this are families. But schools and even insurers can come out ahead. It makes you wonder why more schools don't do it.

Not all student health centers operate the same, of course. Basically, students pay a fee each year that entitles them to visit the health center for little or no money. Lab tests, X-rays or minor procedures, such as stitches, cost extra.

Health centers say they don't have the staff, know-how or time to bill numerous insurers for these extra costs.

But they can provide the necessary documents so families can submit claims to their insurer.

Student health centers usually aren't part of an insurer's network. You could have a claim denied for being out of network, particularly with an HMO. Or, you might have to meet a high out-of-network deductible before you see any reimbursement, Boyle says. And even if you are reimbursed, it will be at a lower rate than if the student had seen a doctor in the plan's network.

Student health centers accept insurance sold through the school. A standard policy runs $900 to $1,500 a year. A handful of schools require students to buy a policy even if they have other insurance. Others only require a policy be purchased if the student doesn't have insurance. Critics say the coverage is often less generous than the parent's plan.

Michael Feuerstein, a sophomore at the University of Virginia, is frustrated. He visited the student health center a year ago with a case of bronchitis. The visit was free, but the test the doctor gave him wasn't. He later got a bill for about $50, although the health center offered to provide information so he could file a claim with his father's plan.

The 19-year-old history major says schools make it difficult for students who are sick and away from home. Schools need to figure a way to directly bill at least the major insurers, he says.

"Every private doctor's office can find a way to do it and still manage to be a profitable business," Feuerstein says.

The University of Virginia did try to bill insurers a dozen years ago, says spokesman Jeff Hanna. Students had more than 900 different plans from across the country and abroad, and a quarter of the plans changed annually. Many of the claims went unpaid, with the school recouping less than 20 cents on the dollar. The school abandoned billing after two years.

But that was then. Some schools now are able to bill major insurers.

Kent State University started doing so three years ago largely because parents and students wanted it, says Mary Reeves, director of the Ohio school's health center. The clinic handles as many as 25,000 patient visits a year and didn't have the staff to devote to billing, she says.

Instead it hired Highland Campus Health Group. The Texas company handles the billing, teaches doctors how to code patient visits and works to get clinic staff added to insurance networks. The Kent State health clinic now bills most major insurers and Medicaid, Reeves says. Uninsured students still visit the center for little or no cost.

The revenue from insurers is slightly higher than what the center received from students, Reeves says. Some of that goes to Highland, but the rest allowed the clinic to hire more medical staff and health educators as well as expand its mental health services, she says.

Highland's chief executive Andrew Menter says insurers benefit, too. Insurance companies want students to seek medical help early instead of waiting to see a doctor when they go home on break, he says. Waiting can turn a small ailment into costlier illness, and possibly lead to a trip to the emergency room.

"That's the last thing insurance companies want. You're turning a two-figure bill sometimes into a four-figure bill," he says. "For the relative low cost that the insurance companies are having to pay the campus health centers, they are very supportive."

Highland works with 13 schools, including Towson.

Towson's health center will start billing private insurers in the coming academic year. Most students are covered by a parent's plan and families want to be able to use the insurance they pay for, says Dr. Jane Halpern, the center's director. "It's customer friendly," she says.

Budget concerns also are a factor. The center can't count on increases to its budget to meet the rising demand for its services at a school where enrollment is growing by 500 students a year, Halpern says.

By billing major insurers, the center can charge the customary rate for its services rather than the discounted rate students receive, Halpern says. As at Kent, students without insurance still will pay a discounted rate.

Karen Allen, an office manager in Austin, Texas, has experienced both systems.

Her eldest daughter attended Texas A&M; University, which didn't accept the family's insurance. Allen says she paid double for insurance. She spent nearly $500 a month for insurance for her husband and three children. Plus she had to pay a student health fee for her daughter.

Her other two children are enrolled at Baylor University, which bills the family insurance plan. Allen prefers this method, and says other parents would, too. "Once more parents become educated in this particular area, I think parents will start pushing for it," she says.

Questions? Comments? Or to share a tip with readers, contact Eileen Ambrose at 410-332-6984 or by e-mail at eileen.ambrose@baltsun.com

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