College students who don’t have private health insurance in Massachusetts are required by law to buy the insurance provided by their university, and are ineligible for Mass Health, the state’s public insurance plan.
At UMB, health insurance is provided through Aetna Medicare, which is one of the biggest insurance companies in the nation with over 17 million members and over $30 billion in revenue in 2009.
Some students, dissatisfied with Aetna’s coverage, started a group called the Student Union this November to raise awareness about the student health care program, which they deem inadequate.
Under the current plan UMB students must pay a 15 percent co-pay for most procedures, so on a $10,000 hospital bill a student would be expected to pay $1,500. The co-pay can be higher than 15 percent depending on the procedure and whether or not the student receives treatment from a facility that is associated with Aetna.
Kathleen Golden McAndrew, interim Assistant Vice Chancellor for Student Affairs and Executive Director of Health Services, explained that the process of deciding the coverage of the student health care plan includes both guidelines set by UMB and statistics gathered by Aetna about popular prescriptions and common diagnoses.
Representatives of the university and Aetna then meet every year to determine the details of the plan.
“We haggle over what should be covered and what it should cost,” said McAndrew. “For example, in last year’s meeting, emergency room co-pay was argued over and eventually cut down from $100 to $50.”
Another example is the reduction of the ambulance co-pay, which was also cut from $100 to $50.
“We are working towards better coverage and this is a lot better than previous plans,” said McAndrew. “We try to do the best for our students.”
Last year, former USG president Neil MacInnes-Barker was a member of the university representative body and was a vocal part of the proceedings.
According to McAndrew, the utilization of the health insurance plan’s services is the main factor in determining the cost of the plan. The more people who use health care services while covered by the schools plan, the more coverage will be offered and consequentially the cost will rise.
Robert Birmingham, a senior and member of the Student Union, believes that students don’t have enough of a say in the implementation of insurance plans and that there is a complete lack of education on the matter.
“Other universities and community colleges have better health insurance plans than UMB and it’s completely criminal,” he said.
Although he believes the plan has been slightly improved from last year, “it still isn’t nearly good enough. I think co-insurance is no insurance,” he said.
In response, McAndrew said that during the negotiations, the students’ needs are of the utmost priority and the administration along with student representatives’ work to provide the best care available.
“Last year the students were a huge part of this negotiation process and we want that to continue,” she said. “We want to represent our students and we want to listen to what they want. Students’ feedback is always welcome.”
What’s New In The Student Health Insurance Policy
2010-11 Plan:
• No deductible
• Aggregate maximum benefits: $100,000
• 90 percent coverage of outpatient mental health and substance abuse treatments
• $7,500 out-of-pocket maximum
• $100 emergency room co-pay
• $100 ambulance co-pay
• $5,000 prescription maximum
2011-12 Plan:
• $100 waivable deductible
• No aggregate maximum on benefits
• No referrals
• 100 percent coverage of outpatient mental health and substance abuse treatments
• $5,000 out-of-pocket maximum
• $50 emergency room co-pay
• 100 percent coverage of ambulance costs
• 85 percent coverage of impacted wisdom teeth
• 100 percent coverage after $20 co-pays for physicals and immunizations