Business & Finance
Business and Finance
Business and Finance 
Tue, October 13, 2009
eHealth, Inc.: Student Health Insurance: eHealth Reviews Plans Available to University Students -- Offers Five Tips
MOUNTAIN VIEW, CA--(Marketwire - October 13, 2009) - University students are returning to Fall classes at a time when many are less likely to find jobs that offer [ health insurance ] benefits after graduation, and others are at a relatively high-risk for acquiring the H1N1 virus. At the same time, a series of independent reports from bloggers and journalists have been written to address the quality of student health insurance plans.
Nation-wide, journalists including Jackie Johnson at [ Wisconsin Public Radio ], Francesca Lunzer Kritz at the [ Los Angeles Times ], Makenzie Marineau at the [ Daily Barometer ], Douglas Jennings at the [ Utah Chronicle ], and Roman Zhuk at [ DailyCal.org ] have stressed the need for students and/or their parents to carefully consider their options for health coverage.
To address some of the questions raised, eHealthInsurance ([ http://www.ehealthinsurance.com ]) conducted an independent review of health plans offered by 10 of the largest public universities in the country and found that monthly premiums and deductibles were fairly consistent among most plans, while annual out-of-pocket maximums and lifetime coverage limits varied(1).
Further complicating the matter, a 2009 eHealthInsurance survey(2) showed the majority of college students could not confidently define premiums, deductibles, annual out-of-pocket maximums and lifetime coverage limits; the items that constitute the basic components of a health insurance product.
This confusion may be partially responsible for the increasing number of college students who are going without health insurance. A 2009 report by the Lookout Mountain Group(3) (LMG) found that over 4 million college students are uninsured; approximately 9 percent of the total uninsured population in the United States. According to the LMG report, 57 percent of all colleges sponsored student health plans, but, the plans varied greatly from school to school.
To help students (and their parents) who may be grappling with decisions about purchasing college plans or selecting other forms of medical coverage, eHealthInsurance has provided its health insurance buyer's guide for students located at [ www.ehealthinsurance.com/101guide ].
eHealth has also provided five tips for first-time student buyers, along with a summary of findings from eHealthInsurance's review of student health insurance plans offered by 10 leading Universities.
Tips for reviewing University plans:
1. Before you buy, make sure you know what all of your health coverage options are:
-- Your parents' plan: If your parents obtain their health insurance through a group/employer sponsored plan, then in most cases, college students who were covered by their parents' plan in high school are eligible to remain on that insurance policy. Many plans require students to be on full-time class schedule in order to stay on their parents' plan and many policies require students to drop off the plan once they turn 25.
-- Plans offered through your University: The plans eHealth reviewed provided students with access to preventive care and typically provided at least $50,000 for care received on or off campus. In most cases students received more favorable pricing terms for care delivered by a provider in the insurer's network
-- [ Individual health insurance ] policies: Parents and students looking to save money on monthly premiums may also want to consider purchasing individual health insurance policies.
-- Free or low cost-government programs: Many Americans are not aware of free or low-cost health care programs that are available for people who cannot afford or qualify for private insurance, or who don't have access to employer-provided coverage. Any student searching for these programs can contact eHealthInsurance.com's Customer Care Center or contact the Foundation for Health Coverage Education directly at [ www.CoverageForAll.org ].
2. Know where to go for care: Many students who are out on their own for the first time may never think about how or where to go for care until an emergency pops up.
-- On-campus clinics: Many colleges and Universities have student clinics on campus that provide varying degrees of basic care; some may offer advanced care as well. For students living on or near campus, these clinics may be your best source for low-cost, high-quality preventive care. You may also want to find out if they can provide emergency care.
-- Physicians and Care Centers in your network: Most health plans will provide you with reduced rates from care providers that are in your health plan's network. When you get care outside of your network, the cost typically goes up. So, before you choose a health insurance product, it's a good idea to find out if the places you're most likely to go for care are included in the plan's network.
-- Emergency Rooms: Emergency rooms are an excellent resource when you have a medical emergency. But, when you don't have a medical emergency, it's a good idea to try to find care somewhere else first. Any form of care provided in an emergency room is typically very expensive and, with or without insurance, the costs for delivering that care can often be extremely high.
3. Understand how pre-existing medical conditions can impact your ability to obtain medical coverage on different plan types:
-- Your parents' plan: Pre-existing medical conditions are typically not an issue as long as you stay on your parents' plan.
-- University plans: If a student has not had a gap in creditable coverage, the majority of student plans offered through a College or University will provide some level of coverage for most pre-existing medical conditions.
-- Individual health Insurance plans: Insurance companies can choose not to offer a student an individual health insurance product for reasons including a pre-existing condition.
4. Understand the value of a maximum coverage amount or lifetime coverage limit: When buying health insurance, one of the things you're paying for is a maximum amount of coverage, which is typically referred to in a health insurance policy as a "maximum coverage amount."
-- Your parents' plan: If your parents get their insurance from their employer, they will be on what is called a group health insurance policy. These policies typically either do not have coverage maximums or have maximums that exceed $1 million of coverage.
-- University plans: Many of the student policies we reviewed have coverage maximums for each medical incident. So, for example, if a student has multiple unrelated accidents, each new accident will entitle them to the same dollar amount of coverage. However, if a student contracts a costly disease or long-term illness, the policy would only provide the single maximum coverage amount for all medical costs related to that illness.
-- Individual health insurance policies: Like group policies, some individual health insurance policies have coverage maximums and some do not. For those that do, the average amount of coverage available was $3.9 million and the median plan lifetime limit was $2 million, according to eHealthInsurance's 2008 Cost & Benefits [ report ](4).
5. Research your ability to continue coverage after graduation under the plan you choose:
-- Your parents' plan: If your parents get their insurance from their employer, then in most cases, you can remain on your parents' plan after graduation, if you take advantage of COBRA laws, which give you an additional 18 months of access to that plan. The downside is that the cost of COBRA can be extremely cost-prohibitive.
-- University plans: The majority of the University plans eHealth reviewed allowed students to continue coverage after graduation for a short period of time -- from three months or up to one year.
-- Individual health insurance policies: One of the key benefits of individually purchased health insurance policies is that they're yours to keep.
Summary of eHealthInsurance findings from 10 University plans:
1. Premiums: Of the plans reviewed, monthly premiums ranged from about $90 to about $140, with some exceptions.
2. Deductibles: Most plans had deductibles, which ranged from $75 to $300 for in-network medical services, with some exceptions. In some cases deductibles were waived if care was received at campus medical centers.
3. Pre-existing conditions: The majority of plans covered pre-existing conditions, provided the student had not had a gap in creditable coverage. Again, there were some exceptions.
4. Out of pocket maximums: Most plans had out of pocket maximums, which ranged from $1,500 to $10,000 for in-network medical services, with some exceptions.
5. Lifetime coverage limits: Most plans had lifetime coverage limits, which ranged from $50,000 to $300,000 for in-network medical services, with some exceptions.
6. Coverage after graduation: All of the plans reviewed set a time limit or cap on the amount of time benefits could be kept after graduation. Of the plans we reviewed, the longest period of time allowed to extend benefits, barring medical reasons, was one year. In most cases coverage must be terminated within 3 months of graduation, again, barring medical reasons.
Average Individually Purchased Health Pre-existing General Ability Insurance Policy from conditions to continue eHealth's 2008 Cost & Costs / Max covered for new coverage after Benefits Report Coverage applicants graduation --------------- --------------- --------------- Adults Aged: 18-24 -- Average In most cases Yes Premium not without Male: approval via $94 per medical month underwriting. -- Average Premium Female: $115 -- Average Maximum Coverage: $3.9 Million -- Average Deductible: $1,932 -- Annual out-of- pocket maximum: *averages not available but most policies range from $0 to $10,000. higher maximums may be offered in some plans --------------- --------------- --------------- Average Group Health Costs / Max Pre-existing Ability to Insurance Policy from Coverage conditions continue after The Kaiser Family covered for graduation for Foundation's Employer new applicants non-medical Health Benefits 2009 reasons Annual Survey --------------- --------------- --------------- -- Students on group -- Average Yes No. Some plans policies would Annual have a firm age typically be dependants Family cap of 25 in a family plan where Premium: years-old. the primary policy $13,375 holder is one of their ($1,114 per parents. month - $300 out of pocket) -- On average, the -- Average primary policy deductible: holder on a group $634 for policy contributes PPOs, $699 27% of the total for HMOs, premium cost out $1,061 for of their own pocket POS plans, and their employer and $1,838 covers the remaining for HDHP/SOs 73% -- Annual out- of-pocket maximum: Ranges $1,500 or less to $3,000 or more -- Maximum coverage: 41% of plans have no lifetime maximum, 16% range from $1 and $2 million, and 43% are $2 million or more. School Required Offer Costs / Max Pre-existing Ability to and for Referral Coverage: conditions continue Student Admission? For For covered for graduation Plan Student In-Network new applicants for Plan? Services not non-medical Provided On reasons Campus --------------- --------------- --------------- Ohio Yes Yes -- Premium: Yes. No State $367 per * With exceptions University, quarter related to gaps in Columbus ($92 per creditable coverage http://www.ohio.edu/ month(5)) and duration of finance/bursar/stud -- Maximum coverage. enthealth.cfm coverage: UnitedHealthCare: $50,000 Policy number -- Deductible: 06-BR-OH (Rev $75 07-09) 34-1103-01 -- Annual out- of-pocket maximum: $5,000 --------------- --------------- --------------- Arizona No Yes -- Annual Yes. Yes, State premium: * With exceptions for up to University $1,523 related to gaps in 3 months http://students. ($126 per creditable coverage asu.edu/healthco month(5)) and duration of verageoptions -- Deductible: coverage. Aetna Policy $250 Number 697443 -- Maximum coverage: $300,000 -- Annual out- of-pocket maximum: $1,500 --------------- --------------- --------------- University No Yes -- Annual Yes No of Florida premium * With exceptions http://www.shcc. < 25: related to gaps in ufl.edu/insurance. $1,391 creditable coverage, shtml#insurance ($116 duration of coverage plan 2: Aetna per month and the location where Student Health (5)) service is delivered. Policy No 474890 -- Annual premium> = 25 : $1,731 ($145 per month(5)) -- Maximum coverage: $200,000 -- Deductible: $200 -- Annual out- of-pocket maximum: $10,000 --------------- --------------- --------------- University Yes Yes -- Premium: Yes Yes, for up to of Minnesota $1,814 per * With limited one year with Twin Cities, year ($152 exceptions exceptions Minneapolis per month(5)) http://www.s-hb. -- Annual out- umn.edu/ of-pocket index.htm maximum: University-sponsored $2000 Student Health Benefit Plan --------------- --------------- --------------- University No Yes -- Annual Yes Yes, of Texas at Premium: * With exceptions for up to Austin $1,100 ($92 related to gaps six months http://healthyhorns. per month(5)) in creditable utexas.edu/ -- Deductible: coverage and insurance.html $300 duration of UnitedHealthCare -- Maximum coverage. 06-BR-TX-PPO (Rev 07-08) coverage: $100,000 -- Annual out- of-pocket maximum: $10,000 --------------- --------------- --------------- University Yes Yes -- Annual Yes No of Central Premium: * With exceptions Florida $1,384 related to gaps Aetna Student ($116 per in creditable Health Plan: month(5)) coverage and http://www.hs.sdes. -- Maximum duration of ucf.edu/healthcenter/ coverage: coverage. insurance.html $250,000 -- Deductible: $250 -- Annual out- of-pocket maximum: $2,000 --------------- --------------- --------------- Michigan No Yes -- Annual Yes Yes, State premium: * With exceptions for up to University: $1,390 per related to gaps 9 months http://www.hr. year ($116 in creditable msu.edu/ per month(5)) coverage and benefits/ -- Maximum duration of studenthealth/ coverage: coverage. index.htm $50,000 per Aetna Life accident or Insurance Company illness (ALIC) -- Deductible: Policy Number $150 711130 -- Annual out- of-pocket maximum: $1,650 --------------- --------------- --------------- Texas A&M No Yes -- Annual Yes, with some Yes, for one University: premium: limitations and year http://www. $1,213 exceptions. aipinternational. ($102 per com/TAM/ month(5)) plan_select.html -- Deductible: Delos Insurance $250 Company -- Maximum 50K Plan: coverage: Policy # $50,000 per DSP0003209 condition -- Annual out- of-pocket maximum: $1,000 --------------- --------------- --------------- University Call Yes -- Annual Yes No of South premium: * With exceptions Florida $1,539 related to gaps http:// ($129 per in creditable studentinsurancegroup.us/ month(5)) coverage and PDF/Brochure%2009-10.pdf -- Deductible: duration of Blue Cross/ $300 coverage. Blue Shield: BCBSF -- Maximum Group # coverage per 65145 year: $200,000 -- Annual out-of-pocket maximum: Varies from service to service, but typically the deductible, plus 80% of the allowed benefit. --------------- --------------- --------------- Pennsylvania No Yes -- Annual Yes, with some No State premium: limitations and University $1,107 exceptions. 06-BR-PA ($93 per (Rev 07-08) month(5)) http://www.sa. -- Deductible: psu.edu/uhs/ $50 basics/ -- Maximum insurance.cfm coverage: $50,000 per injury or sickness -- Annual out-of-pocket maximum: $150
eHealth has also provided links to the student health insurance pages of 20 of the largest Public and Private University Campuses in the United States.
1. [ Nova Southeastern University ]
2. [ Columbia University ]
3. [ Northeastern University ]
4. [ DePaul University ]
5. [ Long Island University ]
6. [ University of Pennsylvania ]
7. [ George Washington University ]
8. [ Harvard University ]
9. [ Cornell University ]
10. [ Syracuse University ]
11. [ University of Washington ]
12. [ University of Wisconsin-Madison ]
13. [ University of Illinois at Urbana-Champaign ]
14. [ University of Michigan ]
15. [ Florid a International University ]
16. [ New York University ]
17. [ Brigham Young University ]
18. [ University of Southern California ]
19. [ Boston University ]
20. [ Liberty University ]
(1) The review conducted by eHealth, Inc. was done by a random sampling of Universities. The review is not meant to indicate or predict any trends or practices. This information is presented for the sole purpose of illustrating the diversity of health insurance products available and should, in no way, be perceived as a comment on the value or quality of insurance products recommended or offered by the Universities listed.
(2) eHealth, Inc. Consumer Survey of College Students, May 14, 2009 ([ http://www.ehealthinsurance.com/content/expertcenterNew/CollegeStudentsSurvey_ToplineAndResults.pdf ])
(3) Analysis and Policy Recommendations for Providing Health Insurance and Health Care Services for the College Student Population, p. 31, Lookout Mountain Group, June 2, 2009.
(4) eHealth, Inc. Cost And Benefits Of Individual And Family Health Insurance Plans, November 2008 uses 2007 plan data:[ http://news.ehealthinsurance.com/pr/ehi/document/eHealthCBreport2008FINAL.pdf ]
(5) All dollar amounts listed for premiums are rounded up to the nearest full dollar.
About eHealth
eHealth, Inc. (