Melissa Brown
Published: February 22, 2006
Are you covered? By health insurance, that is.
A study by the Heinz Family Philanthropies and The Chickering Group found that about 30 percent of college students in 2002 were uninsured. And according to a 2004 report by the Kaiser Family Foundation and eHealthInsurance, “43.3 million non-elderly Americans lacked health insurance for the entire year [2002].”
If you’re not covered, take a moment to ponder the consequences of treating an illness or injury without the benefits of a health plan.
An initial visit to a walk-in clinic starts at about $100 – and that’s for a brief consultation. Add up the costs for procedures, labs, prescriptions, and before you know it, an entire paycheck is spent in one sitting.
“I would love for these students to realize that they really have to have some [health] insurance,” stresses PJC Health Clinic nurse Judy Harrington. “It’s not for the little stuff, it’s not for the well-care, it’s for the big stuff that can absolutely devastate them financially if they ever get hospitalized or go to the emergency room.”
Many options are available when buying insurance, and the plans are often difficult to decipher. Don’t impulse buy. Take Harrington’s advice, and “Do some research. Really look and see what you’re getting.”
First, decide which type of insurance is best for you.
To get an insider’s opinion, ask your auto insurance agent to recommend a company or individual broker. The website www.eHealthInsurance.com offers free quotes, comparisons and information for several companies.
Check with your employer’s human resource department to determine eligibility for benefits. Joining an employer’s health insurance policy is typically the easiest and most affordable way to obtain insurance.
If that option isn’t available, a college student policy might be your match. The PJC Health Clinic (Bldg.3 Room 301) has a few student health insurance packets available. The Chickering Group (an Aetna company) and eHealthInsurance offer student policies that you can apply for online.
Individual or family health insurance is generally the most accessible and offers the most benefits (at a more expensive price).
Temporary or short term insurance is usually purchased by individuals between policies, such as during the period before an employer-based policy takes effect. Most insurers only offer a temporary policy for one to six months that isn’t renewable and won’t cover pre-existing conditions.
If you’re already covered, evaluate your current plan. Will it cover an emergency room visit? Does it offer prescription benefits? If your plan falls short of the target, consider supplemental insurance to enhance your coverage.
Once you’ve chosen the proper type, you must pick a plan: HMO, PPO, and indemnity are the most common.
A Health Maintenance Organization (HMO) is the least flexible. You’re limited to the doctors, specialists, and hospitals in their exclusive network and must choose a Primary Care Physician that coordinates all care. The premium is usually paid monthly and co-payments are required at the time of service.
Preferred Provider Organizations (PPO) offer more flexibility than with the benefits of an HMO: you still have a primary physician but can see doctors and specialists out of the PPO’s network at a higher cost. Co-payment or co-insurance is often required at the time of service.
Traditional health insurance, indemnity or fee-for-service, is the most flexible and usually the most expensive. Consumers must meet an annual deductible ($250-$2000+) before the insurance company will cover a percentage of the fees (usually 80 percent). Full payment may be required at the time of service and then the consumer or healthcare provider must bill the insurance company. Any doctor or hospital is allowed with this type of policy.
Harrington urges students to make an informed purchase:
“I tell them they have to read [the information], they have to know exactly what they’re buying because don’t buy something you don’t know. There’s 1-800 numbers, they can get on the website.
“I also remind people that yes, I have insurance information, but that PJC does not endorse these programs; they’re just information that was sent to us that we’re offering [to students].”