After tuition, books, and room and board, colleges’ escalating health fees hit a nerve

I have compared tuition fees. Review on-campus housing costs. Even the student meal plan prices are digested.

But have you thought about how much your son or daughter’s dream school will charge for health coverage?

You may go into shock.

Hawley Montgomery Downs was thrilled when her daughter, Brynn Trunko, was awarded a scholarship that pays half of the $63,000 annual tuition at USC. But once school started in August, she was shocked to receive a bill from the University of Southern California for $3,000 to cover both the student health insurance premium and a fee that gives students access to on-campus clinics and other services. In her West Virginia home, she paid nothing for her daughter’s health insurance, through the state’s children’s health insurance program, which serves lower- and middle-class families.

Montgomery Downs, who lives in Morgantown, West Virginia, was particularly upset that USC charged her not only for health insurance but an annual health fee of $1,050. “It would be great for her to go to the student health center, but with the purchase of insurance to go to a primary care provider, I feel like I’m paying twice,” she said.

He said mandatory medical insurance and health service fees are common at colleges as an entry requirement Stephen Beckley, a health and benefits consultant for colleges in Fort Collins, Colorado. While health fees can help reduce student insurance premiums, parents may feel as if they are paying double. “This is a big puzzle in our field,” he said.

For parents, these large payments may come as a surprise, making a barely affordable education even less so. After all, students can save by choosing a snack plan and cooking their own dinners or buying used textbooks, but there’s no way around the mandatory health fee.

Costs vary by school, but often run into several thousand dollars annually—costs that healthcare advocates say should be carefully reviewed by parents and students to ensure they understand their options while also meeting university requirements.

Students can request a waiver of university health insurance by proving that they have their own or are covered by parental insurance that meets specific university criteria. Schools usually want to see that the student’s insurance covers local doctors and hospitals at a low cost out of pocket. However, health fees cannot generally be waived for students.

USC, a private college, Fee $2,273 per year For the Aetna student health insurance plan. The average for public colleges is $2,712 and $3,540 for private universities, according to Survey 2022 By Beckley Inc., Beckley & Lyon Hodgkins.

Other notable colleges charge much more than that, eg $6,768 at Stanford and $4,163 in Dartmouth College.

the University of Montana She charges $4,700, and most of the services at her school health clinic are covered entirely by her health plan. the University of Colorado Fee $3,976.

at HarvardStudents who purchase school insurance pay $4,080 annually and $1,304 in student health fees.

The easiest solution to avoiding this fee is for students to remain on a parent’s health policy—which the Affordable Care Act allows—until they turn 26. But this only works if the student’s parent has a policy that meets the school’s comprehensive requirements and offers in-network coverage where the college is located.

Otherwise, parents may want to shop around ACA marketplace plans to see if they can find a deal. If their incomes are low enough, students can sometimes enroll in Medicaid or a CHIP plan in the states where they go to school. But this strategy also has limits. Students must meet government residency requirements where they attend school, and parents cannot claim them as dependents on tax returns. CHIP coverage also ends once the student turns 19.

Schools that charge for student health and require insurance coverage say the funding helps cover services at campus health clinics, which can cost students hundreds of dollars a year or more.

the USC Student Health Fee – which covers primary and preventive health services – also helps the school pay for services not normally covered by insurance, such as monitoring disease outbreaks on campus.

Doctor. Sarah Van OrmanThe Student Health Fee provides funding for additional mental health service providers on campus and a team focused on sexual assault prevention and education — services that are available to students without any co-payments, noted Chief Health Officer of USC Student Health. She said these additions are necessary because, even with insurance, students may face challenges finding private counselors to provide timely assistance, and if they do, students will incur cost-sharing expenses.

“Student health fees support the public health infrastructure on campus,” said Van Orman.

Because students can get primary health care services on campus at the Student Health Center, fewer of them seek care that insurance pays for, she said, and that helps keep the monthly premium for Aetna’s student health insurance plan lower. “These things work together and it’s not a duplication at all,” said Van Orman.

USC Student Health Insurance has an annual in-network deductible of $450 and a $20 co-payment for doctor’s office visits. It also provides comprehensive services nationwide, so students are covered when they are at school and back home – even if it’s across the country. About half of USC students buy student insurance from Aetna, according to Van Orman.

Other colleges have a different strategy. for example, George Washington UniversityCompulsory health insurance covers the services of the health center on campus. Unless they receive a waiver, undergraduates must enroll in a student health insurance plan—at a cost of $2,700 per year—unless they can prove they have another insurance plan that meets the school’s criteria. The health plan premium allows students to receive many free services at the Student Health Center, including medical office visits, some prescriptions, and routine screenings for STDs.

College rules differ on whether to allow students to choose insurance plans other than what the school offers, Beckley said.

USC allows students to purchase a replacement insurance policy through their parents’ plan or from the ACA marketplace as long as it meets the school’s requirements which include comprehensive health coverage in the Los Angeles area and preventive care coverage without cost sharing. Out-of-state Medicaid or CHIP plans do not meet university standards because they do not have provider networks for routine care in California.

That was unwelcome news for Montgomery Downs.

“It’s not something we budgeted for,” she said of USC’s health costs.

Just as her daughter’s classes were starting in August at USC, Hawley Montgomery Downs was shocked to receive a bill from the university of nearly $3,000 to cover health insurance and student health fees. At home in West Virginia, Montgomery Downs paid nothing to cover her daughter Brynn through the state’s children’s health insurance program. (Photo by Rebecca Kiger for KHN)

Montgomery Downs, a former assistant professor at West Virginia University who is now a freelance editor, said she wasn’t sure what to do when she got the USC health bill. She had thought Brynn, who turned 19 last week, would be covered at first because her CHIP plan provides coverage for treatment in emergency rooms and urgent care centers out of state. And Montgomery Downs wanted to make sure her daughter had health coverage for the summer holidays and holidays when she was home.

Unsure of market coverage options that meet school rules and deadlines, I decided to go with the Aetna student plan offered by USC.

A look at Covered California’s market options shows that the $2,200 USC Aetna student plan is competitively priced. California Blue Cross’s lowest-priced comparable PPO plan that would provide Bryn with a nationwide network of providers costs about $2,400 a year including government subsidies. On the basis of family income. PPOs provide some coverage to out-of-network doctors and hospitals.

Montgomery-Downs gets its market coverage and said it will shop around for a market plan for Bryn for next school year. She said she wishes they had known about all health costs at the time of admission rather than just before classes began.

“All of this is terrifying, even for someone with the privilege of time and some understanding of these bureaucracies—higher education and medical insurance,” Montgomery Downs said.

This story was originally published by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and reconnaissance, KHN is one of the three major drivers in the KFF (Caesar Family Foundation). KFF is a non-profit organization that provides information on health issues to the nation.

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