By Phil Galewitz,
Kaiser Health News
You compared tuition fees. Review of on-campus housing costs. Even digested student meal plan prices.
But have you thought about how much your son or daughter’s dream school will charge for health coverage?
You might get a shock.
Hawley Montgomery-Downs, for example, was thrilled when her daughter Bryn Tronco won a scholarship that pays half of USC’s $63,000 annual tuition. But just as school was starting in August, she received a $3,000 bill from USC to cover both a student health insurance premium and fees for students to access clinics on campus and other services. At her home in West Virginia, Montgomery-Downs had paid nothing for her daughter’s health insurance, through the state’s Children’s Health Insurance Program, which serves low- and middle-income families.
Montgomery-Downs, who lives in Morgantown, was particularly upset that USC not only charged her health insurance, but also an annual health fee of $1,050.
“It would be nice for her to go to the student health center,” she said of her daughter, “but with buying insurance to go to a primary care provider, I I feel like I’m paying twice.”
Compulsory medical insurance and health service fees are common in universities as a condition of enrollment, said Stephen Beckley, a Fort Collins, Colorado, college health and benefits consultant. Although healthcare costs can help lower student insurance premiums, parents can feel like they’re paying double.
“It’s a big puzzle for our field,” Beckley said.
For parents, these large payments may come as a surprise, making a barely affordable education even less. After all, students can save by choosing a lean meal plan and cooking their own dinners or buying used textbooks — but there’s no way around mandatory healthcare costs.
Costs vary by school, but can often add up to several thousand dollars a year – costs that health care advocates say should be carefully considered by parents and students to ensure that they understand their options while meeting academic requirements.
Students can apply for a waiver of university health insurance by showing that they have their own insurance or that they are covered by their parents’ insurance, as long as it meets university-specific criteria. Schools generally want to see that the student’s own insurance covers local doctors and hospitals for a low cost. However, student health costs generally cannot be waived.
USC bills $2,273 per year for its Aetna student health insurance plan. The average for public colleges is $2,712 and $3,540 for private universities, according to a 2022 survey by the Beckley firmHodgkins Beckley and Lyons.
Other top colleges charge significantly more: Stanford University charges $6,768, for example, and Dartmouth College invoice $4,163.
the University of Montana charges $4,700, though most of her school health clinic services are fully covered by her health plan. the University of Colorado invoice $3,976.
At Harvard University, students who purchase school insurance pay $4,080 per year and $1,304 for student health costs.
The easiest way to avoid these fees would be for students to stay on a parent’s health policy — which the Affordable Care Act allows until age 26.
But that only works if the student’s parent has a policy that meets the school’s full requirements and provides in-network coverage where the college is located.
If not, parents may want to shop around among ACA Marketplace plans to see if they can find a good deal.
If their income is low enough, students can sometimes enroll in Medicaid or a CHIP plan in the states where they attend school. But this strategy also has limits. Students must meet the residency requirements of the state where they attend school, and parents cannot claim them as a dependent on tax returns. CHIP coverage also expires once the student turns 19.
Schools that charge student health fees and require insurance coverage say the funding helps cover services at campus health clinics that would otherwise cost students hundreds of dollars a year or more.
the USC Student Health Fees – which covers primary and preventative health services – also helps the university pay for services not usually covered by insurance, such as monitoring for epidemics on campus.
Dr. Sarah Van Orman, director of health at USC Student Health, noted that the student health fee provides funding for additional on-campus mental health providers and a team focused on sexual assault prevention and education – from services available to students without any user fees. These additions, she said, are essential because, even with insurance, students might struggle to find private counselors to provide timely help and, if they do, students would incur fees. to share.
“Student health fees,” Van Orman said, “support our public health infrastructure on campus.”
Because students can get primary health services on campus at the student health center, few seek insurance-paid care, she said, and that helps keep the monthly premium down. from the Aetna Student Health Insurance Plan below.
“These things work together,” Van Orman said, “and are not redundant at all.”
USC student health insurance has an annual in-network deductible of $450 and a $20 co-pay for doctor visits. It also provides comprehensive nationwide services, so students are covered while at school and at home, even if it’s nationwide.
About half of USC students buy Aetna student insurance, Van Orman said.
Other colleges have a different strategy.
George Washington University’s mandatory health insurance, for example, covers on-campus health center services. Unless they get a waiver, undergraduates must enroll in the Student Health Insurance Plan — which costs $2,700 a year — unless they can prove they have another insurance plan that meets the school’s criteria.
The health plan premium entitles students to many free services at the student health center, including doctor’s office visits, certain prescriptions, and routine screenings for sexually transmitted infections.
College rules vary in whether they allow students to choose insurance plans other than those offered by the school, Beckley said.
USC allows students to purchase an alternative insurance policy through a parent’s plan or in the ACA marketplace, as long as it meets the school’s requirements, which include comprehensive medical coverage in the Los Angeles area and preventive care without cost sharing. Out-of-state Medicaid or CHIP plans do not meet the university’s criteria because they do not have provider networks for routine care in California.
This was bad news for Montgomery-Downs.
“It’s not something we budgeted for,” she said of USC’s healthcare costs.
Montgomery-Downs, a former associate professor at West Virginia University who now works as a freelance writer, said she didn’t know what to do when she received the USC health bill. She had thought Bryn, who turned 19 earlier this month, would initially be covered because her CHIP plan provided coverage for treatment in emergency rooms and out-of-state urgent care centers. State.
And Montgomery-Downs wanted to make sure her daughter had health coverage during summer break and vacations at home.
Unsure of market coverage options that would meet school rules and deadlines, she decided to opt for the Aetna student plan offered by USC.
A look at the market options on Covered California shows that the $2,200 for the USC Aetna student plan is a competitive rate. The cheapest comparable PPO plan offered by California Blue Cross that would provide Bryn with a nationwide network of providers costs about $2,400 per year, factoring in a government subsidy based on their family income. PPOs provide some coverage for out-of-network doctors and hospitals.
Montgomery-Downs gets her market coverage and said she will buy a market plan for Bryn for the next school year. She said she wished they had been aware of all health costs at the time of admission rather than just before classes started.
“This is all nightmarish,” Montgomery-Downs said, “even for someone who has the privilege of time and some understanding of these bureaucracies — higher education and medical insurance.”
Kaiser Health News is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the Kaiser Family Foundation’s three major operating programs. KFF is an endowed non-profit organization providing information on health issues to the nation.