Rising college health fees hit a nerve for already strapped parents

you may be in shock.

Hawley Montgomery-Downs was thrilled when her daughter, Bryn Tronco, won a scholarship to pay half of her $63,000 a year tuition at the University of Southern California. But just as she started school in August, she received a loan from USC to cover both student health insurance premiums and fees that allow students to access clinics and other services on campus. She was stunned when she received a $3,000 bill for At her home in West Virginia, 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, of Morgantown, West Virginia, was particularly upset that USC charged her $1,050 a year in medical bills, not just health insurance premiums. “It’s nice for her to go to the Student Health Center, but I feel like I’m paying double when she buys her insurance to go to a primary care provider,” she said. .

Mandatory medical insurance and health service fees are common as admission requirements at colleges and universities, said Stephen Beckley, a college health and benefits consultant in Fort Collins, Colorado. Health insurance premiums can help reduce student premiums, but parents may feel like they’re paying double. “It’s a big challenge for our field,” he said.

For parents, these hefty payments come as a surprise, and an almost-affordable education feels even more uncomfortable. You can save money by buying textbooks, but there is no way to avoid essential medical expenses.

Costs vary by school, but can often reach thousands of dollars per year. Medical advocates say parents and students need to weigh costs carefully to make sure they understand their options while meeting college requirements.

Students may request a college health insurance waiver by demonstrating that they have their own insurance or that they have a parent’s insurance that meets the criteria for a particular college. Schools usually want students’ own insurance to cover local doctors and hospitals at a nominal cost. However, student health insurance premiums are usually not waived.

USC, a private university, charges $2,273 annually for the Aetna Student Health Insurance Plan. A 2022 study by Hodgkins, Beckley & Lyon, Beckley’s firm, found that public colleges average $2,712 and private colleges average $3,540.

Other notable universities cost even more, such as Stanford University at $6,768 and Dartmouth College at $4,163.

The University of Montana charges $4,700 and most services at the school clinic are fully covered by health insurance. The University of Colorado bills him $3,976.

At Harvard, students who purchase school insurance pay $4,080 annually plus $1,304 in student health insurance.

The easiest solution to avoid these fees is for students to purchase parental health insurance. This is allowed until he turns 26 under the Affordable Care Act. – Network coverage where the university is located.

Otherwise, parents may want to shop among the ACA Marketplace plans to see if they can find a bargain. If your income is low enough, a student may be able to enroll in the state’s Medicaid or her CHIP plan where she attends school. However, this strategy also has limitations. Students must meet the residency requirements of the state in which they attend school, and parents cannot claim to be dependent on their tax returns. CHIP coverage also expires when the student turns 19.

Schools that bill medical bills for students and require insurance coverage say the funds will help cover services at campus clinics.

USC’s Student Health Coverage (which covers primary and preventive health care services) also helps pay for services not normally covered by insurance, such as monitoring for outbreaks of illness on campus.

Dr. Sarah Van Orman, Chief Health Officer of USC Student Health, said student medical bills fund additional mental health providers on campus and teams focused on sexual assault prevention and education. pointed out to This is a service available to students at no out-of-pocket cost. She said these additions are essential because even with insurance, students can struggle to find a private counselor who provides timely assistance.

“Student healthcare costs support public health infrastructure on campus,” said Van Orman.

Because students can access primary health care services at the student health center on campus, fewer students will seek out insurance-paid care, resulting in lower monthly premiums for the Aetna Student Health Insurance Plan, she said. Told. “They work together and don’t overlap at all,” she said Van Orman.

USC student health insurance has a $450 annual deductible within the network and a $20 co-pay for doctor’s office visits. We also offer a nationwide comprehensive service, so students are covered whether they’re at school or at home, even if it’s across the country. According to Van Orman, about half of USC students have his Aetna Student Insurance.

Other universities have different strategies. For example, George Washington University’s mandatory health insurance covers on-campus health center services. Unless waived, undergraduates are required to enroll in a $2,700 annual student health insurance plan unless they demonstrate that they have another insurance plan that meets the school’s standards. A health insurance premium entitles students to many free services at the Student Health Center, including medical visits, prescriptions, and routine STD testing.

College rules depend on whether students can choose insurance plans other than those offered by the school, Beckley said.

USC allows students to purchase alternative insurance through their parents’ plans or on the ACA Marketplace, as long as they meet the school’s requirements, including comprehensive health insurance in the Los Angeles area. Out-of-state Medicaid or CHIP plans do not meet the university’s criteria because California does not have a network of providers for routine care.

This was not welcome news for Montgomery Downs.

“This is not something we budgeted for,” she said of USC’s medical bills.

Montgomery Downs, a former associate professor at West Virginia University who now works as a freelance editor, said when he received USC’s health bill, he didn’t know what to do. She thought Bryn, who turned 19 this week, would be covered initially because the CHIP plan covered treatment in out-of-state emergency rooms and urgent care centers. Montgomery’s Ms. Downs also wanted to make sure her daughter had health insurance during summer vacations and vacations at her home.

Not sure which marketplace option fits her school’s rules and deadlines, she opts for the Aetna student plan offered by USC.

Looking at the Covered California marketplace options, we can see that $2,200 for the USC Aetna Student Plan is a competitive rate. Her PPO plan, the equivalent lowest price offered by California Blue Cross, which provides Bryn with a nationwide network of providers, costs about $2,400 a year after factoring in government subsidies based on family income. PPO provides some coverage for out-of-network doctors and hospitals.

Montgomery-Downs said she received her article on the Marketplace and will purchase Bryn’s Marketplace plan next school year. She said she wished she had known all her medical expenses when she enrolled, rather than just before her classes started.

“Even for someone with the privilege of time and some understanding of bureaucracy such as higher education and health insurance, it’s all a nightmare,” said Montgomery Downs.

Phil Galewitz is senior correspondent for Kaiser Health News, an independent program of the Kaiser Family Foundation in which this article first appeared, covering Medicaid, Medicare, long-term care, hospitals, and other state health issues. Email: pgalewitz@kff.org. Twitter: @philgalewitz.