GU Health Insurance Fares Favorably

Georgetown’s student health insurance program provides coverage at least as comprehensive as that of many surrounding universities, but it has remained mostly unaffected by the health care reform signed into law this year.

The first of the Affordable Care Act’s regulatory changes, including several that affect young adults and students, came into force on Sept. 23. Most notably, young adults may now remain covered by a parent’s insurance plan until the age of 26.

According to The Wall Street Journal, however, most university-run student insurance plans are exempt from the new regulations, since they were negotiated before the September deadline. Georgetown’s Student Health Insurance Office also told THE HOYA that regulations are still being hammered out about plans not covered by the Employee Retirement Income Security Act. The office did not provide specifics about any changes in store.

The university requires that all degree-seeking students be covered by some insurance plan; if a student is not already covered, he or she must enroll in the university’s Premier Plan. The plan’s premium for this semester is $1,745.

Students who study abroad must simultaneously carry a domestic health insurance plan and the university’s pre-set study abroad plan, which is provided by CMI Insurance and is $70 for four months of coverage.

A survey conducted in 2007 by the American College Health Association found that 57 percent of colleges and universities require their students have health insurance as a condition of enrollment, and that private institutions are nearly two times more likely to do so than public ones. The federal government’s healthcare.gov website details that 30 percent of young adults are uninsured, representing one in five of all uninsured in total.

Students said they choose their insurance plans on the basis of a variety of factors, including costs.

Rachel Nethery (COL ’12) said that although she doesn’t use Georgetown’s Premier Plan and isn’t currently searching for a plan, she would look for a program that has student-friendly prescription coverage as well as low premiums.

“I would prefer to pay a high co-pay the two or three times per year that I have to go to the doctor,” she said.

Therese Federowicz (COL ’11) said that, although she isn’t in need of the Premier Plan, she would search for a plan that is “full, comprehensive and reasonably priced.”

The Premier Plan separates the expenses of its members into three categories: those incurred at the Student Health Center, those from the Georgetown University Medical Center and the plan’s preferred network and those from out-of-network providers.

It also caps the benefit for a particular illness in a given year at $300,000. By comparison, American University’s student health insurance plan enforces a similar cap at $250,000 and The George Washington University’s, which is provided by Aetna Student Health, only covers up to $100,000. GWU’s policy, however, is $110 cheaper per year than the Georgetown plan.

The Premier Plan covers up to 70 percent of the usual charges for chemotherapy, whereas GWU’s and American’s student insurance only provides up to 60 percent.

oreover, the Premier Plan provides $5,000 for an accidental death; GWU’s will pay up to $10,000. Both are higher than American’s plan, which offers only $1,000.

All plans, though, will pay any maternity costs, both during and after a pregnancy, for both parent and child.

Laura Hardman Crosby, director of Georgetown’s Student Health Insurance Office, noted that there is debate over whether student plans should be forced to maintain the same ratio of medical payments to administrative costs as other insurance companies do. The health care reform act mandated that 80 percent of most plans’ expenses be reserved for medical care.

“The reason for the concern is that the cost to administer 100 small student claims that total $100,000 is more than the cost to administer one large employer claim that totals $100,000; the average student claim is smaller than the average employer claim, so the administrative claim cost per dollar on a student plan will be higher,” Crosby explained.”

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