September 5, 2013

Cornell Warns International Students About Inadequate Health Insurance

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Cornell officials are warning international students about purchasing health insurance plans from misleading companies that have previously left some students unable to pay for their health care expenses.

Last year, “a considerable number of international students” purchased insurance plans that were made to look as if they were Cornell’s student health plan, according to Craig McAllister, director of Risk Management and Insurance and chair of the Student Insurance Advisory Committee. Some insurance companies even offered a $50 rebate for students who signed on and were able to convince a peer to purchase the plan, McAllister said.

Although the companies described their plans as being comprehensive and affordable, “students with the plan ended up having unexpected health care costs, including out-of-pocket expenses and difficulty accessing services,” McAllister said.

“This was problematic, as the plan did not actually provide coverage meeting Cornell criteria,” he added.

Because a significant number of students bought these plans, McAllister said that, this year, the committee sent out an email warning international students of such companies in the hopes that it could help “spare international students and others looking at online plans this unfortunate and costly experience.”

“This is the first time an alert went out this wide,” said student insurance administrator Jo Ann Molnar-Kieffer, a member of the University’s Student Insurance Advisory Committee.

Although students who reside in the United States may already have insurance or are covered by their family’s insurance, most international students must choose their U.S. health insurance for the first time before coming to Cornell.

“International students are constantly struggling with the strong Internet approach of other companies,” Molnar-Kieffer said. “Their representatives say ‘this is all you need,’ or ‘many students buy this plan.’ What students don’t hear of are the large medical expenses that are not covered. It can put them in a really stressful situation or give them a huge financial burden [later on].”

The challenge for the University is to not only make sure that Cornell students –– both local and international –– are not paying too much for insurance or being excluded from vital coverage, but also to examine how marketplace changes in health insurance affect students, according to McAllister.

“Health insurance is a very complicated area, and it has a lot of moving parts,” McAllister said. “There’s a lot of information that doesn’t mesh together with the different programs that are available. [The Student Insurance Advisory Committee] is looking at the larger picture to make sure students are getting the appropriate healthcare.”

Since 1974, students have had the option of enrolling in Cornell’s standard Student Health Insurance Plan, or SHIP, which is run by Aetna, an insurance company. About half of students are covered by it, according to McAllister –– unless they are otherwise covered by an outside plan that meets all of Cornell’s “criteria for adequate health insurance.”

These criteria, according to McAllister, have changed with the passing of new legislation such as the Patient Protection and Affordable Care Act of 2010.

“As benefits expand, the marketplace is changing,” McAllister said. For instance, many self-purchase or out-of-network health insurance plans require that patients pay for a significant portion of health care costs.

Students who do not know they have enrolled in “heavy” cost-sharing plans are in danger of not being able to afford critical health care, he added.

“Some out-of-network plans could have a 40 percent cost-share,” McAllister said. “If Gannett makes a referral for you to get an MRI that costs $2,000, you can imagine how much that cost-share could affect you.”

Currently, Cornell’s criteria for non-SHIP insurance include having a maximum benefit of at least $500,000 per year and a policy year deductible of $2,500 or less, as well as being provided by a company licensed to do business in the United States that does not require the student to leave the U.S. for care during the academic year. Plans must also include care for pre-existing conditions, prescription drug coverage and injuries from recreational activities, among other requirements.

“It’s easy to think that the criteria are arbitrary,” said Katy Reines ’14, undergraduate representative of the SIAC. “They’re not. There’s a reason we [continue to] change them.”

Students must be aware of what criteria their health insurance plans meet, Reines and Gannett officials said.

According to Reines, a friend of hers once fell and needed to be taken to the hospital but hesitated before calling the ambulance; the friend was afraid she was not covered by insurance.

“We had debated if we should call an ambulance or have me drive her just because she was afraid she might not be covered,” Reines said. “When something bad happens, that’s not what you should be talking about.”

Some insurance plans complicate the attempt of students to understand their coverage by using unclear wording.

Wording like “[hazardous activities] is sometimes open to the interpretation of the insurance companies,” Molnar-Kieffer said. “It could exclude things like hiking, club sports or snowboarding.”

Valerie Lyon, associate director of business and finance at Gannett, said she believes students have a responsibility to be informed consumers.

“Ask yourself, ‘How will my insurance work, if I need testing or specialty care that can’t be provided at Gannett?” Lyon said.

“Plans with restrictive networks may require students to travel outside of Ithaca to another county without public transportation to receive those services. These restrictions create significant barriers to getting care — and subsequent health risks — when students feel that time away from classes and/or money for transportation is too high a price to pay,” she added.

Reines echoed Lyon’s sentiments, saying students need to be aware about their health insurance options.

“As students, we have so much to think about, especially at the beginning of the year,” Reines said. “But [health insurance] is a really important thing to consider.”

Original Author: Noah Rankin