Finding a new doctor for child in college

<p>I was just checking my HMO plan and found plenty of in network doctors about 20 miles away from the college my son will be attending, Beloit. I could switch to a PPO plan that has providers in Beloit but that would cost about an extra $160-200/m which would be even more of a stretch combined with the monthly tuition payments. I don't believe my son has been to the doctor for anything besides a physical since he was very, very young. Pink eye I think. So I don't anticipate frequent visits. But living in Philadelphia, I have become very spoiled by convenience. Both of our current doctors are within walking distance. Twenty miles seems very far to me. He doesn't drive, so any visits to even an in city doctor would be by taxi or bumming a ride from someone. Is 20 miles a reasonable distance for a primary care physician?</p>

<p>Does Beloit have a student health center for most ‘minor’ things, or will students need to go off-campus for any kind of medical thing?</p>

<p>reeinaz: you should visit beloit’s webpages. Practically all resident colleges have simple ins coverage for situations like your son’s.</p>

<p>Agree with purpleacorn, if your s has been healthy to this point, and the school has a student health center, he should be fine.</p>

<p>Another thing to research, would your HMO consider him “out of area” and still provide the same coverage?</p>

<p>The school’s health center should be able to handle the usual illness and minor stuff. I know DS’ health center does about everything (x-rays, testing, pharmacy) and if it is a major problem they send the students to the hospital. They also take the major insurance plans.</p>

<p><a href=“Health & Wellness Center • Beloit College”>Health & Wellness Center • Beloit College;

<p>Is your son likely to need more than the health center does? My daughter, who doesn’t go to Beloit and who is in basically good health but does have chronic issues for which she takes daily medication, has been fine seeing her specialist when she’s home and using the college’s health center for ambulatory care.</p>

<p>Yes, Beloit has a health center. It says that the students can see the RN for free but if they see the MD or NP, the insurance is billed and neither the HMO or PPO covers that. </p>

<p>T26E4-The student insurance is $2600/y and there are deductables. I would switch to my employer’s PPO before choosing that plan.</p>

<p>Highlandmom - I would just have to switch his primary care doctor to one in the area.</p>

<p>Are any of the visiting physicians covered by your insurance?</p>

<p>If the health center referred out to a specialist nearby, would that specialist be covered?</p>

<p>Can the primary care physician at home communicate with nurses at school if needed?</p>

<p>How far is the nearest ER?</p>

<p>For your son, without any health issues to speak of, I would keep the primary care doctor at home- and any specialists, who can be seen during vacations. (My kids have chronic health issues, some serious, and we still followed this plan for the first few years.)</p>

<p>If a doctor is needed while in Beloit, check with your insurance (ask for a care advocate or supervisor if you really want the scoop) to see how that can be accomplished. </p>

<p>Transportation to the doctor should not be a big deal if it is not going to happen regularly. Check out public transportation and taxi costs, but if your son is sick enough to need a doctor, or injured, chances are an ER will be involved, not a doctor’s office. In that case, the school will transport or call an ambulance.</p>

<p>I don’t think there is anything to worry about really.</p>

<p>Every plan is different, so one can not check too carefully. It is worth researching how emergency or urgent care when at school would be covered, assuming one does their routine physicals/check-ups when home. How about if you break an ankle while on vacation, is that covered? Most plans distinguish between routine and emergency/urgent care or none of us could go 30 miles from home freely. It could be that with a campus health center (that is usually a required fee plus services) and emergencies covered, your student would be fine. If your student studies abroad, take another look at the insurance issue as it relates to that circumstance.</p>

<p>I am sympathetic to the concerns about insurance and local hospitals/doctors.</p>

<p>One very expensive summer, while my daughter was at overnight she had 3 visits to the local emergency department. A few of the doctors participated in our insurance, but the hospital didn’t.</p>

<p>Travelnut makes some excellent points. Have you tried calling your HMO to find out exactly what you would need to pay if your son needed medical attention at Beloit? All of my daughters went to school >250 miles from home, and we never switched their primary care doctors. They went to he health center for minor ailments, and were referred to local urgent care centers for problems needing more attention. Don’t think we ever paid more than $100 for any services rendered there. Before you start switching primary care physicians, give your HMO a call. You will have a better understanding of what your financial responsibilities will be, and can make a more informed decision.</p>

<p>ITA with CompMom - call and see if your insurance provider has a care advocate and go over your policy with them. We have a PPO and before D went away to college, I went over everything with them about her coverage. Massachusetts is very picky about insurance and I wanted to be sure we had the right coverage to qualify for a waiver. Good luck!</p>

<p>QLM</p>

<p>My 2 cents, definitely check with your insurance carrier what would happen in an emergency if your daughter was in another city for college. I am sure they come across this question alot, or have had experience with those who got sick or hurt on vacation.</p>

<p>My kids were very healthy so I wouldn’t have expected something to go wrong when my oldest went to college, but during his freshman year he became very sick and ended up being diagnosed with Type 1 diabetes. We were lucky he was home for spring break when this happened (rather than 7 driving hours away) although we had to scramble to get a new primary doctor here at hom as he was on the adult hospital floor as he was now 18, but his pediatrician was not allowed to treat him there. It is smart that you are checking out what is covered and what is not NOW because things do happen.</p>

<p>I have found that going beyond the customer service folks can often get coverage for things that would appear not to be covered. Higher ups, as I said, often called “supervisors” or even higher up, “care advocates”, have more flexibility and power to help.</p>

<p>Most insurances will pay for emergency care when a patient is far from home. Copays for ER’s are often around $100- 150 and zero if the person is admitted. But, yes, check and get a reference number or note the date and customer service person’s name. Some companies give you wrong information on the phone!</p>

<p>Liability is a concern for college health services. If they have the slightest nervousness they will refer a student to an ER. My daughter has neurological and some other health problems, and went in with numbness in her arm. It was a form of migraine but they sent her to the ER just in case it was a stroke, which cost us $150 and cost her many hours of waiting (under bright lights). This kind of think happened a lot to her.</p>

<p>I do have to say that since we paid the college health insurance fee (in addition to the regular health services fee), and she got herself a primary care doctor in the college health center, this no longer happens. Not only is her care covered, and happen on site, but the primary care doctor and specialists work as a team and actually- amazing- communicate, both within the college center and also specialists in the city who teach at the college.</p>

<p>For a kid without health issues, this may not be relevant but adding it for those who may be dealing with chronic illness and college.</p>

<p>Wanted to respond just in case others may read this thread (OP this may or may not apply to you).</p>

<p>My child’s college has an upfront fee (included in their semester fees) that funds an on-campus wellness center. This includes physicians, lab, x-ray, and pharmacy. The school’s insurance is a separate fee and is not required (if you have your own coverage). The cost of the physician, minor labs & xrays and some prescriptions are FREE for the students and only more extensive labs and xrays and more expensive drugs are billed to the insurance (or require cash payment). The on-campus doctors are considered to be their primary care physician and all treatment is coordinated by them. </p>

<p>Please check with your child’s school to make sure they do not offer something along these lines as we had no clue until we attended orientation. If our child is sick during regular business hours they will go to wellness center on campus, if after hours they will go to the local urgent care or emergency room.</p>

<p>Reeinaz: Okay, let me tell you how our family handled it across the country. </p>

<p>My DD went to school from California to NY. She didn’t want to change from our pediatrician, Dr. B, and wanted to continue to be his patient and see him for anything when she was home. (The pediatric staff explained a number of options to us, including, how the insurance issues would pan out and about the family staying within the same medical group.) </p>

<p>If DD had changed from her primary care physician (Dr. B) to one in NY, it would have been a mess for her at home:<br>
-DD couldn’t return to Dr. B, as a patient, because she would have to be considered a new adult patient (18 yrs), and, as Dr. B was impacted, he wouldn’t have a new spot for her, AND she would not be considered “pediatric” anymore.
-This was unacceptable to DD.
We figured her **school’s clinic <a href=“which%20also%20had%20a%20med%20school%20on%20campus”>/b</a> would be sufficient while she would keep seeing our pediatrician, at home, until age 22. </p>

<p>Best plans fizzled. In her sophomore year, **DD had a serious bout with pneumonia in school<a href=“we%20didn’t%20know%20that%20at%20the%20time!”>/b</a> and the school clinic couldn’t get her in for 2 weeks!!! So she painfully waited, called me crying everyday, went to classes, and couldn’t wait any longer and went to their “urgent care”; sat and waited for 1 hr and 45 min. (I, in the meantime, was going through all of our paperwork and insurance coverage, and was on the phone with her pediatrician, and located the nearest real HOSPITAL ER-5 miles away from her college). I was also trying to find a flight.</p>

<p>The school clinic Rx’d “tylenol” and told her to “rest”. I told her that with a fever, that would not go away with tylenol for 2 weeks, she needed to go to the ER. She insisted she was too sick to drive, but I told her she had to get there and I sent her the scanned paperwork from our pediatrician, as well as the insurance company forms. </p>

<p>DD arrived at Hospital ER with insurance approvals in hand and they immediately took her vitals and admitted her to the hospital! She said she did not have to pay a penny! Dr. B’s wonderful pediatric staff had faxed her records to the hospital, (in case she had lost the initial paperwork) as well as pre-approvals from the insurance company. They had also provided the hospital staff with Dr. B’s pager number and cell number! The hospital staff knew she was a student and worked well with Dr. B.</p>

<p>Now, here’s what happened at home. When I went to the CVS pharmacist to pick up my RX, I casually mentioned DD’s situation in NY. He asked, why she initially hadn’t initially gone to a public clinic like CVS? I told him I didn’t know they could diagnose pneumonia; he said he wasn’t sure, so he sent me to their mini-clinic-2 feet away. The NP there said she would have recognized the symptoms and given DD a referral. I asked the NP about the insurance issues and she said that our current insurance would cover DD at the CVS mini-clinic. </p>

<p>About 2 months later, the DD had another medical issue and she called me saying she needed to see a physician on the weekend! Before jumping through hoops again, I told her to go to the CVS clinic and pay $40, to see if they could help. She complained that she didn’t think they knew enough, but I told her it was close by, and, if they could rule out minor issues then, why not? She called me less than an hour later saying she had just returned from CVS. (She had taken all her medical records from the previous ER visit.) She was seen and had a 5 minute wait for her prescription. Our insurance had covered her visit as well as her meds!</p>

<p>From then on, while she was at school, whenever she needed to be seen for a medical concern, she walked over to CVS and never had a wait, got her meds, and returned to her dorm. When she came home in the summers, she had her annuals with Dr. B.</p>

<p>So, this is what worked for us and could be an option for you. But I need to caution you that dd does not have a complicated or chronic medical history-no allergies, no diseases, no fractures, etc. So you do have to consider your son’s medical history, if you plan on taking this route.</p>

<p>Oh, I forgot to add, when our family needs to be seen for a semi-emergency, instead of driving 20 minutes and waiting 2 hours to be seen by the medical group’s urgent care staff, we go to the CVS (5 minutes from our house) mini-clinic. If it’s something more serious, they give us a referral letter and send us to the appropriate hospital.</p>

<p>Our kids have chronic medical issues. When they were admitted I had long chats with the school and they advised us to arrive on campus early with each child and have each seen by a few MDs at the med school, so they could get any needed care more extensive than the health center could offer. We took their advice. S fortunately never needed any medical care. D on the other hand did and we were glad we had set things up and established contact with the med school. The specialist in her condition took her under his wing and helped keep her healthy enough that she could complete her coursework this past term and graduate. </p>

<p>Our insurer continues to keep both our kids on the family plan until they turn 26, at no additional charge. As long as they see participating and preferred providers, costs are comparable to them getting care in HI. S won’t get his own insurance until he turns 26 and is forced to obtain his own policy, which employer will pay 67-75% of premiums.</p>

<p>The way my insurance works, the primary physician must be in network and has a $15 co-pay. Urgent care has a $25 co-pay, but does not need to be in network. I try to stay in network anyway to make billing easier, but the insurance company realizes urgent issues occur on evenings and weekends or when you are traveling. The Walgreens clinics are actually considered in network for me. I would suggest checking how your insurance handles these options before going to a new primary physician 20 miles away.</p>

<p>Along the same lines, I was going to say to check and see if minute clinics, Doctors Care, or other walk in clinics would be covered. The other benefit to these, if covered or not too expensive, is that may have longer hours than college clinic. Really varies. D at small LAC has 24 hour access to student health and it is excellent and we don’t pay a dime extra except for drugs. D2 at state univ has a co-pay every time and is not even open on weekends.</p>