Healthcare at Yale -- waive hospitalization / specialty coverage?

<p>It seems to be a no-brainer that one should waive Yale's Hospitalization/Specialty Care coverage if one has a family medical plan that covers the student. However, maybe I'm wrong. Has anyone found a reason to purchase the Yale insurance if the existing family coverage premiums would not be reduced (i.e., he is not the only child on the policy). </p>

<p>Just in case the answer is dependent on specifics, we have a BC/BS high deductible policy for the family (and use the HSA account as a stealth IRA). Because of some expensive medication, we always max out the in-network out-of-pocket, making all additional care and medicine "free."</p>

<p>My questions are:
1. Have any of you found a reason not to waive if you have existing medical coverage?
2. Have any of you encountered difficulties having expenses at Yale covered by your family medical insurance?
3. Slightly different topic, but how has your (or kids') experience of medical care at Yale been in general?</p>

<p>I will not be much help because D has very limited need for health coverage to this point.</p>

<ol>
<li>No</li>
<li>NA. Only two visits to Yale Health. Both were covered under the Basic Coverage which is free of charge to all students.</li>
<li>Good, but very minor issue to address.</li>
</ol>

<p>I think if a student has major medical needs it would have to be looked into in depth, especially if a specialist is required on a regular basis.</p>

<p>Thanks, musicmerit. I should have been more clear. DS has no major medical needs, it is his parents who have chronic, well-treated, but expensive medical situations. DS has an annual physical because schools require them, flu shots, etc., but is generally a low-end consumer of medical care.</p>

<p>My daughter’s a senior and we have waived each year (also have BC/BS). But we’ve not really tested the system. She needed stitches freshman year, but that was treated at Yale Health no charge. She’s gotten flu shots at Yale Health free of charge. But aside from that I don’t believe she’s required any care at all while in NH. She does her physicals when she comes home. But given that the Yale policy was something like $2000 (as I recall) and we wouldn’t drop her off the other coverage, since we’d want her to be covered at home with her regular doctors, that seemed like a lot of room for paying any extras that did happen to come up.</p>

<p>Please clarify for me…</p>

<p>If DD has health insurance, she doesn’t need the Yale Health Plan?? We live in NHV and she can get to her doctor without any difficulty. </p>

<p>How much is the Yale Health Plan? I don’t believe the form stated that anywhere. </p>

<p>Thank you! </p>

<p>Certainly if you live in NHV and have health coverage for her, the Yale Health Plan would be crazy. As for rates this seems to be it: <a href=“http://yalehealth.yale.edu/student-rates”>http://yalehealth.yale.edu/student-rates&lt;/a&gt;&lt;/p&gt;

<p>Thank you! I wasn’t sure & had planned on calling them tomorrow to ask! </p>

<p>@NewHavenCTmom - Mostly they want to be sure everyone has coverage. You have it, so you give them proof that she is covered and it is waived. No $2000 charge. Absolutely no reason for you to get it. I would think someone who is a flight away and has complicated medical needs may want to consider it. But for a generally healthy student or a local student, I see no reason to get it. The Basic Coverage that is free to all students actually covers a lot. Your D could stay on campus and get basic treatment for free.</p>

<p>From the PDF file - Student Guide 2014 - found by googling Yale Health Basic Coverage:</p>

<p>Every student is covered at no charge for these
services, even if you waive Yale Health coverage:
Acute Care
Gynecology
Health Education Programs
Inpatient Care
Laboratory Services
Mental Health & Counseling
Nutrition Counseling
Student Health
This includes the following:
Physical exams
Gynecological exams
Pap smears
Flu shots</p>

<p>And a bit more detail on this website. Your D may want to use the after hours care on campus instead of going off campus for care. Free of charge to all students.
<a href=“http://yalecollege.yale.edu/content/yale-health-plan-1”>http://yalecollege.yale.edu/content/yale-health-plan-1&lt;/a&gt;&lt;/p&gt;

<p>All students enrolled at least half time in a Yale degree program are provided with Basic Coverage at Yale Health Plan (YHP), located at 55 Lock Street. Yale Health Plan Basic Coverage includes the following services at no charge:</p>

<p>Primary care through the Student Medicine department, including routine, ongoing, and wellness care as well as same-day care to accommodate immediate health issues. Services of specialty physicians are not covered unless you purchase YHP Hospitalization/Specialty Care (see below)
Gynecology services, including annual exams and Pap smears
Preventive medicine services, such as routine eye exams and flu shots
Laboratory services
Access to care after hours and on weekends and holidays through the Acute and After Hours Care department
Mental health services
Nutritional counseling
Use of the Transitional Care Unit (Infirmary)</p>

<p>For the past three years we have waived coverage for my son. Although we have run into some minor issues (more on that below), we are waiving coverage for his senior year, as we are covered by Blue Cross/Blue Shield with prescription coverage, so the Yale hospitalization/specialty coverage is duplicative and would act as secondary insurance.</p>

<p>Minor issues that Yale doesn’t tell you about when you waive the hospitalization /specialty coverage</p>

<p>-- The Yale pharmacy, which is located in the Student Health Center, is for the convenience of students who accept the hospitalization /specialty coverage (which also includes prescription coverage). The Yale pharmacy DOES NOT accept outside prescription plans, such as Medco/Express Scripts.</p>

<p>If you waive the hospitalization /specialty coverage, and your son or daughter goes to the Student Health Care Center and receives a prescription, they must go to another pharmacy in town, like Walgreens, to get that prescription filled. If they get the prescription filled at the Health Care Center, the non-discounted price of the drug will be added to your term bill. This happened to us freshman year and we ended up having to eat the $40.00 cost of the antibiotic my son had filled at the Yale Pharmacy, which was automatically added to our term bill.</p>

<p>-- If your student goes to the Health Care Center, and the staff decides they need to see a specialist, the staff DOES NOT inform the student that they are about to see a specialist and are not covered for the specialist (who sometimes is located just down the hall). Last year, my son went to the Student Healthcare Center, complaining of foot pain. The staff shuffled him off to the podiatrist (a specialist) and our term bill was billed about $260 for the cost. When we complained that my son never was told he was seeing a specialist and not covered, the response was, “Our staff does not check which students have accepted or waived the hospitalization /specialty coverage and students should know the difference between a generalist and a specialist.” </p>

<p>@gibby, when your son was billed for the podiatrist, did he get a standard bill (or whatever one calls a bill acceptable to an insurance company)?</p>

<p>^^ @ixnaybob: The cost of the specialist was added directly to our term bill with no explanation of costs or any paperwork given to our son. When we discovered the term bill charge, we called Yale Health and asked for an itemized statement, which they sent us. However, Yale Student Health Center, like the Pharmacy ** DOES NOT participate with any other insurance plan**, so Blue Cross/Blue Shield considered them an out of network provider and we were responsible for 100% of the charges. Bottom line: as our co-pay for an ER visit is $150, it would have been less expensive for my son to go to the Yale New Haven ER rather than to Yale Student Health Center for his foot pain.</p>

<p>If you have healthcare that covers you for the entire school year, is it wise to waive the Yale Health Plan for the entire year, or only waive for the fall, and then waive again in the Spring in case some change will happen?</p>

<p>I suppose you could waive it by the semester, but we’ve always waived it by the full year.</p>

<p>Okay great! I’m glad you guys have added your experiences here. It’s sad that they don’t accept BC/BS. Doesn’t make much sense to me. </p>

<p>We have Cigna and a HSA…I assume I don’t need to buy Yale coverage, right? My son is going this fall</p>

<p>Check with Cigna and a HSA. If your plan covers your son while he is away at school, then you don’t need Yale’s coverage.</p>

<p>@saona63, for us, I figure that having the insurance would be duplication, as Gibby said.

  1. He is unlikely to need a specialist (or hospitalization, heaven forbid)
  2. If he needs a specialist on a non-emergency basis, he can find one in network (or do whatever it is during a school break)
  3. Even if he gets a bill for out of network medical, there is a limit to how much out of pocket we would have to pay
  4. The odds of any of the above reaching $2000 in a year is small</p>

<p>Btw, it’s off-topic, but you mentioned an HSA. If you can afford to do so, I would not use it to pay current medical bills. Keep it for retirement; it’s a stealth super IRA if you keep your medical receipts. </p>

<p>

Yale Health is a very quirky system. My daughter, who is at Harvard, does not have the same issues, as Harvard’s Student Heath Center accepts outside insurance. </p>

<p>Most of the time, it doesn’t matter that Yale Health doesn’t take outside insurance, because most of the routine items are free (as noted above). I think it’s important that you explain the details to your student.</p>

I know this thread is from last year but I’m finding it helpful, and based on what I’m hearing from Yale Health now the information above still seems current.

I was all set to waive coverage for my daughter as we have insurance that’s good and much cheaper than Yale’s and even includes Yale New Haven Health in network, but am thinking it through a bit more now.

It seems that Yale Health (for hospitalization and specialty) is an HMO that is only in-network for students on the Yale insurance. It’s totally separate from Yale New Haven Health. Confusing to me but seems to be true. I believe that’s why the kind of issues that gibby mentioned come up when there’s a need for specialty care.

Has anyone had experience using the Yale insurance off campus? That’s one reason I was planning to waive coverage and keep our current insurance, which I know works well across the US and also includes coverage overseas . . . at this point that’s a complete unknown to me for the Yale insurance.