Medical Insurance

<p>D has always been covered under DH's policy with Blue Cross of California. She'll be going to school in Indiana. Is Blue Cross going to cover her in another state? OTOH, will the school's plan cover her when she's home at Christmas? Will we have to get her a 3-month Blue Cross policy every summer? (I shudder to think what that would cost.)</p>

<p>I understand that I'm going to have to speak with both Blue Cross and her school to get specifics but before I do, I want to get the lay of the land. What has been your experience with this? Thanks!</p>

<p>You have to read the terms of DH’s policy to know what is & is not included. In general, if it’s a BCBS PPO plan, there is coverage pretty much nationwide (that’s what we have). The age limits & whether the student must be full-time to be covered also varies by policy (& sometimes by state law). </p>

<p>My hubby is a federal employee & both kids are covered until they turn 22 (or get married), no matter what state they’re in under the PPO BCBS plan, even tho the policy was issued in HI. They are covered at school, when they travel and when they’re home. We’ve gotten care in CO, CA, NY & also where the polcy was issued in HI.</p>

<p>My sister has a policy which covers her kids until they turned 25. I know of others whose policy requires the child to be a full-time student during the school year or there is no coverage. Some policies only cover children until they turn 18. Most policies stop covering kids once they get married.</p>

<p>School policies vary and you should read those terms as well. The policy my kids’ school offer allows you to get medical attention during breaks at wherever the student is rather than sticking with docs associated with the U. Our kids’ U also allows you to waive out if you provide proof that the student has coverage that meets of exceeds their requirements. We’ve opted out every year so far but will get coverage for S this fall, for his senior year since he’ll be turning 22 & losing coverage under hubby’s policy.</p>

<p>The policy we have is a BCBS PPO and I’ve already contacted the Benefits Department through my husband’s employer to check on coverage. I was told that for emergency care my daughter is covered under the terms of our policy, and for ‘regular’ type visits all she needs to do is see a doctor within the PPO network…and its pretty extensive.</p>

<p>I’ve already compiled a list of local doctors in a group that are in the plan for her, easy enough for her to get to, and will contact the office this summer to ask about any special procedures or information she will need to have, just in case.</p>

<p>I strongly suggest you contact the benefits department of your husband’s employer to get the information directly from them, as what the previous poster said…much depends on the contract the employer has.</p>

<p>We have a local HMO. All of our three went to school out of area. No chronic health problems, save one on ADHD meds, and all routine care was arranged for break times. The plan covers emergency care while out of area, that and the school health center are all we used.</p>

<p>Thank you for your responses. I will contact Blue Cross to check. DH doesn’t have a benefits administrator or department; the business is too small – 4 employees, and it’s an individual plan which his company pays for. That’s one reason I wanted to ask you all about this, to know what questions to ask. I don’t trust Blue Cross to tell me what I need to know unless I specifically ask, and even then… </p>

<p>Has anyone ever taken the school’s medical plan? If so, does that cover the student year-round, or only when school is in session?</p>

<p>My father has Blue Cross (well, it’s Anthem in CT, but the same big Anthem BCBS company) and he had to fill out a form for away from home care. Then, I am essentially given MA BCBS coverage. Without the form, I would be able to get MA coverage, but it would be considered out of network, and might have fewer providers. I don’t know if it’s a state-by-state thing, but ask if they have an away-from-home policy for students in another state.</p>

<p>My kids’ USoCal plan covers the dates they tell you – for fall, it’s mid-Aug thru mid-Jan, for spring it’s mid-Jan thru mid-Aug (it costs more since it also covers summer). For those who need it, they also offer GAP coverage (after the kid gets a degree & before they get own insurance. It costs more since its like COBRA (about $400/mo instaad of the about $1000-12000/year for the student group plan). </p>

<p>The good thing about the plan is that there is no pre-existing condition exclusion & it has pretty broad coverage, tho there is a deductible.
One bad thing I read about the plan is that it requires the insured (or family) to do the paperwork to get reimbursement because the student health center isn’t geared up to do that (tho you can call the insurer & they will provide help to get you thru the process). I believe if you see providers off campus, most will do the paperwork for you, but I believe you need a referral if it’s when school is in sessoin.</p>

<p>BlueCrossBlueShield told me my son was covered out-of-state while at school with no extra arrangements necessary. (Our BCBS plan is also an individual one that we pay for.) My son did, however, take the school’s insurance coverage because it’s much better than our ****-poor BCBS plan. The school did not consider our plan as comparable to theirs. In his case, the school insurance is good for the full-calander year, including when he’s home during summer. That will vary by school though. At my daughter’s school the college insurance plan is not good outside of the academic year.</p>

<p>You’ll just have to check the specifics with your private health plan and the school’s. In my son’s case the college’s coverage is better and the cost is less than any comparable private insurance I could buy… assuming I had the money to buy it, which I don’t.</p>

<p>we are also Individual plan-holders - very expensive with a massive $5000 deductible per person.
In our case it made much more sense to purchase the school plan. It was a good $1200 cheaper PLUS no deductible, just a minor co-pay for some things. It covers him for one full year from about the time of when school begins. Check with your school’s policy. They are often not auto-renewable and make sure they will continue coverage past the end date if the child is under medical care for a condition. Of they are under treatment or now have a medical condition, you may not be able to get your child back on your own policy</p>

<p>In generally, under HIPPA laws, if an individual has had no lapse in coverage, they should not have problems with pre-existing conditions, but it’s very important to check before making any assumptions as the insurance business tries its best to deny coverage whenever possible, especially for expensive medical conditions and treatments.</p>

<p>right - which is why I checked and found out S could not automatically be added back on once he was taken off.
I can’t stress enough to talk to your individual plan providers to see what is best for you</p>

<p>Just in case this info is helpful to others, here’s how this resolved.</p>

<p>Anthem Blue Cross told me that D will continue to be covered at school under DH’s policy. They faxed me a list of primary care providers near her school, and are sending a “Blue Card” for her to carry, which apparently is valid at all Blue Cross providers nationwide. Since I don’t trust Blue Cross further than I can throw them, I confirmed all of this with our broker.</p>

<p>LasMa-another Anthem Blue Cross of Ca customer with an individual PPO plan. My D has had no problem getting health care in two other states. To find providers we go on the Blue Cross website of the other state and search providers. One thing that was frustrating is that my D saw someone who was not a preferred provider. We had to submit the claim to BC of the other state. We kept getting letters from BC of Ca that we needed to submit to the other state which we were doing. While following up was difficult since BC of Ca was no help since they can not access the info for the other state. When we contact the other state BC they had a hard time finding the claim information since we had a Ca BC id number. We finally reached someone helpful but it took months. When my D has any medical care provided by a PPO provider in her away state it has been hassle free. She has never been asked to provide any form of payment. They process with BC of Florida and we get the same EOB forms. The unpaid portion gets billed to us. An important thing to remind your child is to provide the home address as the billing address unless the child is going to pay the uncovered portion.</p>

<p>We also have Anthem BC/BS. Our kids both attended college out of state. We had to fill out a form annually letting them know that they were still students anyway (to maintain their coverage) and this showed Anthem WHERE they were going to school. All they needed to do was find a provider in THEIR college state that was an Anthem provider. In addition, they could either call or go online to find a provider. BOTH kids used their coverage in their college states!</p>

<p>Our policy is with Blue Cross Anthem of Ca and in 4 yrs have not had to verify school enrollment or let them know she is in school outside of Ca. Son in Ca has also never been asked to verify school enrollment. Our agent also told us that BC of Ca now will cover them till 25 regardless of student status.
Also I would go online to the BC of her college state to get the most update list of preferred providers. I would not go off a list provided by BC of Ca. The list could be out of date. Online would be the most current.</p>

<p>We have Cigna and although D goes to school out of state, it covers her at school. Fortunately there are many providers in-network where she is. We opted out of the school insurance plan, but she can still use the school health center without cost for basic needs. The school has the list on their health center web site of what’s free even with no school insurance. She’s used it with no problem. Worth checking into at your D’s school.</p>

<p>Thank you, LasMa, for starting this thread! This is something I didn’t even think of! (calling ins co to check son’s coverage, now that he’ll be out of state).</p>

<p>That’s on my list for Monday, in addition to calling our homeowners insurance to check deductible and see if it’s worth putting $2500 laptop on it.</p>

<p>Great info, here…</p>

<p>When I researched DS health insurance when he became ineligible for our employer’s group health (family plan with one child) I discovered that, we would have been better off to have started on his own health insurance as a freshman in college. By looking at the rates, one easily discovers that the family plan “predicts” coverage for multiple children. </p>

<p>As I researched more I discovered that private health insurance varies from state to state and region to region. IOW, a child with insurance in his home state may be reimbursed at a lower rate because the child is going to outofnetwork medical work. Whereas, if you enroll child in the state where he attends school, the reimbursement is infull. </p>

<p>Lastly, the cost of coverage is different in each state/region. My state’s coverage for DS was much higher than what he needed vs the state where he resided had lesser coverage but the cost and needs fitted him more closely. ie he didn’t need pregnancy coverage. </p>

<p>Our current system encourages choices, the problem is to understand your choices and how much you pay for it. We paid dearly.</p>

<p>A reminder to check your tuition bill which is probably arriving soon if it hasn’t already. Many schools automatically charge you for their health plan. You must opt out. If you aren’t paying close attention you might be paying for something you don’t need. Also remember to send in your waive and copy of card if required. At son’s school registration is blocked if they don’t have a copy of the insurance card on file.
Also as health insurance premiums are constantly rising many people are switching to high deductible plans. Make sure you check with the college to find out what the min. requirements are. I know several people who switched and found that the college now required them to purchase the school insurance. There went any savings.</p>

<p>I just wanted to add that we’ve had 3 go through college and have not had any problems getting reimbursed through Blue Cross. Our only problem was getting the paperwork from our sons so we could submit the forms. </p>

<p>S4 will be going this fall with double coverage, so we already waived the school insurance online.</p>