<p>Just found a Facebook page: <a href=“UCSB parents page”>https://www.facebook.com/UCSBparents</a> I am seeing many parents are complaining about this. One parents even opened a case “with the California Department of Insurance, the California Department of Managed Care as well as with Kaiser Permanente. The encouraging news is that the CA Dept. of Insurance has taken this matter under investigation. Case # 6949551. Case Officer: Ms.Dhru, Tel: 213-346-6569, Email: <a href="mailto:Dhruva@insurance.ca.gov”>Dhruva@insurance.ca.gov</a>." Good the fight is on.</p>
<p>I’m reviving this thread because I’ve started to focus on this and my head is spinning. I’m hoping someone can answer some of my questions.</p>
<p>My daughter goes to a UC in another part of California from where we live. We did not waive UC SHIP (UC Student Health Insurance Program). I’m now changing jobs and trying to figure out my healthcare options. I’d like to switch to an HMO (let’s say Kaiser for sake of argument). Since my daughter is covered by UC SHIP, I shouldn’t ALSO have to enroll her in an HMO through my employer, too, right? After all, UC SHIP is supposed to be comprehensive medical coverage. </p>
<p>HOWEVER, I haven’t been able to obtain satisfactory answers to the following questions:</p>
<ol>
<li><p>What if a student falls seriously ill while covered by UC SHIP and has to come home? For example, (God forbid) the student comes down with cancer. Will UC SHIP cover treatment in the student’s home town? The student obviously cannot continue to reside in student housing while undergoing treatment for cancer. But will treatment near the student’s home be covered?</p></li>
<li><p>What if a student becomes seriously ill and has to withdraw from school or has to take a leave of absence? Will the student be eligible to continue coverage to allow for uninterrupted care? This is of particular concern because if the parent did not enroll the student during the parent’s employer’s open enrollment period, the parent will not be able to enroll the student until (perhaps) months later.</p></li>
<li><p>The coverage is supposed to continue through summer. But all initial treatment has to happen at the university’s student health center at the student’s home campus. What if the student needs non-emergency medical care in the summer, say for strep throat or something. Does the student have to somehow make it to the student health center at the students campus to obtain care or get referred to a specialist? Not going to happen.</p></li>
<li><p>Do all of these factors essentially mandate that the parents have continue to pay for coverage for the student in the student’s home town IN ADDITION TO the UC SHIP coverage? If so, this is the world’s most expensive insurance. I think the mere fact that a seriously ill student WOULD NOT BE ABLE TO CONTINUE TO LIVE IN STUDENT HOUSING DURING TREATMENT FOR A SERIOUS ILLNESS makes this coverage illusory for many students. If the student’s primary residence is not in the coverage area, a serious illness would essentially require the student to move outside the coverage area and to seek non-covered treatment. </p></li>
</ol>
<p>I really hope that this is addressed in the policy, but I haven’t been able to figure this out. Does anyone know for certain what would happen in these situations? </p>
<p>I think you would be able to add her to your insurance if she had to drop out of school and lost her coverage (if she was still under 26) because it is a ‘life event’, which includes loss of insurance to another family member. For example, if spouses each have insurance through their employer and one loses a job, that spouse can be added outside the annual open enrollment period. I think the university insurance is good all over California though.</p>
<p>Is she your only dependent? Does it cost you more to add her to your policy? If she has double coverage, the insurers will coordinate coverage and it may cost you less for co-pays, etc.</p>
<p>Thanks for the helpful response. She’s my only dependent and adding her to my employer-provided policy would nearly triple the cost of my insurance because the employer subsidizes the employee but employees pay full cost for dependents.</p>
<p>If the university policy covered non-emergency services throughout California, that would allay my concerns. However, I’ve seen nothing that suggests that’s true. What’s the source for your conclusion that the UC SHIP policy would cover such services?</p>
<p>@nottelling</p>
<p>Start at <a href=“http://www.ucop.edu/ucship/”>http://www.ucop.edu/ucship/</a> and follow the links to the campus. Dig around for the documentation on out-of-area coverage. Example, for Davis, <a href=“http://shcs.ucdavis.edu/pdf/OrientationBooklet.pdf”>http://shcs.ucdavis.edu/pdf/OrientationBooklet.pdf</a> (pages 14 and 15) says that, away from the Davis area, covered students need to call for a referral before using non-emergency medical services.</p>
<p>Thanks ucbalumnus for that research. Looks like my concerns shouldn’t be a problem; only real potential problem is that it appears that a physician at the student health center has to be the primary care physician. But it appears that the physicians can make referrals by phone and make referrals throughout the state. It also appears that all the UC medical centers will be in-network for all students. So it should be okay to have this be the only coverage for the student, allowing me to drop her from my employer-provided plan.</p>
<p>If there is anyone out there whose student had to use UC SHIP for care beyond routine services – especially if your student had to receive non-emergency care outside the university’s immediate area, I would love to hear about your experience. Feel free to PM if you are not comfortable sharing more publicly.</p>
<p>It seems to me that any University requiring this should be required to disclose any compensation they receive particular insurer they are directing business to.</p>
<p>I believe the UC system claims they are receiving no compensation from the insurers and that the insurance is being offered to students at cost (or, for some students, subsidized through financial aid).</p>
<p>After studying the details, I think the plan offered by my daughter’s school is pretty good.</p>
<p>The issue raised by this thread is not UCSB specific – it can apply to any college where the selection of nearby medical providers is limited. Parent expecting to keep their kids on their family insurance plan need to check to see whether covered medical providers are conveniently available to students at the college. Checking before deciding what college to attend is essential if the added cost of a separate student medical insurance policy would influence that decision.</p>
<p>^^exactly. A few months ago, there was a thread in the Parents Cafe regarding health insurance, and a family in Santa Cruz was sending their child to UC Davis. But the family was enrolled in the state new health plan under the Affordable Care Act and their providers were only available locally, not in Davis.</p>
<p>Of course, those enrolled in HMO’s have experienced such out-of-network issues for a long, long time, when their child goes away to college, particularly out of state. Limited coverage is one of the downsides of an HMO.</p>
<p>PPOs, the common alternative to HMOs in employer provided medical insurance plans, also have coverage networks and limitations to watch. While there is some coverage for out-of-network providers, the cost to the patient can be significantly more expensive, especially since such out-of-network providers do not have an agreement to charge a specific discounted price like an in-network provider would have.</p>
<p>Users of Kaiser HMOs may not have had to deal with coverage networks as much, since it is relatively simple to determine which providers are covered (i.e. are they based in a Kaiser facility?).</p>
<p>The issue is particularly irksome for UCSB students because the committee that decided maximum radius for acceptable coverage appears to have intentionally jiggered the numbers to exclude Kaiser as an option. No justification for this change (from 40 miles in past years to the new 30 mile limit) has been provided outside of vaguely worded references to students with inadequate care. Where’s the data?</p>
<p>Apparently, students with Kaiser insurance are now having success in waiving the campus insurance. The procedure has been spelled out in several places, including the UCSB Reddit thread and the UCSB parents Facebook page. </p>
<p>Let’s hope that they know the implications of needing to travel to Ventura 40 miles away for non-emergency medical care. I.e. they should not be complaining later about how no one in the UCSB area will accept their Kaiser cards and how much of a hassle it is to get to the Kaiser in Ventura.</p>
<p>I haven’t looked up the rules for UCSB specifically, but I believe for a nominal charge ($90 a quarter?) students can get full coverage for services provided at the on-campus health center. That, plus emergency care, will greatly reduce the need to travel to Ventura for care. Many students will travel home for non-emergency care too complicated for the student health center.</p>
<p>Any student can use the campus health service. Those without campus insurance pay $50 for an office visit with a doctor, $30 for a visit with a nurse. Other fees are similarly reasonable (urinalysis & culture: $22-$35; strep test: $27; pregnancy test: $20; blood count $36). You’d have to visit a doctor 17 times each quarter before reaching the cost of the insurance premium. The insurance coverage comes with lots of strings attached, since the Student Health Center is the gatekeeper for all referrals to outside healthcare. They operate with limited hours (8-4:30) on weekdays, closed on weekends and holidays. Insured students must call a toll free number if they fall ill outside of Student Health opening times and obtain permission to visit an off campus provider. Co-pay for urgent care off campus is $50. They provide the phone number of Yellow Cab for transportation to off campus medical facilities with the footnote that your cab fare can be conveniently added to your billing account. </p>
<p>True, at certain times of day the drive to Ventura can take close to an hour. However it isn’t hard to time the trip to avoid traffic. Even with the oil platforms it is one of the most beautiful 40 mile drives in the country, and the freeway widening is almost finished. But the point is that the majority of students can get care for their most common ailments right on campus for a fraction of the insurance premium cost. On weekends they can visit an off campus urgent care facility without having to make phone calls and request referrals. Urgent care walk ins probably run about $100, $50 more than the co-pay Aetna charges. If the issue is deemed an emergency, then Kaiser coverage kicks in. </p>
<p>The decision whether to accept the “risk” of having the nearest provider in Ventura should be made by individuals, not a committee comprised of students staff and faculty.</p>
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<p>Agree in principle. However, I would not be surprised if the SHC got tired of telling numerous students that their Kaiser cards are not accepted there, or anywhere nearby, and that an office visit costs $50 or whatever.</p>
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<p>I have a “gold” type insurance plan, and I wish those where my cost…</p>
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<p>What!?! Don’t you know that all decisions must be made by a committee comprised of students, staff and faculty! Everything from students health care options to US foreign policy! </p>