Waive health insurance?

<p>I just got off the phone with my insurance company and my son would only be covered for emergency services outside of our area, including mental health, plus any followup that would be deemed urgent. The nearest PCP and hospital that takes our insurance is 26 miles away from his college.</p>

<p>Do you think this is sufficient coverage? He does not have any serious chronic conditions, and only uses prescription allergy medication and carries an inhaler although he hasn't used it in years. Both of which I can fill and send to him.</p>

<p>What, precisely, would constitute an “emergency” for your insurance company? Is a visit to an urgent care facility for the flu/stomach bug/scraped knee/etc. included, or would something that simple require a visit to the ER of a hospital?</p>

<p>Is he moving to a different part of the country where he might encounter new, unexpected allergens, thus necessitating consultation for the allergies?</p>

<p>Can your insurance provider offer a rider that will cover your son for more stuff, that would cost less than the college insurance?</p>

<p>Does the college consider that your insurance is sufficient? Some have minimum requirements for waiving health insurance.</p>

<p>This is a tricky situation. Trust me when I say that it is extremely common for freshman (and sophomore) students to get sick more often than when they were in HS. They’re packed into dorms like sardines. Mono and strep are everywhere. While they seem like minor illnesses, they can become complicated very quickly—especially when they’re not in an environment conducive to recuperation. Don’t forget about sprained/broken bones, stitches, flu, food poisoning, etc.</p>

<p>If you can afford the insurance, I would get it. The peace of mind is worth it—especially when they’re college is far away. If you can’t afford it, all you can do is hope that all goes well.</p>

<p>I don’t want to be penny wise and pound foolish. He would be covered for any emergency room visits. He would also have access to the campus clinic of course. He is only 3 hours away from home with similar climate, and 25 miles from the nearest town where he could be seen without restrictions. He has only missed one day of school in the last 7 years, but I agree he will probably get sick much more often.</p>

<p>My insurance company’s website seems to be down at the moment so I think I’ll go through the benefit coordinator. I guess if he needs any services that could not be provided by the campus clinic or that would be considered an emergency we would have a problem. It is making me uncomfortable, so maybe that is my answer.</p>

<p>Suppose an emergency visit (something like - broken bone, sprain, etc.) turns into the need to see an orthopedic a few times over the course of the injury - you would be in a bind. I think you have to get the health insurance. College kids also get things like mono etc. which are probably not ER worthy and may be too much for the on-campus clinic.</p>

<p>Call your insurance company to make sure he will be covered at the college health center if he shows up there for treatment for a bad case of the flu, or even a mental health issue. But you should also call the college he’ll be attending to ask what their minimum insurance requirements are. I know my D’s school requires a certain level of coverage or you automatically have to sign up for their insurance. It may actually be cheaper to take the college insurance than to increase yours.</p>

<p>Oh, and happymom makes a great point about allergies in different parts of the country. We live in MA, and my son doesn’t suffer much from asthma anymore when we’re here, but when we visit my family in Seattle, he always needs an inhaler.</p>

<p>Another thing to look into is if the school has a requirement that there’s a primary care physician within a certain distance of the school. My school had that requirement, and I didn’t know that until my waiver was denied.</p>

<p>Thanks for all the good points. So I will make a list of things to ask the insurance company and the college. </p>

<p>I think we will probably end up taking the coverage, it will just take a couple of hours (or days) to digest the fact that we have to cough up even more money than expected.</p>

<p>We wound up buying the college’s health insurance because our D was going to be a 3 hour plane ride from coverage. So far it’s a waste of $$. D had to go to an ER once which was paid by our insurance emergency benefit. Her follow up care and other small stuff has been at the college clinic for free which I think (but am not sure) she could have used even without the insurance.</p>

<p>I think if my kid were only three hours or 25 miles from coverage I wouldn’t buy the additional coverage. Your emergency benefit should cover most things, and if he needs follow-up care, then he takes a taxi the 25 miles or comes home.</p>

<p>Our insurance is similar. When our D went across country for college, we broke down and bought the insurance offered by the school. It paid off as she ended up getting really sick her first semester - finally hospitalized over night. Later she had several X-rays and lots of physical therapy for a knee issue and it was all covered. Our son is going 3 hours away and we went back and forth. Fortunately his school offers a “mini” plan that covers very basic services for only $50 a semester. If he has anything big, we will have to bring him back home. I am guessing it will be less than buying the insurance even if we have to pay some out of pocket expenses at school. It kind of depends on how far away he will be. A lot of kids seem to get sick more often that 1st semester away-probably being exposed to so much in the dorms. You might check how much a standard appt. would cost without insurance.</p>

<p>Similar to a lot of the responses, we did not buy the college insurance for our 2 kids who were a 4 hour drive away. Our HMO only covers emergency care out of area, but each of those kids’ colleges has a clinic for sore throats, etc, routine illness. Oldest D only used her school clinic once in 4 years for a sore throat. Son has not visited his school clinic yet in 2 years. If they had an emergency that needed my help I could drive there. However, youngest D is going across the country and I feel better buying her school’s insurance.</p>

<p>Also be certain that the school’s insurance will cover him during the summer breaks. That may not always be the case, and you’ll need to figure out what to do in that case. Insurance is always sort of a gamble. We hope no one needs it but when it is needed, it’s pretty important for it to be very easily navigated.</p>

<p>if your company offers an open PPO with local hospital coverage, you might consider the costs of switching for next year.</p>

<p>This is a timely question for us. We bought the school plan for daughter’s first year, but the rates are doubling this year to more than $800 per quarter. She visited the health center several times (at my urging) when she had symptoms of strep throat during her first year. They did some sort of quick test and told her it was negative for strep, gave her a Tylenol and sent her on her way. Kids who don’t buy in to the plan pay $50 for a doctor visit and $20-$45 for most lab tests at the same facility. So she would need to make more than 8 visits per quarter for the plan to be cost effective. The plan also covers dental and vision, which duplicates our existing coverage. Emergency care is covered by our family plan. We’re going to opt out this year and hope for the best.</p>

<p>My husband is more annoyed than I am. He is going to talk to the plan administrator and see if we can " buy up" on our plan, I don’t know if that is even possible. His employer also has locations elsewhere in the country so maybe we could get into one of those plans instead. They just switched insurance plans last year, and with our old one there would have been no problem.</p>

<p>Agree to check college clinic policy. My D at small LAC doesn’t pay anything for visit to student health center except for prescriptions (and flu shot). She had to be referred to orthopedist in town after a fall and that’s the only time we used our insurance. OTOH, our second D at large university pays for health center the same as doctor - $20 copay. Not sure if that’s a flat rate for students or specific to our health insurance.</p>

<p>DD is an hour away so our insurance qualified for the LAC waiver (teacher’s Cadillac plan). She used the on campus clinic a lot: caught many respiratory viruses, had an eye infection, worms, intestinal issues. The clinic staff knew her by name when she walked in. While she missed a day or two per year in HS, she managed to catch a lot of illnesses in school. Visits were $0-25, some were billed to our insurance. It was a lot easier for her to visit the clinic or an urgent care than for us to try to coordinate a visit to the MD at home.</p>

<p>My son goes to school in Houston and we live in Northern California. We have an HMO so he is only covered in Ca or for emergencies. I waived the schools health insurance. He just finished his second year. As fate would have it, two weeks before school was out last year he broke his leg in half on a trampoline accident. Our insurance covered everything from the hospital costs, to the surgery, to the follow up visits. The only thing we had to pay was $250 co pay for the ambulance ride. He has used the health clinic on campus for everything else. They actually staff 2 internists, 1 family practitioner, and a couple of PA. So it probably depends on the school. But I am really happy that I haven’t paid the $2000 for the schools coverage! And of course when he flew home after school was out he followed up with a surgeon in our area and then again when he came home for Winter break. But everything worked out fine. Our insurance covers prescriptions anywhere in the US.</p>

<p>If I only lived a few hours away and a covered doc is only 26 miles (1/2 hour) away and ER treatment is covered, doubt I’d buy extra coverage for student. </p>

<p>I’m risk averse. Since my policy only covered S until he turned 22, we had to get him coverage ( tho fortunately never used any benefits). Also bought S private insurance once the school policy ended (summer after graduation). Luckily for us, that January 1, our insurer moved the maximum age for family coverage up to 26!</p>

<p>We have decided to get the coverage. I don’t feel comfortable with worrying about how he would get back and forth, at least during freshman year. Once he has a car, it would be feasible for him to travel farther for routine medical care.</p>

<p>We are just unpleasantly surprised that our insurance that we pay so much for is not adequate. My husband’s employer has assured us that out of network coverage will be one of the items they look at next year when deciding which insurance plan to go with.</p>

<p>Also, they make it clear on the school’s website that the waiver will only be approved if the student can receive routine and outpatient care in town. Not sure how they feel they can force that on anyone, but it is what it is. From what I have found online, their price is not the worst ~ $820.</p>