Is it worth the price you pay?

University at Buffalo undergraduates, as well as most 18-25 year olds nationwide, are not known as the best planners in the world. Many college students take for granted the assurance that medical insurance provides until disaster strikes. Fortunately, the State University of New York (SUNY) school system has taken a proactive approach to the problem of uninsured students. In 1976, the SUNY system collaboratively enacted a mandate requiring all full-time students to have medical insurance.

Sub-Board I, subsidized by your student activity fee, pays for all of the accounting and administrative costs associated with the student medical insurance program. The fee pays for staff members like Catherine Englehardt-Ellis, the Director of Medical Insurance Programming for UB.

“Our office [located in 116 Student Union] manages student medical insurance as a whole, including the subprograms associated with international students and study abroad,” said Engelhardt-Ellis. She also sits on the SUNY statewide international committee, a decision making body for the plan instituted for international students’ medical insurance. “If there’s a way to fix anything health-related for a student, that’s what we do,” she said.

Student medical insurance is a mandatory-with-waiver program. Unless a student goes through the process to waive the annual premium for medical insurance, their account will be billed for SUNY insurance. If you are a full-time student who is still being covered by an outside insurance provider, such as your parent/legal guardian’s insurance or company insurance, there are steps and deadlines to this process.

According to UB’s Student Medical Insurance Plan, “All full-time domestic students are eligible to receive and automatically enrolled in the University at Buffalo Student Medical Insurance Plan unless a Waiver Form with proof of comparable coverage is returned to the Student Medical Insurance office by the applicable deadline.” In order to escape being held liable for student medical insurance for the fall semester, students would have had to file the paperwork by October 1, 2004. For the spring semester, the deadline is February 11, 2005.

In the late 1970s and early 1980s the Buffalo medical community was having a major problem with students walking out on their medical bills after receiving care. Engelhardt-Ellis says that “this created poor relations with local medical providers.” Therefore, when students were required to have insurance after the passage of the 1976 mandate, the medical community again began to open its arms to college students.

A Necessary Increase

Many UB students are unhappy with being automatically billed for the student medical insurance, especially after the cost of the insurance has increased from $935 last year to $1,214. According to the Office of Student Medical Insurance and Programming, the increase was a result of rising national health care costs and a need for increasing the amount of student coverage.

Last year, students were covered for a $25,000 maximum. This year, because of the need for increased coverage, all students now have a $50,000 maximum.

“Since 1996, we’ve seen two, then three, then four students exceed the maximum $25,000 coverage. In the last three years, we’ve seen those numbers increase to eight, ten, and then 15 students maxing out the plan’s coverage, and many more students coming close to doing so,” said Engelhardt-Ellis, explaining the need for increased maximum coverage.

“When you begin having significant numbers within a certain population maxing out coverage, you slow the premiums to claims being paid out ratio, and therefore need to re-evaluate the benefits,” Engelhardt-Ellis added. The aggregate maximum for UB’s plan is $50,000, which is the most money that will be paid out under the policy for all covered medical expenses incurred during the policy year, which runs from August 22, 2004 through August 22, 2005.

When asked what the reason was for this increase in students racking up medical bills in excess of $25,000 annually, Engelhardt-Ellis responded, “The student medical insurance programs costs are completely income offset. The increase in claims accounts for 95 percent of the increase.” The students who fully understand what their insurance covers take full advantage of their insurance.

A Look Around the State

UB’s is one of the few medical insurance programs that covers pre-existing conditions. SUNY Binghamton is one of a number of schools that does not. Offering one of the cheapest plans in SUNY, Binghamton’s medical insurance costs $710 annually. This price will cover students for up to $25,000, along with various other benefits like ambulance expenses. Along with the benefits, Binghamton’s medical insurance also has some exclusions. The exclusions range from coverage of injuries resulting from playing an interscholastic sport to any cosmetic surgery.

SUNY Albany, a school with a demographic similar to UB’s, offers the only medical insurance in the SUNY system that comes with a higher price tag. Charging students $1,320 annually, Albany covers up to $25,000 per condition. Unlike UB, Albany’s insurance program is voluntary but they do require international students to enroll in their plan.

Additional Services

One proof-positive way to tell if you’re getting a good bang for your buck, in terms of medical insurance, is if your policy will meet heightened immigration standards. The United States immigration program requires UB’s international students to have health insurance that meets or exceeds immigration standards. Luckily, these students have to look no further than their university plan to meet these standards.

According to literature on UB’s MEDEX program, an additional service that provides medical evacuation and repatriation coverage for those planning on studying abroad, “Medical evacuation benefits provide for the arrangement and payment of medical and travel expenses to the nearest appropriate facility, or return home, when seriously ill or injured. Repatriation benefits cover expenses related to the preparation and return of remains to the family in the event of death abroad.”

MEDEX coverage is included under the SUNY international insurance plan. One notable and highly unfortunate example of when MEDEX coverage was utilized was when Gregory Capasso, a former UB student, was killed on September 21, 1988, when Pan-Am flight 103 exploded over Lockerbie, Scotland. MEDEX covered all of the expenses associated with returning Capasso’s remains and recovered possessions to his family back here in New York. If you are a student who is covered by another form of insurance and are planning on studying abroad, it is possible to purchase the plan separately.

UB’s medical insurance is good all over the country. AETNA is a popular insurance group. In order to maximize your savings and reduce out of pocket expenditures, you’ll want to use an AETNA-preferred provider. For provider listings, including AETNA Pharmacy Management locations, you can use AETNA’s DocFind Service, on www.chickering.com and enter 100116 as your policy number. The student plan covers all injuries on- and off- campus. Any referrals made by Michael Hall will be to doctors who are a part of this plan. Also, the university provides reduced rates for dental and optical treatments.

UB Pharmacy

UB is one of the few SUNY universities that provides comprehensive primary care, urgent care, and limited special services, as well as a Clinical Lab and Pharmacy. To avoid the $10 co-pay associated with utilizing community providers, you should visit Michael Hall. There is no limit to the number of office visits. The health center is funded partly by the university’s comprehensive fee, so you may as well take full advantage of the establishments you pay for.

Sub-Board I provides drug coverage to students and those prescriptions filled at the pharmacy. The Sub-Board I pharmacy, located in the basement of Michael Hall (open Monday-Friday, 9 a.m. to 4 p.m.), is a full-service licensed pharmacy that supplies students with doctor-prescribed medications at a minimal $10 co-pay per prescription. Additionally, the pharmacy provides reduced price over-the-counter medications including Tylenol, Neosporin, vitamins, and Sudafed.

Also funded by Sub-Board I is the NYS certified medical laboratory that permits students access to a variety of diagnostic tests (i.e. blood, pregnancy, strep throat, and sexually transmitted infection screening) at a relatively minimal price. The lab prices range from a $10 urine-dipstick test to a $50 chlamydia screening. It is possible to be reimbursed by your insurance plan by submitting a copy of your lab invoice with your insurance claim.

UB was looking out for its students when it designed this comprehensive student medical insurance program. It was designed to be accessible to the most students possible and do the greatest good for the greatest number. The student medical insurance board at UB actively looks for participation from students to sit in on the negotiation process to evaluate insurance policy options. By getting involved, students will understand first-hand the values of their insurance programs.

However, says Engelhardt-Ellis, “You never want to know just how good your insurance coverage is.”