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On the way to school? This is what students with health problems need to know

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College is a time of transition, but for those dealing with chronic illness, it may also be the first time they are fully responsible for their own health: making appointments, securing supplies and medication, and monitoring symptoms.

Those who go to school far from home can find it especially difficult to navigate the complex world of insurance to pay for such vital care. Home coverage networks may not cover a patient’s new doctors or a trip to an emergency clinic. New plans may not cover the same medications or procedures.

“Even for people in health care insurance doesn’t make sense,” said Jenna Riemenschneider, Head of advocacy and special projects at Asthma and Allergy Foundation of America.

Ensuring continuity of care and medical assistance in the school will allow students to better continue their studies and enjoy the college experience, health experts said. They recommend that students and their families do their research before leaving for campus. Call local or university health centers and get adequate insurance for a smooth transition.

“You need to do real due diligence to make sure you have the right protection,” said Erika Emerson, Managing director of Diabetes Management Council. “There are things that are good to sniff at, for example when some things don’t happen and you learn a hard lesson, fine. Health care is not one of those things that is very forgiving of mistakes that can be costly in terms of health outcomes and certainly financially. “

Income-based plans

Sam Grover turned 26 when he went to New York City from Utah to study medicine. According to federal law, he would no longer be entitled to remain insured with his parents after his birthday.

Grover, who has type 1 diabetes, needed to be able to pay for his medical supplies, including a continuous glucose monitor, pump, and insulin that kept his blood sugar levels within a safe range. After exploring his options, he enrolled Medicaid, the federal health insurance program for low-income Americans.

“Growing up I never saw myself as someone in need, but then times changed and I got diabetes, turned 26, and had no job,” said Grover, who has a year left in medical school to begin his studies Assistantship. He said he hoped his work as a doctor would help make up for the help he received from the state-funded health program as a student.

Medicaid coverage varies by state. Grover found that Medicaid in Utah, for example, didn’t cover continuous glucose monitoring, but he said the New York program covers all of his medical needs.

“It has been the greatest blessing,” he said, adding that the cost of equipment and supplies to treat diabetes are high. “Just knowing that I can deal with my diabetes during my studies relieves a lot of the stress and anxiety that come with diabetes.”

Medicaid benefits typically only apply in the state where the plan originated, and not all states have extended coverage to more adults under the coverage Affordable Care Act. If Medicaid isn’t an option, experts said, individual coverage through the ACA insurance exchange can be a good option for students, especially if they can take advantage of tax credits and federal subsidies to make these plans more affordable.

As with most insurance options, students need to know exactly whether the insurance coverage extends beyond the location of their university and whether it covers specialist medical care and required medication. They also need to know what ongoing expenses they are responsible for.

Parental insurance

For many students younger than 26 years old, sticking with a parent or guardian insurance company may be the best option. Experts said reading the fine print was imperative to ensure coverage is comprehensive and extends to school attendance.

Both of Kathy Przywaras Children have asthma and food allergies. Both left California to attend schools in rural Pennsylvania. After doing research, the family both kept their existing insurance policies but still had to find providers on the network near the two schools.

While they could transfer one student’s prescriptions to a national pharmacy chain, it wasn’t an option for the other. Przywara, who is also the Senior Community Director of the Asthma and Allergy Foundation of America, worked with a local pharmacy to ensure prescriptions were filled out. The pharmacy already had a delivery program to the school health center that made it easier for students to get medicines.

Przywara said shipping medicines, if covered by insurance, could also be an option for college students. Some insurance companies will take prescriptions for medication for several months.

“Know what your policy says and make sure the things you need are covered,” said Przywara. “It is important that you are in control of your condition. That means access to your doctors and your medication, otherwise the financial burden will get worse. “

Despite efforts, Pryzwara and others warned, emergencies can occur. It is therefore important that students determine whether there are any emergency and emergency centers closest to them in their network. According to the Law on Affordable Care First emergency care should be covered however, other services may not.

University sponsored insurance

Many schools require students to have health insurance and offer university-sponsored plans, said Jake Baggott, a past president of American College Health Association and Assistant Vice Chancellor for Student Affairs at the University of Wisconsin-Madison. He said that some university health programs are equipped for more complex medical problems or diagnoses, but others are not. Students need to be clear about the details, e.g. B. Whether your policy covers off-campus care.

Shay Webb, 22, a University of North Carolina-Wilmington graduate with a Masters in Clinical Research and Product Development, thought she had her basics covered when she acquired a university-sponsored policy as a student in 2017. She was given the policy to cover expenses for her type 1 diabetes that are not covered by a parent’s insurance policy.

After moving to campus, Webb was diagnosed with rheumatoid arthritis. She believed the student policy would help cover her rising medical costs.

A few months later, she learned that her claims had not been processed. The insurer told her that she would not pay the claims because she did not attend classes in person, even though she had remained a full-time student, lived on campus and had no say in whether the classes were online or in person. The online program was part of the university’s effort to simulate the real-world experiences of professionals in their field.

“I was just shocked,” said Webb. “Nobody had ever told me.”

Webb and her family were left with thousands of dollars in unexpected medical bills.

“Unexpected health care costs are a tremendous burden,” said Baggott, adding that unexpected health care costs can make things much more difficult to manage for students who may be taking on college debts. Baggott and others said students should seek help from campus staff, advocacy groups, or other experts if problems arise.

Bottom line: know the details before you sign

Before anyone committing to an insurance plan, it is important to understand the specific type of plan, which company offers it, and how exactly the coverage works. If problems arise, students should be assured that they can switch plans as needed.

The Partnership to Protect Coverage, a consortium of patient advocacy organizations, published a report It states that the insurance rules introduced during the Trump administration allowed the spread of plans that do not comply with the Affordable Care Act. These plans, such as short-term insurance options and ministries of health, put those enrolled at financial risk, especially those with pre-existing and chronic illnesses.

“Take a good look at all of your options. Check out the benefit plans. Call provider. Call the insurance company, “said Erin Hemlin, Director of Health Policy and Advocacy Young invincible, a Washington, DC-based group focused on improving the economic security of young adults. “Double and triple check to make sure your child has a plan that is there when they need it.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health topics. Along with Policy Analysis and Polling, KHN is one of the three main operational programs at KFF (Kaiser Family Foundation). KFF is a non-profit foundation that provides the country with information on health issues.


This story can be republished for free (details).

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