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Health policies help avoid complications

October 25, 2007

Students should learn about their health insurance policy to avoid complications when they get sick or injured, Director of Student Health Services Alice Reilly-Myklebust said.

In the 2006 National College of Health Assessment of UW-River Falls students, close to 6 percent of respondents didn’t know whether or not they had health insurance. This illustrates how seldom students think about health insurance, Reilly-Myklebust said.

Most insurance policies have a number of treatments and preventative screenings they don’t cover. Reilly-Myklebust recommends that students study these exclusions and call before going to the doctor if they’re unsure whether or not something is covered.

“The bottom line is, if a student gets a treatment that’s not covered by their insurance, the student has to pay out of pocket,” Reilly-Myklebust said.

Sophomore Sid Rasmussen, who is covered through his parents’ health insurance policy, said he gets confused when he thinks about the specifics of health insurance. He took the time to learn the benefits and exclusions of his policy, and this knowledge helped him avoid insurance confusion the one time he sought medical attention since starting college, Rasmussen said.

Students also need to be aware of the policies of their insurance company regarding deductibles, preferred providers, claims and co-pays, Reilly-Myklebust said.

Patients may need to pay a certain amount, a deductible, for the year before their insurance company begins paying for medical care. Additionally, the policy may pay less for treatments when patients seek care outside of their network of preferred health care providers.

In some instances, insurance companies may require policy holders to send in a claim form along with copies of their medical bills.

Other insurance policies require co-pays, which means that the student and the insurance company each pay a preset portion of a certain treatment.

Students should also make sure they are not underinsured, Reilly-Myklebust said.

Some cheaper plans have very limited benefits and high deductibles and leave students as financially vulnerable as those who are uninsured.

Students have a number of options available for dealing with limitations of their insurance policy. Reilly-Myklebust recommends they first do all they can to make sure they stay healthy, which means keeping up to date on immunizations, getting enough sleep and exercising.

Additionally, some hospitals may offer scholarship programs to help patients who otherwise would not be able to afford a procedure, UWRF Student Health Nurse Lori Otto said. This is by no means a solution for chronic conditions since scholarships only cover an isolated procedure.

The UW System plan through Student Assurance Services, Inc., like some other plans, doesn’t cover many preventative screenings.

“The idea is to make this plan work together with Student Health Services,” Reilly-Myklebust said.

Student Health Services contracts with the River Falls Medical Clinic and Pierce County Reproductive Services to offer all students many of the tests not covered by their health insurance.

One major problem is that there is no maximum on what students can end up paying out of pocket, Reilly-Myklebust said.

“There’s very little hospital coverage, which is very concerning as well,” Reilly-Myklebust said.

UWRF and other UW System campuses joined together several years ago on one insurance plan to allow students better coverage for less money, but the major limitations have Reilly-Myklebust looking into other insurance plans.

No final decision has been reached on the issue because the process of sorting through benefits and exclusions is very complicated. Further, if UWRF would break away from the group insurance plan, students would probably have to pay more to be covered by an adequate insurance policy.”If anybody has an answer, that’d be great,” Reilly-Myklebust said. “But there are no simple solutions.”