<p>We currently have Blue Cross of Cal HMO and just went through open enrollment in April. Our son is heading to Pennsylvania and I have just found out that he will only be covered for “Emergency Services” when out of state…he will only be covered if he goes to an ER or Urgent Care…but not if he makes a regular appointment with a doctor, when out of state.</p>
<p>He is generally in good health but I am now befuddled… what should we do? He can get an Aetna PPO thought the school for for $1150 for the year but it will still cost out of pocket with a $50,000 limit (which could be a few days in the hospital)…plus, do I really do not want to take him off of our HMO policy?</p>
<p>We have a friend who has Kaiser HMO & for his D he didn’t buy the university insurance. She had a bad injury & ended up in the nearest hospital & it cost a LOT of $$$ (wasn’t covered by her HMO plan). He has since bought the university-offered insurance for all his college kids so he won’t end up with similar bills in the future. It was a good idea for him because his kids have had other injuries & he’s glad it was covered by their university plans.</p>
<p>$1150 isn’t that high a premium for a year, even tho the limit does sound a bit low.</p>
<ul>
<li><p>Most campuses have a health service where kids can go for basic medical care (colds, flu, minor infections, STDs :eek:, etc.). That is usually covered as part of your tuition. So that fills in some of the gap.</p></li>
<li><p>If you are just looking at your paperwork and have not called your HMO, do so. It turns out that our insurance has multiple types of “out of network” coverage. It varies depending on whether you are traveling temporarily, living in a different state (like a college student, they have a sort of external network nationwide with some coverage), or outside the states. Often you have to submit your own claims for one or more of those categories. And if they have some special coverage for the last two, you have to notify them as your kid comes and goes from your “home network” area. But you would never figure this out from looking at the coverage booklet, I only know after several conversations with the insurance company. So call 'em if you haven’t.</p></li>
<li><p>That is just for health care appointments. Drugs and dental for us are completely different companies, with completely different policies.</p></li>
</ul>
<p>Before D1 left for college two years ago, I ended up talking with each of the companies, locating a few clinics and dental offices in her college town that were in this extended network “just in case”, and writing up a document for her on what to do if she was sick. Along with ordering extra copies of all three insurance cards for her (which I need to re-request now each year, as they only provide copies for me and ex-H each year). She has a big envelope of health stuff that I put all this stuff in for her.</p>
<p>Also the college might require you to purchase the school insurance if they determine your HMO will not cover your child to the limits they require. My friend said when she went to the parent orientation for her son last summer the school specifically said they would not consider out of area HMO’s as adequate coverage.
Many schools also want you to have a certain level of coverage. Another friend found that his high deductible plan was not acceptable to the college and they were required to purchase the school plan.
On the other hand my D is going to be attending an OOS public that only requires proof of insurance for international students. My son’s college requires proof each fall.</p>
<p>Like mom60 said, I think a lot of colleges ‘require’ you to purchase their health insurance coverage if they deem yours inadequate which it sounds like yours would be. </p>
<p>Have you considered just switching your family to a PPO type of plan for the time period when he’d be there - assuming it gives you the adequate coverage of course? If this sounds viable to you then check with your plan administrator since even if the open enrollment period is over, for major changes, which this should be considered (according to me ), plans will sometimes let you switch outside of the enrollment period.</p>
<p>I much preferred our insurance plan to the ones offered by the colleges so we always opted out of the college plans. It also saved money.</p>
<p>Our older 2, covered by Kaiser at home, did not buy school coverage when in college in non-Kaiser areas. They were 3-5 hours from home by car. They saw their regular doctors for routine care and prescription refills; used university health services for the sore throats, and sinus infections.
Our third attends school in a different Kaiser region and if she needs care there just calls member services to have her plan switched to that region.</p>
<p>I agree that during next year’s open enrollment period, you should consider switching to a PPO or HMO with nationwide coverage. Blue Cross does have a national network at least for those with a PPO through them (I do). If the college allows it, he can just keep his current plan and have routine care done at home during breaks. For minor issues, some drug stores offer low-cost clinics and maybe there is one near his college.</p>
<p>With all due respect, may I suggest that this thread of conversation is far too narrow? What parents should be concerned about is the fact that more than two-thirds of college students have coverage through their mom or dad’s plan, yet the vast majority of campus health centers refuse to accept private health insurance as valid payment for services rendered.</p>
<p>Even after “historic health care reform,” we have a 3rd-party payer system now and into the future. Most colleges, however, seem to want to continue their own closed-loop, single-payer system, with some schools going so far as to not allow enrollment in class without the purchase of their school-sponsored insurance plan. There should be no reason for a parent with a student on high-quality employer plan to have to purchase another insurance policy at a cost of $900 to $2200 a year. If your son or daughter’s school does not accept outside insurance, ask why not? They will almost surely have to by 2014 when the health reform is fully in effect, so why not institute a family-friendly policy today?</p>
<p>Our Blue Cross HMO covered our kids out-of-state with only a few hiccups for the past 7 years. It sounds like the OP’s Blue Cross HMO is inappropriate for a family with a member who is going to school out of state. But it may be cheaper to buy the college’s insurance than to switch the whole family to a more expensive plan. If the OP’s employer has a cafeteria plan, this may qualify.</p>
<p>We changed our plan from an HMO to a PPO at the last open enrollment so that the plan would cover D in college across the country. I checked with the PPO and have found a doctor and a hospital near her school just in case.</p>
<p>Sockhermom-
We have the similar coverage as you. Prior to school, I called our insurer and found out that son was covered by our HMO for emergency care or urgent care/walk-n center. We waived school coverage.</p>
<p>Son had mono during the first weeks of freshman year. Had blood work and got meds at the school infirmary- covered. He’s been seen since, over the past 3 years and he is always covered.</p>
<p>Younger son was also seen a couple of times at his U’s Health Center. No cost.</p>
<p>Son was to have a CAT scan and our insurance co. did not question getting it out of state, just the cause. (In the end he didn’t need it anyway, but we did hear they approved it.)</p>
<p>We have our local Rx’s at CVS and son gets them filled at his local CVS.</p>
<p>(When son broke his wrist in camp, he was followed up by the orthopedist that fixed his arm and casted him. The insurance co. agreed to let this MD follow him for the summer as he was not at home to receive follow-up care.</p>
<p>What got me was that one college wanted one’s private insurance to have coverage levels that reimbursed at 90%, including mental health. Who lives in that fantasy land any more? </p>
<p>We have great coverage through DH and a nationwide PPO, and feel darned fortunate. Checkups and med appts are done when the guys are home, Student Death takes care of routine illnesses, the guys have their PPO cards and a list of docs near campus, and we have a HIPPAA/medical POA waiver to deal with anything else.</p>
<p>OP may not have the option of selecting a PPO network if their family’s coverage is through a small employer. There may not be any affordable options. This is happening at my office now – the premiums for the PPO w/out-of-network option have gotten so high that everyone is now on Kaiser in-house only, and folks are grumbling a lot. No raises in the past two years make it hurt even more.</p>
), plans will sometimes let you switch outside of the enrollment period.</p>