Insurance waiver

rualum
Wed, 18 Jul 2012 11:24:45 +0000

From what I have learned, the changes to college health care plans should be instituted on a national level by next year, assuming nothing changes. What does this mean? It means that while in prior years your family health coverage could easily be used to waiver out of the college plan, now you will have to meet much stricter guidelines.

For example, while in the past our NJ state statute specified that one’s health plan must provide “a minimum of basic hospital coverage”, the new federal standards specify that your plan must meet the equivalent of certain categories which include providing benefits in your state, having health care providers in the campus area, cover mental health conditions, cover prescription drugs, and provide wellness benefits. Each college specifies things a little differently; google around and check.

This is fine for people who have this coverage, but many do not. A lot of people who self-insure often decline extra coverage like prescription care because it is very costly, or carry a high-deductible, catastrophic type of plan. Now, these people will have to pay for the college’s plan or upgrade their own plans to meet the standards, which may be very costly either way. A state school may charge in the several hundred dollar range for coverage while other schools charge in the thousands. It will also impact those who are not offered things like prescription coverage as an option. Again, they will now be forced to pay for the college’s plan. This can be a very costly, unexpected expense, especially if you have more than one child attending college.

Although these rules are technically not yet ‘in effect’, as I was told, a lot of colleges are activating the requirements now in anticipation of the changes. S1’s school has these requirements in place and denied my waiver; S2’s school does not, and accepted my waiver. This is supposed to change by next year, when all schools will have to match the same federal requirements.

I didn’t find out about this until I went to apply for a waiver on Sunday and was denied due to lack of prescription coverage. It is unfortunate that no one had the foresight to notify families of this change. Usually there is an adjustment period once per year where you can add, drop, or change your insurance coverage. My change period was in June of this year, before the waiver became available, so even if I wanted to change my coverage now, I could not. I have to wait until next June to make changes.

What you can do: go now and apply for your insurance waiver via your school’s designated website. If you are approved, no problem. If you are not approved, find out why. Speak to someone at your school and see if there are any options. Assess your health plan and know how much extra you may have to pay if you are lacking in certain coverage. If you have a problem, call or write your local representative as this is a legislative matter, not a school matter. The schools have to adhere to the legislation so it is not a matter of evaluating things on a case by case basis as it would be if they had control.

I surprised that I am the only person having this issue. Is everyone else easily waivering out of their college health plans? Maybe all schools have not yet enacted the change, or maybe most people just have excellent health coverage. Good for them, but it’s hard for me to believe.

If you do find you have an issue, don’t just resign yourself to paying it. See if it is worthwhile (or even possible) to adjust your plan and if you think it is unfair that you have to base your family’s health insurance on what someone else has dictated for college students alone, in order that they may claim “Supports Higher Education!!”, speak or write to your government representative.

I view this as lopsided legislation: our government is picking a very specific group of people, in this case college students, and legislating that they have excellent health coverage. That’s great, but where are the low-cost, excellent plans for the rest of us? I currently pay 18k a year for my family coverage premiums, without prescription coverage, and with a high deductible.

In any case, families should not have to pay to upgrade their existing health plans, or pay the college’s fee, duplicating some coverage, based on their student’s requirements. I’m glad that college students have the option to acquire excellent health insurance at a decent price, but don’t penalize a responsible citizen who already carries coverage at great expense, and don’t force me to subsidize the insurance companies so that this plan can work.