Health Insurance Blog

Four years ago the National Collegiate Athletic Association (NCAA) started to require universities to make their athletes have health insurance coverage before competing in sporting events.  A mistake was made as the Association did not set forth clear standards for the coverage leaving the students to decide for themselves what they needed.  This is all according to the article “College Athletes Stuck With the Bill After Injuries” by Kristina Peterson on nytimes.com. 

Some colleges accept a lot of responsibility for medical claims but others assume none according to a review of public documents.  Many university officials say they definitely inform their students about the limits of certain health insurance options, but the situation has left students and families frustrated and very confused as many have had to take on large and unexpected medical bills. 

Many athletes have health insurance through their parents but often times the coverage does not include injuries due to varsity sports.  This is where it gets tricky.  They need additional coverage but are unsure where to begin and often do not get enough coverage and are left with mountains of debt.  One solution is to require universities to offer quality coverage to all of their varsity athletes, but this is suspected to put too much of a burden on schools financially.  Because of this the NCAA is unlikely to require that sort of mandate anytime soon.

On BlueCross BlueShield of Illinois’ website they have details on a new Illinois health insurance law that went into effect on June 1st.  The Young Adult Dependent Coverage Law states that if you have dependents meeting certain criteria  you may be able to extend their coverage under your current health insurance policy.

Some eligibility requirements for non-military dependents include:

1. Must be under the age of 26
2. Unmarried
3. Do not have to be enrolled as a full time student

Some eligibility requirements for military veteran dependents:

1. Must be under the age of 30
2. Unmarried
3. Do not have to be enrolled as a full time student
4. Illinois resident
5. Must receive a discharge other than dishonorable

Dependent coverage change doesn’t apply to everyone.  Additional eligibility requirements may apply.  If you have questions contact BCBSIL if you are a member.  If you have coverage under your employer’s health plan, contact your group administrator.

Most colleges and universities offer their own health insurance plans for students, and some even make it mandatory that you purchase health coverage through them.  Students and more specifically the parents of students should make sure they understand the provision related to such policies since they vary so widely from school to school.

Some university health plans limit the health care benefits that students can reap from the policies, thus making serious injuries or illness still costly expenses for students and their parents even if they are covered.  It is not uncommon for doctor visits, prescription drugs or even hospital stays be limited.  In addition, maximum benefits per incident can be limited to $2,500, which can evaporate very quickly.

While limited health coverage is better than no coverage at all, there may be better student health insurance plans out there from private health insurance companies, and students and the parents of students should familiarize themselves with their schools health plan before they enroll, and shop for other alternatives if the benefits will be insufficient.

Young healthy adults are attractive targets for health insurance companies.  Consequently some insurers tailor affordable health insurance plans at this segment of the population with individual health plans between $40 and $70 per month.

Two health insurers who offer such products are Aetna (Bodyguard) and Wellpoint (Tonik).  Keep in mind in order to keep monthly premiums low, the insurers have shifted a greater portion of the health care costs to the member, and thus higher out of pocket expenses should be expected.

In a nutshell, the trade-off is lower monthly premiums in exchange for paying a larger amount out of pocket.

These low-cost health plans might be right for you if you are healthy, don’t currently require any perscription drugs and don’t participate in excessively risky activities where severe accidents would be likely.

America’s Health Insurance Plans (AHIP), the health insurance industry trade group, has expressed support for the idea of reforming the health care system. However, in the L.A. Times, Michael Hiltzik warns that insurers may not be as gung-ho about the possibility of universal health care as they present themselves to be.

AHIP recently released a brochure outlining its stands on health care. Some of their proposals include:

• being allowed to offer limited benefit plans among their individual health insurance policies without limits on the premiums insurers are allowed to charge
• a government-run health care option that takes only the “high-risk” patients (with several chronic conditions) private insurers don’t want, which would be very expensive since it prevents the government from spreading risk among a wide population
• a decrease in the fees paid to hospitals and doctors

These proposals are actually quite similar to what the insurance industry has asked for in the past. Michael speculates that insurers seem cooperative now because there is no specific plan for health care reform, but are prepared to fight against specific policies.

Yesterday, the Associated Press reported that Governor John Lynch is planning to allow adults from ages 19 to 25 to buy New Hampshire health insurance through the state-subsidized Healthy Kids insurance program. Healthy Kids was previously open to children under 18 only.

After a three-month waiting period, young adults earning individual incomes below 400% of the poverty level ($3,610 per month) and without access to parent- or employer-sponsored health insurance will be allowed to participate in the buy-in program. The economy’s current troubles make it less likely that this age group will quickly find jobs with medical benefits, making this measure even more urgent. Currently, around 22,000 young adults in New Hampshire are uninsured.

The exact cost of the health insurance premiums is being finalized, but the president of Healthy Kids expects it to be less than $200 per month, significantly more affordable than most individual health plans.