Students attending Portland State in 2012–13 will see extensive changes in the student insurance plan. Five years in the making, the new insurance plan is more comprehensive and more similar to a traditional insurance plan, offering benefits well beyond what current students have. However, the new plan, while a significant upgrade, also comes at a high price.
Currently, students taking more than five credits pay $230 per term—$111 for the basic insurance plan and a $119 fee for health services at the Center for Student Health and Counseling. The new plan, which will take effect Sept. 20, 2012, will cost students taking more than five credits $679 per term—$560 for the insurance plan and $119 for the SHAC health fee. Students who have comparable plans from either an employer or through their parents will have the option to waive out of the new plan.
“The [current] basic plan is really not a major medical plan; it’s only an accident and illness plan,” said Jessica Cole, SHAC associate director. “It’s not comparable to what you’d get as an employer-based plan or something that your parental plan would provide. It’s just there for emergency purposes.”
According to SHAC’s website, the current basic plan benefits include “partial payments for hospitalization, physician’s home and office visits, ambulance service, x-ray and laboratory work, surgery and pregnancy expenses.” The new plan significantly expands the benefits afforded to students.
Under the new plan, students would get $100,000 of annual maximum benefits compared to the previous $7,500 per condition limit. Prescriptions, not covered by the old plan, will be covered up to $100,000, including birth control. Emergency, hospital and surgery costs are now covered, including transgender surgery, which was not before. Additional coverages include routine visits, immunizations, physical therapy and chiropractic service, and outpatient physician and counseling, among others. More detailed information on the new plan can be found online at pdx.edu/shac/insurancebenefits.
One major change accompanying the new plan is that students who take the required five-credit minimum in eligible classes during spring term will also have continued coverage throughout the summer. Even students who graduate in June will have coverage through September.There is no additional cost for the extended coverage.
The new plan is the result of a five-year collaborative effort of SHAC, the Associated Students of Portland State University, the student health advisory board, PSU administrators and individual PSU students. According to survey results provided by Angela Abel, SHAC marketing and communication coordinator, at least half of PSU students don’t have personal insurance and depend on the PSU student plan, and 78.9 percent of students would have to drop out of school if faced with a major medical issue.
“That was important information for us,” said SHAC Executive Director Dana Tasson. “We knew that insurance was important to students.”
History graduate student and student insurance advocate Nick Walden Poublon was faced with an illness a few years ago that put him in a tough situation. Poublon pointed out that it’s hard being a student, even without having any kind of illness.
“I know that as a student who had been suffering from a fairly serious illness, there were times I had to cut corners; I made decisions between a new prescription or a book, or I decided not to take a class in order to have an MRI,” Poublon said. “I think the hope of this plan is that we don’t put students in that position anymore; that we allow students to focus on being a student.”
Poublon said that the student insurance office deals with students in situations similar to his on a weekly basis. He sees students make difficult decisions that often lead them to leaving school. The benefits afforded under the new plan might make it easier to stay in school.
“I think this benefits all students,” Tasson said. “The students who already have insurance benefit greatly because they are going to be able waive out and not have to pay for insurance that they don’t really need. And students who don’t have other insurance are now going to get a real plan that they can use and that will be helpful.”
Students who believe they might have comparable plans and wish to waive out of the new insurance plan will have to go through the online waiver process by Oct. 7, 2012. Students will be asked to answer six questions: Does your plan provide primary care services within 25 miles of PSU? Does your plan have less than a $500 yearly deductible? Does your plan offer inpatient and outpatient mental health benefits? Does your plan pay for at least 80 percent of inpatient hospitalization? Does your plan cover at least $100,000 medical maximum? Does your plan have prescription coverage?
After answering the questions and being approved, students are waived for the entire academic year. According to Cole there is an appeal process handled at SHAC for students denied waivers. More information on the waiver process can be found online at pdx.edu/shac/insurancewaiver.
Being waived from the insurance plan does not mean that students are unable to use SHAC and the resources it provides. That is a separate fee, which all students are required to pay outside of any insurance.