Monday, November 19

Emily Merz: UC SHIP’s off-campus services are inaccessible, potentially expensive


Calculating insurance costs for out-of-network health care facilities can be complicated for students. The Ashe Center could aid students with navigating these costs. (Daily Bruin file photo)

Calculating insurance costs for out-of-network health care facilities can be complicated for students. The Ashe Center could aid students with navigating these costs. (Daily Bruin file photo)


With threats from the federal government to repeal millions of Americans’ health insurance, UCLA students with the UC Student Health Insurance Plan have a sense of security knowing it won’t be affected.

But it’s hard for students to be confident in the quality of their coverage when they try using the service off campus and get hit with a stack of policies they were unaware of.

About 28,000 UCLA students rely on UC SHIP each quarter, said John Bollard, chief of operations at the Arthur Ashe Student Health and Wellness Center. UC SHIP is many students’ only form of insurance, often because they cannot afford private services. The UC contracts Anthem Blue Cross, a health insurance company and provider, for those seeking coverage outside of the UC’s family providers, which include the health facilities on its campuses, said UC Office of the President spokesperson Stephanie Beechem.

But using coverage off campus is far more complicated than just flashing your UC SHIP identification card to a health care provider. In some instances, students have to pay a steep deductible of up to $500 for out-of-network coverage and up to $300 for Anthem Blue Cross care, which they wouldn’t have to pay at health care facilities operated by the UC. Students may not realize this given that the Ashe Center’s staff often assert UC SHIP’s flexibility.

“I haven’t had any calls from students or providers where they haven’t accepted UC SHIP coverage,” said Barbara Rabinowitz, an insurance manager at the Ashe Center. “UC SHIP is worldwide coverage.”

 

These kinds of remarks do not offer much assistance to students unsure of how to use their coverage outside of the Ashe Center.

If students need to use UC SHIP off campus, the Ashe Center needs to help students find a provider that can cover the services they need instead of just offering them referrals and expecting them to navigate an intricate health insurance system on their own.

Rabinowitz said students who want to use their coverage outside of a UC family facility just need to get a referral from a doctor at the Ashe Center. Even the UCOP oversimplifies the issue on its website, saying, “Once you receive a referral, you can use any doctor outside of the (student health center).”

But that overlooks a huge issue: Students must find an Anthem facility in their hometown, figure out how much they must pay out of pocket and determine how to show proof of insurance before they can walk into another health center and use UC SHIP.

Unfortunately, this isn’t something they can simply figure out online. Students first need to get a referral from their doctor at the Ashe Center and then send the referral to another provider. Then, they must determine their treatment price at the in-network or out-of-network facility and figure out how much they’ll have to pay out of pocket after the UC SHIP deductible. The whole process requires communication with multiple doctors, facilities and insurance employees. If students aren’t able to find an Anthem facility, they risk paying ludicrous deductibles at an out-of-network facility.

“Depending on where you’re from and what health care providers are in your area, it could be difficult to find coverage,” said Dani Lowder, a Student Health Advisory Committee member and a second-year political science and international development studies student.

If UC SHIP and the Ashe Center don’t help students determine their options for seeking procedures off campus, some students might end up paying the full cost of treatment. Students seeking emergency or urgent care are especially at risk, since they wouldn’t have the luxury to thoroughly research options for reasonably priced treatment.

Erika Bricky, a second-year sociology student, encountered the difficulties of using UC SHIP off campus when she needed tonsil removal surgery last quarter. She said she planned to get the procedure done in her hometown of Merced during winter break, but changed her mind when her doctor at the Ashe Center told her the procedure would cost more than $1,000, rather than the $500 she would pay at a UC family facility.

“Without my doctor at (the Ashe Center) telling me, I would have been hit with a massive bill after the fact without knowing,” she said. “I’m lucky she was looking out for me, but I can’t say that everyone has access to that information.”

If UC SHIP directly assisted students in finding an Anthem Blue Cross facility and figuring out the cost of procedures, students might be able to actually use their insurance wherever they go.

UC SHIP must set up an Anthem Blue Cross liaison that can handle cases when students are trying to determine the cost of treatment and where they can find it. The liaison would contact providers near a student’s home to determine the exact cost for a procedure, how much students have to pay out of pocket and how much UC SHIP would cover.

It might seem like students can figure this out for themselves, but the reality is that navigating insurance outside the UC family is more complicated than UC SHIP and the Ashe Center’s staff make it out to be. And the UC has a responsibility to give students some guidance in navigating a notoriously confusing health care system.

Sickness and health issues don’t operate on a quarter-system calendar. Student trips to the doctor shouldn’t have to either.

Share on FacebookTweet about this on TwitterEmail this to someoneShare on Google+Share on Reddit
Opinion staff columnist

Merz is a staff columnist for the Opinion section and a staff representative on the Daily Bruin Editorial Board.


Comments are supposed to create a forum for thoughtful, respectful community discussion. Please be nice. View our full comments policy here.