Health care on campus

University of Iowa sophomore Anna Hermsen, 20, receives a mumps, measles and rubella vaccination shot from nurse Jan Bush at the school's Student Health Service.

TEXT OF INTERVIEW

Tess Vigeland: It's thick or thin time -- is that still the rule with college acceptance letters? You probably get the word over the Internet these days, huh?

Well, college decision time also means college how-are-we-gonna-pay-for-it time. Tuition, room and board, books and don't forget the cost of campus health care.

Most colleges require students to have health coverage and a growing number require students to buy a plan through the school.

Kim Clark is a senior writer with U.S. News and World Report. She's been covering this story.


Vigeland: Hi Kim.

Kim Clark: Hey, how are you doing?

Vigeland: We're doing well. So let's take this back, really, to the basics: how are most college students insured right now? Are they on Mom and Dad's plan when they get to campus?

Clark: Right. Various surveys show that anywhere between 60 and 80 percent of all college students already have health insurance by the time they arrive on campus, usually through their parents or if they're independent, on their own.

Vigeland: Now, the assumption is that when you go to the university health clinic and you have this coverage, either from Mom and Dad or from the school, that you'll be able to use that insurance, right? But what's happening instead?

Clark: Only a few dozen colleges around the country accept outside health insurance. It's amazing. There's something like 1,400 colleges that have some kind of clinic -- and the vast majority of these have just a nurse or two who does very basic services for almost no fee or a very small fee -- but a growing number of campuses are having clinics that do x-rays and shots and suture and charging fees for that, because they need the extra money to provide other services that students and parents are demanding like mental health screening to avoid another Virginia Tech situation.

Vigeland: How big is this market? Are college students really big users of health care? Aren't they a fairly healthy bunch?

Clark: They are, but various studies show that the average 18, 19, 20 year old is spending about $2-3,000 a year on health costs of all kinds, including insurance and various over-the-counter products. So when you look at some of these campus health insurance plans and they cost between $1-3,000, that's about the right price; that's what students spend.

Vigeland: Do students find that, like so many other insurance situations, a lot of stuff is not covered?

Clark: Right. So one of the biggest problems is that these schools are caught in a bind: they want to keep the premiums low, because otherwise students scream, but if they keep the premiums low, they have to make such large exclusions that the health insurance is often almost worthless. I found examples of health insurance policies sold to students in which the student would not be covered for any injury that occurred when the student was intoxicated or on drugs. Now, we know...

Vigeland: Which never happens on college campuses...

Clark: Right. Most students are under 21 and shouldn't be drinking; I totally agree with that. But let's face it: what percentage of injuries to 19 and 20 year olds happen because they're drunk? A very high percentage!

Vigeland: You also talk in your article about colleges that do not register as "in network" with outside health plans -- you know, the plan that you would come in with under Mom and Dad. Why wouldn't they do this?

Clark: Well, as anyone who's dealt with a health insurer can certainly agree with the colleges that it's a huge hassle, absolutely. Is it expensive? Yes. So they don't want to do it, because they can just stick the bills for the x-ray and so on onto the student's registrar bill and the student has to pay it.

Vigeland: So, what is a student who's heading off to college supposed to do?

Clark: Use the clinic when you have to -- the campus clinic -- but try to find an in-network provider near the school that will take your insurance.

Vigeland: Is it possible to figure out what this cost is going to be when you're trying to look at the overall cost of higher education?

Clark: Some schools actually do include this as their cost of attendance and do give you financial aid to cover it, which is great. Unfortunately, some schools don't, so you have to be careful. When you start budgeting "how much is it going to cost to really go to this college?" you have to look and see whether or not your health insurance will be good at that campus and if so, that's a great savings.

Vigeland: Kim Clark is a senior writer at U.S. News and World Report. Thanks so much for helping us out on this issue.

Clark: Always a pleasure, Tess.

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