Changes in Student Health Insurance: 2017-2018

Graduate students may recall receiving an email back in April about changes in the Penn State Student Health Insurance Plan for the upcoming academic year. Here’s a breakdown of what is staying the same, what’s changing, and what you can do to prepare. Need a crash course on the basics of health insurance? Check out this video.
 

 The basic benefit package remains the same.

  • Deductibles (the amount of money you have to pay out-of-pocket before the insurer starts to reimburse you) differ depending on whether your policy is for a single person or a family.

    • The deductible for an individual is still $250.

    • The deductible for a family is still $500.

  • Coinsurance payments (the percentage of the cost covered by the insurance company) remain the same, depending on whether the provider is in- or out-of-network.

    • If you are seeing a provider who is in-network, United covers 90% of the bill.

    • If you are seeing a provider who is out-of-network, United covers 70% of the bill.

  • Out-of-pocket maximum (the most you are required to pay each year in deductibles, copays, and coinsurances) remain the same, depending on whether the provider is in- or out-of-network, and who is covered by the policy.

    • For a single person, the out-of-pocket maximum with in-network providers is $1,300. The out-of-pocket maximum with out-of-network providers is $15,000.

    • For a family, the out-of-pocket maximum with in-network providers is $2,600. The out-of-pocket maximum with out-of-network providers is $30,000.

If your sole experience with the healthcare system involves going to UHS, then you won’t notice any changes in your health insurance coverage. Everything provided at UHS will continue to be covered at 100%. There is still no copay at the UHS pharmacy.

Premiums are going up.

But the increase isn’t extreme if you have an assistantship. The cost of a single student’s plan will increase from $3,296 to $3,418. If you have an assistantship, Penn State subsidizes your health insurance at 80%, so the total cost to you is $683.20, which is $24.40 more than last year. Premiums are automatically deducted from monthly paychecks. Below are the deductions that will appear on your paycheck, and the change from last year. [Note: Premiums are higher in the spring semester to pay for health insurance coverage throughout the summer.]

Household type

Fall Semester (Sept. – Dec.)

Spring Semester (Jan. – May)

Single student

$67.60

-$1.40

$82.64

+$6.00

Student and spouse

$152.10

-$3.15

$185.94

+$13.50

Student and child

$152.10

-$3.15

$185.94

+$13.50

Student and children

$229.84

-$4.76

$280.96

+$20.40

Family (child)

$229.84

-$4.76

$280.96

+$20.40

Family (children)

$310.96

-$6.44

$380.12

+$27.60

We are changing health insurance providers.

The student health insurance will be provided through United HealthCare instead of Aetna, which may mean that some of your providers that were in-network become out-of-network. Many of the providers that accept one type of insurance also accept the other, but this is not always the case. It important to double-check to make sure your provider is in-network with United, or you will be paying the out-of-network costs (Remember: United covers 90% of the cost of in-network visits, but only 30% of out-of-network visits).

So, how can you avoid expensive medical bills because of out-of-network providers? Here are several steps you can take to make sure you are getting the most out of your health insurance.

  • Call your provider and ask them! Your provider, or someone in their office, should know if they accept United HealthCare. Talk to your providers now so you can be prepared when the insurance coverage changes.

  • Search United HealthCare’s website. Visit this website to see if your provider is currently in-network. Click on “UHC Choice Plus” to search for doctors, tests and imaging centers, and other services that are in-network. To search for mental health care providers, click on “United Behavioral Health.”

  • Check the provider directory. CGE has created a pdf directory of the healthcare providers and facilities that are considered in-network as of August 3, 2017. The information in these directories is always changing, so check the website for the most up-to-date information. Also note that the provider directory does not include mental health care providers.

  • If your provider is not in-network, ask them if they would be willing to participate. They may be in the process to be credentialed (i.e. become in-network) – it takes a while to sort out the details. You can also nominate your provider by contacting United HealthCare.

International students have more limited options.

International graduate students must either demonstrate proof of insurance for themselves by submitting a waiver application, or purchase the Penn State Student Health Insurance plan. The following will no longer be considered adequate coverage to receive a waiver:

  • Short-term International Standards Organization plans

  • Health insurance plans through Student Medicover

You can find out more details on the new requirements for student health insurance plans here. If you have any questions about these changes, or run into any problems, let CGE know about it. We want health insurance that works for all graduate students!