The AU Student Health Insurance Plan has changed to reflect new standards required by the Affordable Care Act.
AU already offers free women’s health services, such as birth control, as mandated by ACA. In order to comply with the law, the Center now provides the following free of charge to those who enroll in the plan, according to Center Director Dan Bruey:
• covering wellness and immunizations for children under 18;
• eliminating limits on inpatient mental health, substance abuse and detoxification services; and
• increasing the prescription maximum from $4,000 to $100,000.
Four non-ACA benefits are now included in the plan at no extra cost. These services were chosen based on feedback from those currently enrolled. They include:
• smoking cessation medication and counseling;
• allergy testing and shots;
• non-cosmetic cystic acne treatment; and
• sexually transmitted infection tests.
The AU Student Health Insurance Plan accepts those with pre-existing conditions, according to the Center, as insurance provider GM-Southwest, Inc. eliminated the exclusion last year.
Costs within the plan have changed to offset the price of providing
ACA-mandated services. Many are changes in deductibles, the amount a patient pays before their health insurance begins coverage. Differences include:
• Decreasing the academic year maximum of total coverage from $250,000 to $100,000,
• The option to pay to raise the maximum coverage to $400,000 per injury or illness,
• Increasing the deductible for in-network care from $150 to $250,
• Increasing the deductible for out-of-network care from $250 to $350,
• Increasing the maximum total cost of prescriptions from $4,000 to $100,000,
• Creating a system for prescription co-payments and reimbursement,
• Increasing the out-of-pocket cost of an ER visit from $50 to $150, and
• Eliminating the $4,000 out-of-pocket maximum for payments.
The Student Health Insurance Plan costs students $1,680 for the full year, $40 less than last school year. Purchasing the plan for the spring and summer costs $1,070 or $465 for summer only.
Approximately 3,000 students enroll in AU’s plan each year, Bruey said.
“We have had mixed reactions,” Bruey said in an email. “Some students have expressed satisfaction with the low premium and additions to the plan and some have expressed dissatisfaction with the changes.”
Plan costs are negotiated between AU and GM-Southwest each year, deciding on the best benefits at an affordable price based on the dollar amount of claims made during the previous year. The student health insurance plan had very few expensive claims last year, Center officials said, allowing the University to avoid raising the cost.
Bruey said AU’s health insurance will be as effective as in past years despite the ACA changes. The plan has exceeded American College Health Association guidelines for minimum levels of coverage and benefits for many years and already follows many of the new recommendations in the ACA, he said.
“As the AU student health insurance plan has met many of the standards for coverage included in health care reform, very few changes needed to be made to our plan this year,” Bruey said.
The Health Center will further change the plan next year to fully comply with the law; the annual maximum must be no less than $500,000 and there will be no limits on “essential health benefits” as defined by the ACA.
