Texas A&M State University student health insurance

September 10, 2008

Texas A&M State University student health insurance



Summary - Texas A&M State University recommends that all of its students have health insurance and requires international students to have health insurance. Texas A&M offers a base accident and illness plan insurance plan and a supplemental insurance plan. International students are eligible for the same base student health insurance but not the supplemental insurance. Students and their parents are frequently motivated to find coverage that may offer better protection at a lower price than University sponsored insurance plans. A student can provide their own approved private health insurance or enroll in a group insurance plan offered through the University. Most healthy students can easily find lower price protection with stronger catastrophic coverage with a wider range of providers on a national basis using the plans listed on a state-by-state basis at MedSave.com. Since each student's situation is different, it pays to take a few minutes to compare the available options.

On-campus health services - All Texas A&M State University students have access to Student Health Services (SHS)at A. P. Beutel Health Center located on main campus at College Station. SHS is an accredited ambulatory health care provider serving Texas A&M students by providing primary health care services and promoting health through prevention and education. SHS does not provide major hospitalization or treatment outside of the clinic. Insurance claims are filed only for the university-sponsored insurance. SHS will assist with private insurance claims, but students with private insurance must file their own claims. does not bill insurance companies.

SHS provides students with many basic clinical services including a primary care, gynecology, dentistry, travel clinic, orthopedics, physical therapy, sports medicine, immunizations and allergy injections. SHS complements but does not replace health insurance.

Texas A&M State University Plan vs. Private Insurance - The Texas A&M State University Student Accident and Sickness Insurance Plan is a limited benefit plan underwritten by Delos Insurance Company that covers typical medical expenses up to $50,000. A supplemental coverage is available to raise the maximum coverage limit to $500,000. This insurance allows treatment at Student Health Services without a policy deductible and includes coverage for pregnancy and maternity expenses There is a one year waiting period before pre-existing conditions are fully covered, so this insurance plan is not recommended for students with ongoing medical treatments (or a student who is already pregnant). During the first year, only up to $1,000 can be paid for pre-existing conditions are covered after the policy deductible and a 40% co-payment. This plan covers prescription drugs up to $1,500, diagnostic testing, lab work, x-rays, hospitalization, specialty care and one gynecological examination including mammogram.  The out-of-pocket expenses can be more than other insurance plans because of a $40% co-insurance requirement when using non-network providers. The cost is $1,295 per year for the base coverage and $1,754 per year for the supplemental $500,000 maximum benefit option.

Universities generally prefer that students enroll in the school health insurance because it is easier to administer health care while students are on campus. Parents tend to be uncomfortable with university-based health plans because these tend to provide less protection for catastrophic events and limit access or coverage to top-quality specialists outside of the plan's network. Presumably, in the event of a major medical crisis, most students would seek medical care in the home town of their permanent residence rather than the university community. University-sponsored insurance programs tend to be more expensive than private student insurance plans especially for healthy students who do not need to cover the ongoing costs of pre-existing medical conditions. A typical U.S. college student can improve their coverage and save money by providing their own health insurance rather than enrolling in a University-sponsored student insurance plan.

Any of the major medical insurance plans at MedSave.com will improve the flexibility of coverage and raise the overall amount of protection. MedSave.com insurance plans do not require referrals for treatment. Today's major medical insurance plans provide $1,000,000 or more maximum catastrophic coverage. A healthy student who expect to need minimal medical care will save $500 to $800 per year by selecting commercial insurance over the University's student insurance plan. Popular choices are listed below. See the state listings for details of available plans. Students with significant medical history, those who are pregnant or anticipate a likelihood of ongoing medical care  should use the Texas A&M State University plan and not commercial insurance.

Waiver Procedure - Students with private health insurance must waive out of the University-sponsored insurance plan to avoid being billed for this coverage. (If accidently enrolled in two primary insurance plans, only one insurance will pay benefits). Waivers are processed online at https://www.hr.Texas A&M.edu/studentinsurancewaiver/AppLogin.Asp?.

Supplemental Insurance - Regardless of the selection of the primary coverage, supplemental health insurance is recommended to reduce the financial exposure of the primary health insurance. All students qualify regardless of residence or health history. Most of these plans cover pre-existing medical conditions after a waiting period.

Coverage for U. S. students

Texas A&M State University recommends that its students have health insurance, either private insurance or the university-sponsored plan. The most popular type of health insurance for U.S. students is short term major medical insurance primarily because it is the least expensive type of major medical insurance with adequately high amount of catastrophic coverage. These plans usually offer higher limits of coverage and more freedom to choose doctors and hospitals in the student's home town or across the country.

Policy Deductible - The average deductible for a U.S. major medical policy has increased to more $1,000 in recent years. One major insurance company calculated that less than 15% of the policies issued in 2007 had a deductible of $500 or less. It is always possible to reduce your policy deductible by paying a higher premium but this is not a financially wise decision. The cost to change a $1000 deductible policy to  $500 deductible policy would be more than $500, so there is little financial incentive to make this change. Increasingly, U.S. employers are providing group health insurance with much higher deductibles ($5,000 for example) and employees may purchase individual supplemental policies to cover the smaller medical costs. Additionally, federal law requires that some health insurance plans like Medical Savings Accounts and Health Savings Accounts have a higher deductible.

Pre-existing medical conditions - All U.S. health insurance companies cover pre-existing medical conditions in accordance with federal laws known as "COBRA" and "HIPAA". In addition, some states also have laws that govern coverage for policies issues within its borders. Resulting coverage for pre-existing medical conditions depends on the specific facts and history of each covered member. In fact, both federal and some state laws prohibit coverage for pre-existing medical conditions. We conclude that it is impossible to make a blanket statement that any health insurance company covers all pre-existing medical conditions. This discussion is not relevant to the large majority of Texas A&M State University students who do not have recent significant medical history that would be defined as a "pre-existing medical condition" by their insurance company. (A pre-existing medical condition is usually defined as the diagnosis included in a member's recent medical records. Most students do not have "pre-existing medical conditions" as defined and therefore do not have any waiting period for coverage. Pre-existing medical conditions are also not relevant when an insurer recognizes a Certificate of Creditable Coverage).

Worldwide coverage - Most major U.S. health insurance companies limit coverage outside the U.S. to emergency care only. When international medical insurance coverage is needed it can be easily added to the underlying domestic insurance at a nominal cost (often less than $3 per day) for the period that international travel is anticipated. International polices can be issued for only a few days or for a year or longer.

Mental health and substance abuse coverage - The majority of U.S. health insurance plans provide the amount of coverage required by state law in the state they were issued. Since this coverage varies from state to state (based on the state of issue, not the state of current residence), the benefits in a specific policy can vary. All MedSave.com policies comply with state and federal mandates for mental health and substance abuse coverage.

ID card - All MedSave.com insurance plans provide proof of insurance in the form of an ID card. In most cases the card can be downloaded and printed at the time of online enrollment for immediate proof of coverage.

Provider network - All MedSave.com insurance plans provide coverage with any doctor or hospital in the U.S. and a substantial network of providers are available within 20 miles of Texas A&M State University main campus. There is no penalty for using an out-of-network provider although billing may be simplified by using a network provider. See www.PHCS.com for a provider search tool.

Individually purchased vs. employer-provided coverage - In the past most Americans received their health insurance through their employer and college students were covered as dependants under their parent's group insurance plan. This is changing rapidly. Each year fewer families are covered by employer-provided insurance. The percentage of Americans who purchase their own health insurance under consume-driven health care plans is expected to grow from 8% in 2007 to more than 32% by 2012. The legal framework of benefits provided under employer-provided coverage is significantly different than for individual health insurance so significant social changes will accompany this trend. Healthy individuals tend to find better coverage at a lower price under individually purchased private health insurance. Those who have ongoing costs from pre-existing medical conditions tend to prefer employer-sponsored group insurance. Universities are likely to adapt their student health policies and procedures in accordance with this trend.

In recent years MedSave.com has observed that college students who purchase their own health insurance online tend to but the least expensive coverage with the greatest up-front benefits for low cost medical items like routine doctor's visits. Students who purchase their own private health insurance have a disturbing track record of purchasing inappropriate types of insurance (and in some cases buying into scams that are not legitimate health insurance at all), including insurance for which they were not eligible or would not cover their known medical expenses. These mistakes are presumably caused by their inexperience with the complicated topic of health insurance. Parents, universities and most older adults tend to be more concerned with qualify of health insurance protection for catastrophic expenses. This might be the reason that colleges and universities push students to enroll in the insurance plan selected by the school. While this is a great option, it should be an option and not a mandatory requirement. Mandatory enrollment in a group insurance plan sponsored by the school is likely in violation of the intent of state insurance laws and, at best, creates a conflict of interest for the University and its insurance adviser. We firmly believe that Americans - including college students - should be forced to give up their right to select private individual health insurance simply because of the risks associated with making the wrong consumer decision. University Trustees should be urged to allow their students to select from all responsible health insurance options, especially in this time of crisis for health care affordability.

Renewable vs. Non-Renewable Coverage - There are two types of major medical insurance available to students. The first is a limited term coverage that includes the Texas A&M State University plan and commercial short term medical insurance plans. This coverage ends on the date defined in the policy. The second type is called "renewable" and does not contain an ending date. Renewable coverage is more expensive than short term coverage; the renewability provision generally accounts for about one third of a policy's total cost. Most students opt for non-renewable insurance. Insurance industry statistics indicate that less than one percent of students who have the option of renewing coverage keep the same insurance policy for more than two years after leaving school.

Non-renewable short term medical insurance generally provides the best value for students with no significant medical history. These plans can be purchased for a semester, a year of for up to three years at a time. These are full major medical insurance plans that provide high levels of coverage with any doctor or hospital anywhere in the U.S. Typical premium cost is about $75 per month, or about half of many other alternatives. These plans are not suitable for students who are likely to need ongoing management of care indicated by a history of ongoing medical issues.

For permanent renewable coverage that includes coverage for pre-existing conditions, see Celtic Insurance and Golden Rule Insurance. Both are reputable companies that offer low priced insurance to young adults.

Most Popular Insurance - The most popular student health insurance plans in the United States are American Health Shield and Simple STM. That is not to say they are always the best choice, but the plans enjoy a strong consumer reputation that propel them forward in popularity from year to year. American Health Shield does not offer a downloadable ID card. Coverage is confirmed at the time of enrollment by e-mail and ID cards are sent by mail a few days later.

Highest Quality Insurance - We strongly recommend the 6 month, one year and 3 year major medial insurance policies available in most states under the name "Secure Med". These are among the highest quality immediate issue medical plans regardless of age but they offer lower prices for young adults. See your state listings for availability. All of these plans offer immediate ID card downloads so they are popular "last minute" choices.

International Students

Texas A&M State University, like other colleges and universities, requires that international students to have separate U.S. insurance while attending Texas A&M State University regardless of any other coverage they may have in their country of origin. The U.S. federal government also requires that those visiting this country (both students and their dependants) on a J-1 or J-2 visa carry health insurance.

Texas A&M State University permits international students to enroll in the same base health plan as its U.S. students at a cost of $1,295 per year. This policy is limited to $50,000 maximum coverage, the $500,00 supplemental insurance option is not available to international students. For comparison, the average price of the nation's most popular private international student insurance is about $1,100 per year.

MedSave.com recommends a policy called "Inbound Immigrant" to meet the University's insurance requirements for international students. This is currently the most popular insurance policy for international students attending college in the United States. Like most private insurance, it keeps the premium cost low by excluding coverage for some items (like takeover of payments for ongoing medical treatments) not are needed by a majority of applicants. This insurance has a low deductible and includes $10,000 medical evacuation and $7,500 repatriation coverage. This private insurance may be used with any doctor or hospital and does not require a referral from Texas A&M's Student Health Services. In most cases this private insurance is $100 to $300 less expensive than the University's student health insurance but may not include as many "up front" benefits for preventative care and minor illnesses.

Waiver Procedure - If any international student does not show proof of insurance coverage, Texas A&M University prevents that student from registering for classes. All international students must maintain insurance coverage to stay enrolled in Texas A&M. International student health insurance verification (and potential blocking to prevent class registration) is now monitored by International Student Services. Detailed information on international student health insurance, and what to do if you are blocked, can be found online.

Tips for Texas A&M State University Students

Health insurance is primarily controlled by the state where the policy is issued (rather than the state of permanent address or the school address) which determine the price and coverage details. All plans provide national or international coverage, so for most students the choice of address is primarily a pricing issue. Students with specific medical conditions must also consider coverage laws and "state mandates". Students who spend time in multiple states can use this to their advantage through "address shopping". For example, a diabetic student from New Jersey will do better with a plan from their home state while a healthy New York resident will save more than a thousand dollars each year by using the Wisconsin school address. See the state by state listings for more information.

See the article titled "Student Health Insurance Tips" for more suggestions.

Additional Resources

Health insurance coverage can be a complicated topic. Additional articles and resources are available online here at  MedSave.com. See the site map for a complete listing.

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