A student asks:
“The FAQ states that Aetna is continuing to work on the mental health network. However I’ve heard stories that suggest Aetna is strong arming providers to placate the university. I’ve been told by a provider that Aetna started negotiations in Feb or earlier. The provider responded immediately; Aetna did not respond until after the university signed their contract in mid May. Aetna would not budge on their original very low proposed rates. After turning down the offer and deciding to go out of network Aetna pulled the provider back into negotiations. Aetna again was unwilling to budge. This does not sound like a negotiation at all, they are just trying to force providers into an unsustainable contract. I suggest and hope that the task force will solicit information from all current in-network providers on the impact and fairness of Aetna’s rate negotiations. Students are a high risk population in mental health, it is unconscionable for us to lack sustainable and robust access to care.”
The Task Force responds:
The Task Force has asked Aetna for an update on negotiations and expects to receive that shortly. Independently, our Task Force includes a representative from Counseling and Psychological Services who has kept in close contact with providers in the area. The University has not pushed for this change, so there’s no need for Aetna to undertake this effort to “placate the University.” According to the information Aetna provided, they initiated this change because they saw too much variation in what was being paid under the old Devon contract and sought to bring rates for over 100 providers within a narrower range more consistent with what they pay other mental health providers. We continue to stress to Aetna the need for a comprehensive network because of the importance of mental health.
A student asks:
“Can you make sure that the health insurance provides transgender inclusive healthcare? This is a very important issue for many people, and Is definitely a large decision on many transgender people looking for insurance.”
The Task Force asked the Office of Student Health Insurance to respond, and they replied:
“The services are transgender inclusive. They cover the hormone replacement therapy and the reassignment surgery. We have not heard any complaints at SHI regarding the coverage for these benefits. Please advise if you need additional information.”
Students who want more information about the inclusion of these benefits can contact the Office of Student Health Insurance at 865-7467 or uhs-insurance@psu.edu
A student asks:
“January 2013 Aetna approved new insurance waiver requirements. They consist of about 15 criteria, that are extremely is at all possible to be met by any insurance company. I’ve contacted six major insurance companies and neither of them was able to find a plan that would meet the criteria. I am really frustrated as I feel that Aetna did not leave any choice for me and my family. I am not on an assistantship which means I would have to pay a total of almost 15 thousand dollars next academic year for me, my wife and my 3-years old son.
Is there any way to ease the waiver criteria? To make it at least possible to meet?
Can Penn State, which cares about its students inform on the companies and plans that could meet the criteria. So far, I have a feeling that such outrageous criteria were designed on purpose.
Thank you! Right now I have no idea how am I going to pay for the insurance. But I am hoping that the new insurance plan would not force me to drop out of school”
The Task Force responds:
The waiver requirements for international students that you see and which were expanded in 2013 are not really Aetna’s or Penn State’s. Those are driven by the U.S. government, either through visa requirements for international students or through the new Affordable Care Act regulations on what constitutes adequate health insurance coverage. The change in 2013 was required because the Affordable Care Act expanded the types of benefits that must be provided in health insurance plans. Aetna and Penn State are simply complying with the law as required.
In the current plan year (2014-15), many students like you may have very limited choices. As you have found by your calls, few insurance providers offer the type of insurance that would meet the both the ACA and visa requirements. There are many organizations that try to take advantage of international students, and the University cannot recommend or endorse any of them.
Insurance plans on the ACA exchanges (www.healthcare.gov) may provide another option for international students to explore for their health insurance needs, but international students should discuss that option with someone familiar with immigration and tax law. The Department of Health and Human Services has interpreted the ACA to mean that international students can purchase insurance on the exchanges. However, at this point it is not clear whether there may be complications related to verification of their resident status or completing tax documents for international students to be able to take advantage of the exchanges or to be able to get the subsidies available to low-income individuals and families on the exchanges.
If international students choose to purchase insurance through the exchanges, they still should make sure that the plan they choose meets the waiver requirements and any requirements from their visa. For example, J-visa students must have medical evacuation and repatriation coverage as part of their insurance, and this may not be commonly included in insurance policies through the ACA exchanges.
So, at this time, the Penn State student health insurance plan is the one plan we know that meets the requirements set by the government. While the cost for 2014-15 will not change, the Task Force is looking at options to try to lower costs in the future. Some universities are able to “self-fund” their health insurance, which can help lower costs. Some universities use a narrow network of providers. This can lower the premium cost, but also reduces students’ choices of which doctors they can see without increasing what they have to pay out of pocket. Some universities provide a less comprehensive student health insurance plan than Penn State does—our plan is the most generous allowed, and as a result is also a plan with expensive premiums. Some universities offer students the choice between 2 plans, a generous plan with high costs, and a more basic plan with lower costs. All of these and more are longer-term options that the Task Force will be considering, because we recognize the impact of these high costs on students.
A student asks:
“Hi, I think a community that is overlooked is adult students returning to Penn State. While I realize that many adult students do hold full-time positions while juggling a family and a full credit-load, I believe that there are many students who only work part-time while continuing their education.
The issue that I experienced was that – first, I have to possess health insurance in order to attend Penn State. But, due to my course load as a nursing student I could only hold a part-time position. If I wasn’t going to Penn State, I would be low-income enough that I would not need to purchase health insurance according to the health care act. Unfortunately, I still do need health insurance according to Penn State policy.
This means that the cost in order to attend courses at Penn State is $200 more per month then I initially anticipated. I don’t know of a solution to the problem, but it is a reality that I thought should be noted by the task force.”
The Task Force responds:
The Task Force is trying to make sure that they look at this from every perspective–international students, adult students, those with and without dependents, etc. We do have student representatives on the Task Force to help remind us of these students in these different circumstances.
From the question, it is not clear if you are an international student. In the current Penn State policy, international students are required to have health insurance. Penn State does not mandate coverage for other students, though some individual colleges and programs (like the College of Medicine) do require insurance coverage. Many of our peer institutions do mandate that all students have health insurance. This can actually reduce the overall premium cost of insurance because it creates a broader pool–effectively, that’s what the Affordable Care Act mandate and what national health insurance systems try to do.
So, if you are an international student or a College of Medicine student, then you are correct that you have this additional cost that needs to be factored into the budget. While the University communicates that in several ways, the Task Force can examine whether there needs to be more clear communication about that cost.
The Task Force does not see information on the College of Nursing student materials that indicates a mandate, but it does indicate that clinical agencies may require that students have insurance. They do allow students to meet that in several ways:”Proof of current personal health insurance is required by some clinical agencies, and failure to provide proof of personal health insurance will result in your not being able to meet clinical
requirements. Your options are:
1. Enrolling in the Penn State Insurance Plan;
2. Maintaining a private personal health insurance policy; or
3. If eligible, continuing coverage under your parents’ or spouse’s policy.”
So, it appears from their web site that you could access insurance coverage through the Affordable Care Act exchanges, where you may be able to get lower cost health insurance to fit your circumstances. The Task Force will follow up with the College of Nursing to see if we have understood their policy.
Update 6/18/2014
The Task Force received a reply on this issue from the College of Nursing who explains: “All Nursing students do clinical experiences of some type if they are pre-licensure and also many nursing graduate programs have clinicals (e.g., Nurse practitioner students). The health insurance is required by the clinical institution (I know of none that do not require health insurance) where the student is doing clinical and the College of Nursing is responsible for verifying that the student has health insurance. Yes, students can have insurance other than Penn State’s”