Mount Holyoke changes health insurance provider

 Graphic by Carrie Clowers ’18

Graphic by Carrie Clowers ’18

BY EMMA RUBIN ’20

This school year, Mount Holyoke is using a different health insurance provider, enrolling participating students with Blue Cross Blue Shield instead of the previous provider, UnitedHealthcare. The premium, or the annual cost to enroll in the plan, increased from $1,900 to $1,930 according to fact sheets about each of the plans. 

The new health insurance plan allows students to receive services from in-network providers without needing a referral from the health center, marking a change from previous years, as stated in the fact sheets. An in-network provider is a facility under a contract with an insurance company to offer care to its members. Additionally, these appointments within the insurance’s network are now available at a $0 copay. However, the $250 copay for using an ambulance to get to the emergency room remains. 

“This year the change to Blue Cross Blue Shield provided a broader regional and national network, lower office co-pays and deductible when using in network providers and very limited increase in premium,” said Karen Engell, director of Health Services. She also noted  that the new plan offers more mental health providers, and provides the Holyoke Medical Center emergency room as an in-network option. 

“This is a significant improvement for our students,” she said.

Another change to Mount Holyoke health care is that the Health Center is now collaborating with a new pharmacy to provide prescription drop-off on campus for students. It previously had a working relationship with Louis and Clark Pharmacy in Springfield, but beginning Oct. 23, this 20-year relationship ended. The Louis and Clark Pharmacy notified Mount Holyoke of the change on Oct. 5, citing a new focus on “medication management and synchronization,” and a need to focus on their long-term finances.

Affected students were notified on Oct. 19 with information on the steps that they needed to take. “Students do have a choice to transfer their prescription to another pharmacy, but this process should be smooth,” Engell said.

She said that she has reached out to three other pharmacies in the wake of this change and is looking forward to working with a Walgreen’s located in Springfield for future drop-off services. On Oct. 23, Walgreen’s began filling and delivering prescriptions to Mount Holyoke students, according to the Health Center’s website. 

Massachusetts law 956 CMR 8 requires that every student enrolled in college within the state is  covered by a health insurance plan. The law also mandates that the insurance benefits be on par with standards  set by  the Essential Health Benefits (EHB) Benchmark Plan. The EHB plan is the Massachusetts state-selected benchmark plan from those outlined in the Affordable Care Act. 

Massachusetts law deems coverage meets these standards if it provides the students with “reasonably comprehensive coverage of health services, including preventive and primary care, emergency services, surgical services, hospitalization benefits, ambulatory patient services, mental health services and prescription drugs,” for the entirety of the school year. Furthermore, these services must be “reasonably accessible to the student in the area where the student attends school.”

Every year, the director of Health Services, the director of Counseling Services, the director of Compliance and Risk Management and the director of Financial services meet with the school’s insurance agent to discuss policy renewal for the following year. 

“The agent secures proposals from one to three companies which compare price, benefits and customer service components,” Engell said. Each of the proposed plans meet the standards set by the Massachusetts Division of Insurance. 

As before, Mount Holyoke students may waive the school’s health insurance plan if they can prove that their current insurance meets the same coverage requirements of the school’s insurance. Federal or state plans like Medicaid do not meet the requirements, according to the Health Center’s website. Additionally, international students are not eligible to waive the student plan because short- term plans for international residents do not comply with state regulations. However there is a petition process for students whose families live and work in the U.S. to waive the school’s plan.

Zenia Saqib ’20 is an international student who qualifies to waive the student health care plan. Saqib said, “I am an international student, but I’ve lived in Massachusetts for the past 10 years and have a state-based insurance plan.” 

She explained that the process for waiving is the same as for domestic students, but that access to the waiver is not initially available to her. In order to have the option of a waiver she has to email student financial services and explain her situation. Saqib has found the process to be relatively simple for her, as her family’s insurance “easily met the requirements because it is labeled as a state plan.” 

Tehreem Mela ’20 is enrolled in Mount Holyoke’s student health insurance plan and thinks that the school could do more to financially support students who enroll. “The financial services definitely don’t take into account that some students have to pay for [the insurance plan] as well,” she said, “so it becomes a hidden cost and it becomes harder for parents to pay.”

Last year, Mela needed to fix a bracket in her permanent retainer and went to an orthodontist for a consultation. “Even with the discount my total was $60,” she said, “That was almost two weeks of my earned money here because I worked dining.” The appointment was a consultation, and this charge did not include fixing her bracket, “I had to wait for two months to go back home to get it back in place,” she said.

Under the new insurance plan, students like Mela should be able to receive services from in-network providers available to them at a $0 copay.

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