Benefits that don't benefit: a personal look at student health insurance
Massachusetts law requires all full-time students to be insured. Like many institutions, Emerson students are automatically enrolled in a student health plan unless they possess a comparable outside insurer. Some students waived and avoided this fee to lessen the hefty cost of attendance while others accepted it. As one who accepted and is now insured under Aetna Student Health I figured I made a necessary and proper investment, until I tried to replace my prescription glasses. I lost my glasses during the rush of orientation week. Instead of attending group sessions in the Common or exploring the city on tours like The Boston Experience, I had to sit out and squint my way through mandatory academic events. Of course my mother cautioned me to get a new pair before leaving Miami for Boston, but I told her I would just figure it out when I got there. “Besides mummy,” I said naively, dismissing her warning, “I bought the school’s health insurance.” And for $1,875 a semester, I was sure I would be able to replace my prescription glasses if needed. Unfortunately, that was not the case. Getting new glasses had more hoops than an Olympic gym.
With my tail between my legs, I called my mom when I realized they were gone for good. After a storm of hmphs, didn’t-I-tell-yous and you-don’t-listens, she told me to find a clinic and put the insurance I paid for to use. Since I hadn’t even found the dining hall, I saved finding a clinic for last. During parent orientation all students are given a booklet summarizing the undergraduate plan design and benefits at the Health and Wellness table. The representatives also advised to print my member card before attempting to receive any medical services and take a look online if any questions arised. I started there.
According to the booklet, eyewear (including eye lens also known as eye contacts) are considered prosthetic devices. Eye exams, eyeglasses, and vision aids are not covered under this benefit. Adult routine vision exams are listed as a separate health expense and 80% of the negotiated price is covered if you see a preferred care provider. Non-preferred care providers would only be covered 60% of the negotiated price. Preferred providers are the service providers in-network with insurance company. If you see a doctor or use a hospital that is not on the plan’s list, you are seeing a non-preferred provider. This does not include the cost of prescribed lenses or frames.
Research completed, I located the school clinic at the Union Savings Bank building on the third floor, Room 303. I barely made it across the street because I confused a car for a bike and almost died. When I arrived at the health clinic, I approached the secretary and told her I lost my glasses and needed to replace them. She replied bluntly, “We don’t do that here.” Then she pointed to the cluttered bulletin board where I found a list of places near the area that accepted Aetna Student Health.
I narrowed down the list to three of the five eye resources: Cambridge Eye Doctors, Pearle Vision, and See Inc. Cambridge Eye Doctors was reported to be closed down and Pearle Vision did not answer. When I called See Inc. and asked if I could get information about the cost of a visit and an explanation of their proceedings, the woman told me to shoot them an email instead because they were busy at the moment. This, ladies and gentleman, was the final straw. Not only was I paying more than rent prices in Miami per semester for this health insurance but those who were supposed to assist me were as blind as I was. I decided I would take my chances with my bad sight, even if that meant sitting in the front of every class and staying safely in bed watching the back of my eyelids to avoid death at the crosswalk.
Fortunately for me, I found my glasses later that week. As a courtesy visit, I went back to the school health clinic and told the secretary about my experience. I also asked who I could speak to about the benefits of the health plan. She explained to me that the school clinic is not not responsible or connected to the student health insurance. Any issues must be taken up directly with the insurance provider. All the school clinic can do is make the resources provided through the health insurance more available to students (hence the bulletin board). She also did me the favor of calling back the eye clinic that dismissed my call.
Although frustrating, this experience was very enlightening. All the things I went through are thing to be expected when responsibility has been shifted on to you. It only makes sense that the school’s health clinic is not involved with student health insurance. You wouldn’t go to a hospital to discuss the benefits of your health insurance provided by your employer would you?
So what’s the moral of the story kids? Listen to your mothers and get a new pair of glasses before you leave home.
Photo courtesy of Flickr Creative Commons.