Healthcare at UChicago can be complicated, especially for graduate workers who may be new to having their own health insurance after aging out of parent plans or those residing in the United States for the first time. What follows is a brief overview of receiving healthcare while enrolled and working at UChicago, including frequently asked questions and common obstacles that grads face when trying to receive care.
Health Insurance Terminology
Many graduate workers in PhD programs at UChicago receive health insurance through the University for a certain number of years as part of their funding packages. Our plan is called the United Student Health Insurance Plan (U-SHIP), provided through United Healthcare Student Resources. For workers who receive health insurance as part of their funding package, the University (like most employers who provide health insurance as part of their workers’ benefits package) pays for the premiums. Premiums are the annual cost charged by insurers to be covered by an insurance plan.
Like all health insurance plans, U-SHIP also has out-of-pocket costs, which we as graduate workers are expected to pay themourselves when receiving medical care. Firstly, there is a deductible. A deductible is an amount of money that must be paid by an individual in a policy year (that is, a year of coverage under your health insurance policy) before health insurance coverage will kick in. Out-of-pocket costs also include Copays, which are a flat rate that must be paid for prescription drugs or specific services, and Coinsurance, which is the percentage of the cost of services that is paid by an individual. Copays do not contribute to your deductible; coinsurance kicks in after your deductible is met. The good news is that there is a maximum that individuals are expected to pay out-of-pocket per year (called the out-of-pocket maximum).
Health insurance plans also distinguish between healthcare providers. On the one hand, there are preferred providers, who are considered to be in-network. These are providers who have an agreement with the insurance company. Out-of-network providers don’t have an agreement with the insurance company, and cost more money out-of-pocket to see, or might not be covered by the insurance plan at all.
At UChicago, the department that provides healthcare services directly to both undergraduate and graduate students is now called UChicago Student Wellness (formerly Student Health and Counseling Services). Medical services are provided at the new UChicago Wellness Center at 840 East 59th Street, and counseling and mental health services are provided at Alumni House, 5555 South Woodlawn Avenue (they will be moving into the new Wellness Center between Fall 2020 and Winter 2021). Many routine healthcare services are provided at no additional out-of-pocket cost through Student Wellness; this is because Student Wellness is partially funded by UChicago’sour Student Services Fee, a quarterly fee that all individuals enrolled as students at the University must pay. For the 2020-2021 academic year, the Student Services Fee is $416 per quarter.
U-SHIP requires that both undergraduate and graduate students go to Student Wellness first for any care. If studentswe need care that is not covered under the scope of the Student Wellness clinic, theywe are required to first see Student Wellness for a referral to another provider. This referral lets students seeWe can then see the other provider and have it covered by U-SHIPour insurance–but if studentswe do not receive a referral from Student Wellness first, theywe will be charged an additional fee of $50 for the visit.
U-SHIP Costs, 2020-2021
Premiums: $4,566 per policy year, often paid by the University directly to the insurer as part of graduate worker funding packages
Deductible: $500, per person, per year, for preferred providers
Copays for prescription drugs: Between $10-$40 for up to a 31-day supply, depending on the drug
Copay for a doctor’s visit: $20
Copay for an emergency room visit: $100
Out-of-pocket maximum: $1,500 per person per year
Fee for not having a referral: $50 per visit
Coverage under U-SHIP is relatively good in comparison to other plans available in Illinois, but not as good as some plans available to graduate workers with recognized unions and contracts with their university, like the University of Illinois-Chicago. It covers specific types of preventative care for free, as required by law; most prescription drugs at relatively low costs; and many medical procedures.
It does not cover treatment for addiction; behavioral, learning, or intellectual disabilities; cosmetic procedures; elective surgery; certain types of foot care; some types of hearing loss; alopecia; some types of prescription drugs; reproductive or fertility services; routine newborn care; or speech therapy, among others. Most significantly, it does not cover dental or vision care.
Coverage under U-SHIP lasts for one policy year, from September 1 until August 31, and must be renewed each year while you are a student. You should receive a yearly email while enrolled asking you either to waive your coverage or opt-in. Under U.S. law, you must be covered by a health insurance plan while residing in the U.S., so if you don’t enroll in U-SHIP, and you aren’t already covered by a parent (if under 26 years of age) or spouse’s plan, you will have to find another plan. You should be cognizant of the policy year so that there aren’t any gaps in coverage: for example, if you are an international student and move to the U.S. at the beginning of August, you will not be covered by the plan for another month, and will want to arrange to have that gap covered.
Your insurance plan covers only you as an individual. In order to cover your spouse or children (known as dependents) under the plan, you will have to pay an additional premium per person (for 2020-2021, $4,566 for a spouse and $4,566 for one child, with a very small discount for each additional child). You will also have to pay a dependent enrollment fee of $326. This cost is prohibitive for most graduate workers, and you may want to explore insuring other family members under a spouse’s work-provided insurance plan or a state-subsidized plan for children’s healthcare (see Pro Tips below).
Areas of Concern
GSU has conducted repeated member surveys over the past several years in order to identify major areas of concern related to graduate workers’ healthcare coverage.
Firstly, costs are a huge problem. For most graduate workers, the costs of receiving healthcare under U-SHIP our insurance plan can be prohibitive. Even when premiums are covered in graduateour funding packages, the deductible, copays, coinsurance, and other out-of-pocket costs–not to mention the cost of care that is not covered at all under U-SHIPgraour insurance–can prevent us from receiving the healthcare that theywe need. SomeA portion of GSUour members have reported having to apply for CharityCare from the UChicago Medical Center, a program which assists low-income patients with expenses, which clearly indicates that many graduate workers are unable to afford out-of-pocket costs on our limited incomes. Moreover, these costs have only gone up over the years: in 2016, there was a dramatic increase in out-of-pocket payments.
Communication about costs, coverage, and how to access care is also less than ideal. Graduate workers have reported problems with transparency of costs, in which they were surprised by fees and the cost of care or told that insurance didn’t cover something that they needed. Confusion about the need to go to the student Wellness Center to receive certain services often leads to fees. The healthcare providers that graduate workerswe are referred to are also often unfamiliar with the requirement that theywe receive basic services at the student Wellness Center, meaning that these healthcare providersthey may mistakenly direct patients to receive care elsewhere.
The Wellness Center (formerly the Student Health Center) also poses problems for graduate workers. Firstly, the Wellness Center isn’t paid for as part of gradour insurance. Instead, it’s funded by the Student Services Fee, which is not covered as part of most funding packages and which has been steadily increasing over the past several years. Unlike undergrads, grads don’t always live near campus or even have to be on campus regularly; if theywe live in another neighborhood in Chicago, theywe are unable to access a doctor in theirour neighborhood and instead have to return to Hyde Park during regular business hours to receive healthcare. For receiving care when the Wellness Center is closed, U-SHIP includes an emergency nurse line for advice and referrals (773-834-9355). Unfortunately, GSUour members have reported difficulties receiving the referrals they needed for emergency care through that line, which is outsourced. Many members have reported being dissatisfied with the care they received through UChicago Wellness, reporting that they expect to face, or have faced, racial or gendered prejudices, or have had to deal with practitioners who are not sensitive to cultural differences. Additionally, the center is geared toward people ages 18-22, despite the fact that a majority of workersus at UChicago are older grad students; members have had trouble receiving adequate care because providers were not equipped to deal with healthcare needed disproportionately by older adults, such as treatment for shingles or services for planned pregnancies.
In that vein, coverage under U-SHIP is less than ideal. U-SHIP is offered as a one-size-fits-all plan for students at UChicago, but it’s geared towards the needs of healthy 18-22 year olds, not graduate workers. As older individuals in a different life stage than most undergrads, gradswe have different needs. Because U-SHIP isn’t geared towards themus, GSUour members have reported difficulties getting coverage for things like prenatal care and birth care, making them rely on IL All Kids/ Medicaid for their needs. The high costs of dependent coverage are also a significant barrier for families. Dental and Vision Insurance are not provided through U-SHIP either, unless grads want to pay additional premiums for coverage. Most GSUof our members go without vision or dental insurance due to its expense, and 40% reported having gone over a year without visiting the dentist in GSU’sour bargaining survey. Graduate workers have also faced difficulties with U-SHIP when experiencing life changes that require mid-year changes in coverage: many grads age out of their parents’ plans at 26-years-old or have other life changes requiring that they acquire new insurance, but they can be denied the ability to enroll mid-year if they are not enrolled in the current quarters’ classes (as is common in the summer).
- Always make an appointment with the UChicago Wellness Center first–even if you know you need to see a specialist. If you haven’t been seen for this condition before, they need to refer you. They also provide routine care such as immunizations and blood work that may be requested by your specialist providers. Going to the Wellness Center first will help you avoid fees and being denied coverage by U-SHIP (they will not pay for anything, such as blood work, that you could have received at the Wellness Center).
- For urgent care while the Wellness Center is closed, call the university’s nurse advice line (773-834-9355) for a referral. If you encounter any disputes with the insurance company, such official referrals will be critical for you to defend yourself from paying the full bill. However, some grad workers have had trouble with referrals not going through properly when calling the nurse advice line, so record the time, duration of the call, and the name of the nurse you talked to, and save the phone bill that shows your call record. Make it a point to mention the fact that you have been referred at every juncture possible.
- You are not required to make a payment at the time that you visit a doctor. It is your legal right to refuse if asked. Your bills are generated after the visit, and it is only after they go through the claims process that you are expected to pay anything. Wait for a bill that includes information about the amount that U-SHIP has agreed to cover before paying.
- If you are having trouble paying for treatment received at the UChicago Medical Center, you can apply for relief through CharityCare. UCMC, as a non-profit, is legally required to provide a certain amount of subsidized care: many graduate workers qualify for this type of assistance because theywe are low-wage earners. To apply, go to the following webpage, where you will find a PDF of the financial assistance form. Fill out the form. Under the employer, list the University of Chicago. You will need a copy of your most recent federal tax documents, as well as a copy of your driver’s license or other official ID. Once you complete the form, it can either be mailed (with accompanying documentation) to the address listed on the website, or you can take it in person to Outpatient Services, 1A on the first floor of the DCAM building. You should receive a reply within a week notifying you of your discount.
- Most healthcare providers won’t be able to tell you for sure how much a certain treatment will cost, but you can ask for an estimate. You can also ask in advance if a certain treatment will be covered by your insurance, and call the insurance company to check with them directly.
- If there’s a problem with your bill, you can dispute it. Any time that you get a bill that is unexpectedly high, doesn’t make sense, or contradicts what you were told originally, it might be worth it to call the doctor, the student insurance coordinator, and/or the insurance company. Mistakes in billing happen often, and calling, asking questions, and clarifying often allows one to save hundreds of dollars. However, don’t just sit on a bill past the deadline for making payments, or they may send a collector to your residence.
- The UChicago Wellness Center provides a range of sexual and reproductive health services for free. This includes regular gynecological screenings, pregnancy testing, STI testing and treatment, and contraceptive prescriptions provided with no copay. You can also receive birth control prescriptions and IUD insertions at in-network clinics (such as the OB/GYN clinic at the UCMC) for low/no-cost without a referral.
- You can opt to add dental and vision coverage to your insurance for an additional cost, but it’s not always worth it. For dental, it’s cheaper to pay out of pocket for routine cleanings and x-rays, unless you expect to need significant dental work within the coming year. If you do decide to purchase dental coverage, be sure to check with your prospective dentist which plan they take. You may also be able to receive cheaper dental services by consulting the discount card included with U-SHIP coverage or explaining to dentists that you don’t have insurance. Tread carefully if considering deals on websites like Groupon. The University of Illinois at Chicago student dental clinic is also a good, cheap way to take care of routine dental care needs, though you may need to pay on the spot.
The university’s vision plans, in contrast with its dental plans, can be a good deal. If you need vision correction, you will probably come out ahead with the vision insurance. However, there are some exemptions that may surprise you, and so this may vary depending on your prescription.
International students, or those visiting other countries at any point in the year, often find it cheaper to go to the dentist, get their eyes checked, and purchase new glasses outside the country.
- If you have to purchase insurance coverage (i.e., if you don’t have insurance paid for by the University and aren’t covered under a parents’ or spouse’s plan), you should explore alternatives on the Marketplace at healthcare.gov for cheaper options before paying for U-SHIP. Click here to view GSU’sour more detailed Obamacare guide. Foreign nationals on student visas are also eligible to purchase insurance on healthcare.gov. Depending on income level and whether or not you are a U.S. national, you will likely be eligible for federal subsidies to help make the premiums more affordable. With the federal subsidies, a graduate student earning an average salary might be able to receive comparable coverage through the Illinois Marketplace for $1,000-$1,500 cheaper than U-SHIP. However, grad workersyou do need to be wary of deadlines: since theywe need to confirm otheirur insurance choice with the university in October, you must apply on the Marketplace by September 15 using the special enrollment period and then again during open enrollment (Nov. 1- Dec. 15). If you miss the University’s deadline to waive U-SHIP, you will be charged for insurance coverage, and any changes after that have to meet United Healthcare’s criterion for mid-year changes.
- Graduate workers going through pregnancy and childbirth should consider applying for IL All Kids/Medicaid to cover prenatal and birth care. Many members have reported repeated problems getting U-SHIP to cover basic prenatal care, but many graduate workers make little enough to qualify for IL All Kids/Medicaid, a state-subsidized program that fully covers normal birth and prenatal care. Even if you have U-SHIP, applying for Medicaid can cover your bases if U-SHIP attempts to deny coverage. However, keep in mind that not all providers accept Medicaid, so you will need to check in advance of receiving care.
- Dependent coverage (coverage for a spouse or child) can also be much cheaper through the Marketplace on healthcare.gov (for a spouse) or IL All Kids/Medicaid (for a child) than via U-SHIP. For the lowest income bracket, which includes many graduate students, there is no deductible and very few co-pays under IL All Kids. However, not all providers accept Medicaid, so you will need to check in advance of receiving care. For more information, read GSU’sour more detailed Obamacare guide.
- If at all possible, try to anticipate life changes that may require you to enroll in U-SHIP mid-year. Some life changes, such as aging off of a parents’ insurance when turning 26 or changes in immigration status or marital status, mean that you will be allowed to enroll in U-SHIP partway through the academic year. However, you must be enrolled in the current quarter’s classes to apply for mid-year coverage, meaning that life changes that occur in the summer may leave you stranded until the fall quarter begins. You will also have to pay the full premium for the quarter, even if you try to enroll partway through. If you anticipate any life changes during the coming Academic Year, try to make a plan in advance to enroll in U-SHIP or acquire alternative insurance on healthcare.gov to cover the gap.
- If you need help navigating U-SHIP, there are 2 Student Health Insurance Coordinators, who are available to meet you in person, or discuss over email or phone, anything pertaining to medical insurance. Do note, they are employees of United Health, the company that provides the insurance. You can contact them via the Student Insurance Office.
- If you have a regular prescription you need filled, the pharmacy in the Duchossois Center for Advanced Medicine (DCAM) at 5758 S. Maryland Avenue is often cheaper than the Walgreen’s or CVS in Hyde Park.
What if I don’t have insurance paid for by the university?
If you don’t have insurance paid for by the University and aren’t covered under a parents’ or spouse’s plan, you can purchase U-SHIP at full price, but you should explore alternatives on the Marketplace at healthcare.gov for cheaper options first. Foreign nationals on student visas are also eligible to purchase insurance on healthcare.gov. However, you do need to be wary of deadlines: since graduate workerswe need to confirm theirour insurance choice with the university in October, you must apply on the Marketplace by September 15 using the special enrollment period and then again during open enrollment (Nov. 1- Dec. 15). If you miss the University’s deadline to waive U-SHIP, you will be charged for insurance coverage, and any changes after that have to meet United Healthcare’s criterion for mid-year changes. Click here for more information on how to navigate purchasing insurance through healthcare.gov.
What if I need to insure a spouse or child?
You can add a spouse and/or a child (called “dependents”) to your plan under U-SHIP, but you will have to pay their premiums out of pocket, which can be very unaffordable for graduate workers. A cheaper option is to find an insurance provider on healthcare.gov for your spouse (click here for a guide on how to do so), or to enroll a child in IL All Kids/Medicaid (click here for more information). For the lowest income bracket, which includes many graduate students, there is no deductible and very few co-pays under IL All Kids. However, not all providers accept Medicaid, so you will need to check in advance of receiving care.
How can I dispute a medical bill?
If you receive an unexpectedly expensive medical bill, don’t panic. In the U.S., it is (quite unfortunately) relatively common to have problems arise with a medical bill and to have to dispute them with either your insurance company or the hospital. Try to do the following when receiving a bill:
- Open your bill, as soon as you get it! It takes time to appeal a bill, and if you put off this process too long, your window for disputing it may close.
- Keep all of your documentation, and collect what you don’t have. You may have to take time contacting the healthcare provider, your insurance company, etc. in order to find missing documentation about the services that you received.
- Review your bill and your insurance policy carefully. What were you charged for? Did you actually receive the care that you are being charged for? Is there a different way for your care provider to resubmit the claim to your insurance company? Was your insurance information entered correctly? Does it appear that your insurance should cover something that it is now denying you coverage for?
- Ask for an itemized list of charges. If your bill does not include an itemized list of charges, requesting that they break down exactly what you are being charged for can often result in a lower bill overall.
- Speak with both your healthcare provider and your insurance company to contest the bill. The money you end up owing on a medical bill is equal to what the provider charges minus what your insurance covers, leaving you to pay the difference out of pocket. If you are able to identify problems with the bill, be sure to attack the problem on both ends: the provider may be overcharging you unnecessarily, and/or the insurance company may be denying coverage unnecessarily. Lower charges from the provider and increased coverage from insurance equal a lower amount for you to pay out of pocket.
- Ask for help. There are a few people on campus who can help advise you on how to dispute a medical bill:
–The UHC insurance coordinators. They have offices on campus, and although they are affiliated with the insurance company, they can help especially in explaining the terms of insurance coverage and providing practical advice regarding claims and disputes.
–The UChicago student health insurance coordinator. This position, affiliated with the University, can actively advocate for your case when you experience issues with claims and coverage under U-SHIP.
-Other students and GSU members. Other students in your department, GSU members, and members of the Student Health Advisory Board have inevitably had similar experiences in navigating insurance and healthcare and can provide insights into how it works. Don’t be afraid to ask your colleagues and friends for advice, and check out one GSU member’s experience disputing a medical bill here.
- Be patient and persistent. Disputing a bill takes a lot of time and a lot of phone calls, and it’s not a fun process, but your work can pay off in the form of a less expensive bill.
How can I receive assistance if I can’t afford my out-of-pocket costs?
UCMC, as a non-profit, is legally required to provide a certain amount of subsidized care: many graduate workers qualify for this type of assistance because theywe are low-wage earners. To apply, go to the following webpage, where you will find a PDF of the financial assistance form. Fill out the form. Under the employer, list the University of Chicago. You will need a copy of your most recent federal tax documents, as well as a copy of your driver’s license or other official ID. Once you complete the form, it can either be mailed (with accompanying documentation) to the address listed on the website, or you can take it in person to Outpatient Services, 1A on the first floor of the DCAM building. You should receive a reply within a week notifying you of your discount.
Is paying for dental and vision insurance worth it?
Short answer: it depends. For dental, it’s usually cheaper to pay out of pocket and/or utilize the University of Illinois at Chicago student dental clinic for routine cleanings and x-rays. However, it can be worth purchasing dental coverage if you expect to need significant dental work within the coming year. In contrast, paying for vision insurance can be worthwhile if you need vision correction, but there are some exemptions that may surprise you, and so this may vary depending on your prescription.
International students, or those visiting other countries at any point in the year, often find it cheaper to go to the dentist, get their eyes checked, and purchase new glasses outside the country.