Guide to Healthcare

GSU’s Healthcare committee had one its more active years in recent times. Following the dramatic hike in out of pocket payments (the amount one pays before the insurance kicks in) on the university insurance plan, announced just before the start of the previous academic year, many of us came together to organise against it, and collaboratively better understand how healthcare works (or doesn’t) for us here. We generated some documents, and also organised to build pressure on the university, preventing any further deterioration of our insurance this year. Some of our members work with the Student Health Advisory Board, and through that were involved in a variety of activities, including generating a survey to gain a sense of student views on healthcare, and a townhall where students could ask questions to the Dean and directors of healthcare services on campus.

Through these activities we developed a better sense of the three key areas of concern that we had made note of in the 2015 Survival Guide: 1) costs were the biggest concern, along with concerns about costs not being communicated properly, 2) lack of information, especially regarding the insurance and what is covered, 3) some people said that they avoid the student health and counseling services because 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. Accordingly, we have tried to produce some documents as part of the expanded 2016 Survival Guide, in an effort to pool experiences amongst ourselves, should it in any way help fellow grad students find their feet in a difficult scenario. Please do write to us if you feel your experiences or knowledge can help us improve this document, or if you have unanswered questions. We will continue working to build a movement for better healthcare at UofC: if you would like to be involved with that campaign, or wish to discuss anything else pertaining to health here at UofC, please get in touch with our healthcare committee (gsu@riseup.net)

The university health insurance plan (U-­SHIP), managed by United Healthcare Student Resources, is not as bad as it could be. It covers an okay range of services, at least relative to the high cost of health insurance generally. It is comparable with the best platinum plans available on the Illinois marketplace, though that might not be saying much since the large and relatively young student body who get this plan should allow the university to bargain low prices. There remain significant issues with the plan, and the university could certainly purchase a better plan by paying more. For instance, other universities in the vicinity with recognised unions have much better plans. You could check out the University of Illinois, Chicago plan if you wish. This document you are reading is meant to be a brief introductory note to help make the system work for you. It is divided into the following sections:

I) to help navigate the system
II) important locations
III) costs
IV) dental/vision care

I) To help navigate the system

  • the insurance plan requires you to get your primary care from Student Health Services (SHS) (sometimes referred to as the Student Care Center). If you don’t go there first to get a referral for health services, you may be penalized by the insurance plan. A part of your student life fee goes towards paying for the SHS, and services you subsequently avail there are usually (but not always) without additional charges. However, it is good practice to always clarify these matters with reference to your particular condition when visiting. Also, since you depend on an SHS referral to avail of the benefits of the insurance, it means that if you have delayed paying your student life fee you are in effect left without an insurance for the time being. SHS is no longer a walk-in clinic, you will need to schedule an appointment to be seen there.
  • if it is an urgent matter during out of office hours, it is strongly recommended that you contact the university’s nurse advice line (773-­702-­1915) 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, the university’s nurse advice line is outsourced and run neither by the university nor by the insurance company. Possibly because of this reason, there have been cases of the nurse advice line not entering the referral correctly, making it difficult for the student to retrieve the information when needing it to later dispute that charge. Hence, record the time, duration, and the name of the nurse you talked to, and save the phone bill that shows your call record. (The phone bill may not be sufficient proof for the company though.) If not, 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. Also, if you are being treated at the UCMC, you may qualify for “charity care” because almost all graduate students are low wage earners.The hospital uses this to tout its support for poor people, though, as a “Non Profit,” it pays no income or property taxes and in exchange is legally required to provide a certain amount of subsidized care.
  • the process for applying for charity care is relatively simple. 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 (to the left right when you enter the building). You should receive a reply within a week notifying you of your discount. You can find more details about disputing bills in general in the Survival Guide document titled “Disputing your medical bill.
  • healthcare providers will usually not be able to tell you the cost in advance. However, it may be good to ask, at least for estimates. Also enquire if it is covered by your insurance. Apart from asking the healthcare provider, you can often call the insurance company, if it isn’t an emergency situation, to see if they can clarify how a treatment or service might be billed.
  • 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, SHS, the student insurance coordinator, and/or the insurance company. Folks have been billed erroneously for a variety of things, and a lot of calling and asking questions and clarifying often allows one to save hundreds of dollars. It’s unfortunate that we have to do this work, but it can often be worthwhile not to take every bill as the final word on what you might owe out of pocket. At the same time, do not just sit on a bill past the deadline for making payments, they will send a collector to your house without hesitation, and you don’t want that happening.
  • there are a number of doctors and nurse practitioners who work at SHS, some might be a good fit for you, some might not. If you meet with someone you feel comfortable with, you can request appointments with that person when you schedule a visit. This way, you can feel like you’ve got a primary care physician who knows you and your medical history.
  • If you need hospital care, the University of Chicago Medical Centre (UCMC) will often turn out more expensive than other hospitals. If you are being referred to the hospital if may be good to ask the doctor or nurse making the referral what your other in-­network options are -­ there is usually a tendency to automatically refer people to the UCMC. [The insurance covers more costs if you visit a healthcare provider with whom they have an agreement, rathern that an ‘out of network’ provider] It should be noted, the UCMC is supposed to be a good hospital, and especially if it is a complicated operation there may be grounds for considering the more expensive treatment. Again, low-­income grad students are usually eligible for some amount of subsidized care.
  • the SHS provides a range of preventive care (e.g., physicals, regular gyn screenings, HIV and pregnancy testing) at no cost. Give them a call (773 702-4156), take advantage!
  • you can get contraceptives for free by getting a prescription from SHS, they are covered by the insurance. SHS can (at least in theory) provide long-­term prescriptions and renew them on request.
  • thanks to the Affordable Care Act (aka Obamacare), you can get 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. Contact the United Health Insurance Coordinators on campus to learn about other in-network providers.
  • many students will qualify for IL All Kids/ Medicaid, which covers normal birth and prenatal care 100%. U-­SHIP is notorious for failing to cover basic prenatal care without a lot of wrangling, so it makes sense to apply for Medicaid even if you have U-­SHIP, just to cover your bases. Keep in mind that not all providers accept Medicaid, so you will need to check in advance.
  • 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.Janice Thomas and James Abernathy.Telephone: (773) 834-4543 (press Option #2); Email: uchicagoadvocates@uhcsr.com.
  • Julie Edwards is the Director of Health, Promotion and Wellness, and is also there to address questions about our insurance. She is an university employee. She can be contacted at (773) 702-8247 or julieedwards@uchicago.edu.

II) Important locations

  • the university’s Student Health and Counseling Services (SHCS), in the Office of Campus and Student Life, oversees provision of health care for students and negotiates with United Healthcare about the terms of student health insurance. It is divided into the Student Health Services, Student Counselling Services, and Health Promotion and Wellness. The SHCS seeks input from the Student Health Advisory Board (SHAB), but SHAB, like any student advisory body (including Graduate Council), has no formal decision-­making power when it comes to matters of university administration.
  • the SHS (Student Health Centre) address is 860 E. 59th Street, R100, and phone number for appointments is (773) 702-4156. Go down S.Ellis to E. 59th, then turn right on 59th and keep walking till the Goldblatt Pavilion Entrance. After you enter you can show your card at the desk and ask for directions -­ you have to go left once inside the building to reach SHS.
  • the Student Counselling Centre has moved to a new address. It’s now at 5555 S. Woodlawn Avenue, Chicago, IL 60637 . The entrance is on 56th street. Find more about counselling and mental health in the “Guide to Mental Health” section of the guide.
  • if you have a regular prescription you need filled, the pharmacy in DCAM (Duchossois Center for Advanced Medicine, 5758 S. Maryland Avenue, (773) 834-­7002) is often cheaper than the Walgreen’s or CVS in Hyde Park.
  • Health Promotion and Wellness is at 950 E. 61st Street, 3rd Floor, Chicago, IL 60637 . They organise things such as play time with therapy dogs, yoga sessions, stressbusters such as back-­rubs, etc.
  • United Healthcare’s Insurance Coordinators are located at Woodlawn Social Services Center; 950 E. 61st St., Rooms 368 & 370.

III) Costs

The cost for the 2016-­17 UofC U-­SHIP for students is $3,615, paid in three quarterly installments of $1,205. Depending on your department and offer package, the university may be directly making these payments, or leave you to do so. If you have to purchase coverage (i.e., the University is not providing it as part of your funding package or you are not covered under a spouse’s plan or your parents’ plan), you should explore comparable alternatives on healthcare.gov before deciding to pay for USHIP out of pocket – see our Obamacare guide. Foreign nationals on student visas are also eligible to purchase insurance on healthcare.gov. And depending on income level, whether or not you are an US 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 potentially save $1000-­1500 for comparable coverage through the IL Marketplace.

If you are a returning student, since your previous year’s U-­SHIP lapsed at the end of August, you are eligible within a one month window, till 30 September, to find a plan on the exchange/marketplace through the special enrollment period, but the university’s internal deadline effectively means that you must find coverage on the exchange by 15 September. New students may also be eligible to buy a plan during the special enrollment period. Do note, the national enrollment period for 2016 is open from November 1 to December 15, but since we need to confirm our insurance choice with the university by 30 September you must apply using the special enrollment period and again during open enrollment. If you miss the University’s deadline to waive USHIP, any changes after that have to meet United Healthcare’s criterion for mid-­year changes, which are not likely to be nice.

Dependent coverage has generally been very expensive through U-­SHIP. If you have children, you can look into IL All Kids, a State-­subsidized program for children’s health care. For the lowest income bracket, which includes many graduate students, there is no deductible and very few co-­pays. However, not all providers at the University of Chicago Hospital take All Kids/ Medicaid, so you may need to seek a provider elsewhere. The Friend Family Health Center at 55th and Cottage Grove is associated with the University and accepts All Kids, for example. Thanks to Obamacare, spouses do not have to pay the exorbitantly high premiums for USHIP as they had to, but preferable insurance options may still be available on healthcare.gov. It is generally not advisable to purchase USHIP for children: cheaper coverage is available on healthcare.gov or via Illinois Medicaid and CHIP programs. You may also want to look at our Obamacare Guide and Guide to Childcare.

You can find the details of the USHIP insurance package here.

IV) Dental/Vision

You can opt to add Dental and Vision coverage to your health care plan. It is usually possible to take these plans for the whole year, or for a 6 month period spanning roughly the Winter and Spring quarters. Unless you think you are going to need significant dental work in the coming year, the dental insurance is probably not going to be cost-­effective for you. You can find the three packages offered through the university listed here, and if you consider purchasing any of them be sure to check with your prospective dentist which plan they take. For regular cleanings and x-­rays, you are better off simply paying out of pocket. There is a discount card included with your U-­SHIP that may get you a break on dental services from various places in the city. Many dentists will also reduce their charges if you explain that you don’t have insurance. Also, tread carefully if considering Groupon deals, they may not be advisable -­ while the cleaning itself can be a good deal (depending on the provider and so on), it has been reported that the dentist invariably suggests complicated and expensive follow-­up. The University of Illinois at Chicago student dental clinic is 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. You can find the details of the two plans offered this year here. For a 6-­month premium, you can get an eye exam with only a $10 copay and significant benefits towards glasses or contact lenses. 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. There may also be other factors to consider: international students, or those visiting other countries at any point in the year, often find it cheaper to get their eyes checked and purchase new glasses outside the country.

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