Out-of-state students should not trust their health insurance.
Our student insurance company, Professional Insurance Agents, is making a lot of money off of insuring a bunch of young, healthy students. If you are a UCSB undergraduate, you pay almost $900 a year in health insurance fees, and if you are a graduate student you pay over $1800 per year. Most of us never get any benefit in a given year because our insurance coverage only kicks in when the $250 deductible is exceeded. This does not necessarily bother me, but I do think they should be obligated to actually cover us for what we pay our fees for.
I am a UCSB graduate student who was recently sent out to live in Illinois to do my thesis research there. I never had any problems with my insurance before I moved, so PIA may be reliable for local students. But if you are one of the many students who will be studying abroad, you should be aware that you will no longer be granted all the health insurance benefits you pay for, and you should monitor your bills closely while you are away to guard against the frequent errors you may face.
First of all, our dental plan is only valid when we are treated at the UCSB student dental center, so you have no service while you are out of town. Additionally, as I discovered after I injured my knees while jogging, if your doctor tells you that you need a series of physical therapy appointments, you will also only be covered at Student Health – an impossible commute from Chicago ,Ill.
Now I don’t want to leave the wrong impression – most of the student health policy is not quite so nonsensical. For most conditions, PIA claims it will still cover an out-of-state student at 80 percent as long as you call them up for a list of doctors that are in their “Preferred Provider Network.” If you go to a doctor not on this list, they will only cover you at 50 percent. This is how you might get ripped off. A doctor I went to was on their PPO list. PIA referred me specifically to him, in fact. But PIA only paid the 50 percent non-PPO rate for the fees. When I pointed out this mistake, the telephone operator promised they would fix it, and the next bill I received had a comment written on the bottom saying I was being covered at 80 percent. But check your math! In my case, the comment was completely false and they were still only covering me at the non-PPO rate of 50 percent. I again called them up and pointed out this second “mistake.”
This time the two operators I talked to each responded by claiming that the doctor was not on their PPO network and they had to cover me at 50 percent, ignoring my protests that their company was the one that originally told me to use him. I later discovered a website that allowed me to search for providers, and called back with proof. I told them, “Yes, my doctor is on your network. Even your website says so.” Again, they promised they would fix the mistake. They sent me another deceptive billing report claiming I was covered at 80 percent, but again only paying 50 percent.
As of the time I am writing this, six months and many long phone calls after my doctor visit, PIA still has not paid all that they owe me. Whether this problem is due to incompetence or dishonesty I don’t know. I simply want to draw attention to it and warn other students. Especially if you are treated out of state, don’t assume you are covered, and don’t trust your insurance bills. Check the arithmetic and make sure you aren’t being cheated.