Duke University, like many other schools, requires its students to be covered on some form of a health insurance plan. For many students without coverage from a private insurer, the $1,895 insurance fee for Student Blue is an additional payment made towards annual tuition. Although a sizable number of students enroll in the plan each year, some students do not know that in addition to most common medical services, StudentBlue can help subsidize the costs of more complex diagnostics and procedures.
Sophomore Justin Palpant said he chose the health insurance plan over his previous insurance plan under his mother because it seemed to offer better preventative care and was covered by financial aid. Palpant, however, was unclear as to the extents of his coverage due to his limited use.
“My experience with it so far has been pretty minimal,” Palpant said. “I have had a few booster shots which were conveniently covered completely, and one doctor’s visit for which I think there was a copay but a reasonable one.”
Freshman Joseph Lam, a member of the fencing team and whose plan is also covered by his financial aid package, was also uncertain about the extent of his plan’s coverage. But Lam has used Student Blue to help cover diagnostic exams such as his EKG and sickle cell blood tests.
“I'm certain that the physicals at the beginning of the school year for the fencing team were all somehow included,” Lam said.
According to the Student Blue Benefit Booklet for Duke University, the insurance plan will cover 80 percent or more of most in-network medical services. Some of these services include emergency room visits, mental health and substance abuse treatments, maternity services and most in-patient diagnostics and procedures.
Jean Hanson, associate director of clinical services and outreach for Student Health, wrote in an email Tuesday that students typically use StudentBlue to cover lab tests and medications from the pharmacy. In addition to the coverage provided for pre-matriculation vaccines and contact lens and glasses, the insurance plan can reduce the costs of otherwise high rates.
“Several students have benefitted from the $2500 out of pocket limit,” Hanson added. “Without that benefit, they would have huge medical bills.”
For lab tests that go to an in-network provider, the benefits will pay 80 percent coinsurance, wrote Student Medical Insurance Manager Anna Kenyon in an email Monday.
Kenyon stated the plan is the same for both undergraduate and graduate students and retains approximately 95 percent of students from year to year.
“The numbers fluctuate...but roughly half of students, both undergrad and graduate, enroll in the student insurance plan,” Kenyon said.
Kevin Welch, associate director of business and finance for Student Health, said students who are not on the plan typically remain under their parents’ plans. He added that since switching to Student Blue in 2011 there are certain new areas of coverage based on healthcare reforms that were not available with the previous carrier.
“Oral contraceptives are now covered at 100 percent,” Welch stated. “We also have added fertility benefits for same sex couples, and there are also now expansive transgender surgical benefits that are more consistent with some of our peer institutions.”
A service's eligibility for coverage under Student Blue is based on medical necessity, which is largely determined at the discretion of the provider, Blue Cross Blue Shield North Carolina. BCBSNC’s Corporate Medical policy states that the service must not be for experimental or cosmetic purposes, must be necessary to diagnose or treat a condition, must be generally accepted as medical care by the community and must not be for the sole convenience of the insured or the provider.
Some services that are not covered and deemed medically unnecessary by the Student Blue Booklet include artificial conception, sterilization reversal, personal hygiene services and obesity treatment with the exception of invasive treatments for morbid obesity.
But the plan does provide students the benefit of reducing the cost of other services that they may need occasionally. Kenyon noted that although there is no dental coverage, students on the health plan are eligible for discounted dental services through BASIX, a dental savings program.
“I did need to use [Student Blue] to get some dental surgery last year at Campus Walk Dental,” sophomore Dennis Lynch said. "I know it doesn't cover dental fully...other than that, I'm not entirely sure what else it covers because I haven't really used it.”
Welch said the current Student Blue coverage was already expansive, but that the Student Health Insurance Advisory Committee, which is composed of both students and staff, meets regularly to talk about the plan’s performance and set rates for the upcoming academic year. Students on the committee suggest new benefits they want included in the plan, and the committee votes whether or not to introduce the new coverage.
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