The GSO Healthcare Committee sponsors a yearly question and answer session with representatives from Chickering and Student Health Services. These give students the opportunity to clarify any confusion they have about BU's student insurance and campus health center. Below are questions asked by students with a summary of the answers. Please contact Chickering or Student Health Services when you need the most up-to-date information on these issues.

Chickering/Student Health Services (April 11, 2000)

1. Who is my primary care physician?

If you are full-time (or at least 3/4-time and on the BU Student Medical Insurance Plan), you use BU's Student Health Services as your primary care location.

Other students may need to establish a primary care physician outside of Student Health Services, and should contact their insurance company about how to do so.

2. Student Health Services requires students to come in and wait to see the next available practitioner. Can you comment on why Student Health Services works this way?

Students who have medical problems can come into the health center immediately (during regular business hours) and wait (on average) 35 minutes to see a physician. This is a much shorter wait than for plans in which one must make an appointment to see a doctor.

If students do have a particular practitioner at Student Health Services that they prefer, they may ask to see that person when they come in. (You may wish to call Student Health Services ahead of time to make sure they are in that day.) Because the average time that practitioners stay at Student Health Services is 12 years, students have the potential to see the same practitioner over the entire course of their academic career.

Student Health Services does take appointments in a few areas of service, such as gynecological exams, mental health services, etc. However, they have found that using an appointment system for general problems is worse than the current "open" system, especially since "no shows" for appointments typically average around 10-20% (figures from the industry).

3. Under what circumstances are referrals made from Student Health Services? Do students have the right to "ask for" a referral, e.g., for a second opinion?

Normally, the primary care physicians at Student Health Services, who students must typically see first for medical care, decide whether a medical problem can be handled at Student Health Services or whether a referral to a specialist (or another facility) is necessary.

Although a student can ask the staff of Student Health Services to refer them to an outside doctor, it is ultimately up to the staff as to whether that is necessary or not.

4. How cognizant are physicians at Student Health Services about how referred services will be covered?

The front desk of Student Health Services can provide information about whether a referred-to physician is "in-network" (meaning better coverage under the Chickering insurance plan); however, they may not be able to tell you how Chickering will cover different referred services.

Students concerned about how a referred service will be covered can call Chickering. If the patient can provide information about who is the referred doctor and what is the condition (this will be kept confidential), they can provide basic information about copayments, % coverage, etc.

5. What coverage is available after a student graduates?

If the student purchased the Chickering plan, coverage will run until the end of the normal period (until some time in August), even if the student leaves school before then. In fact, the student may still use Student Health Services until that period ends.

Chickering also offers a plan that can cover students for 3, 6 or 9 months after their student plan runs out. The coverage under this "extension plan" is slightly different and more limited. This plan usually becomes available around May or June each year. Students can call Chickering for information about it. One note--students must decide whether they want 3, 6 or 9 months coverage when they choose the extension plan, it cannot be extended thereafter. Also, under the plan, you don't use Student Health Services, but instead see a doctor (preferably "in-network") and have them submit claims to Chickering.

The NAGPS insurance plan, which is an alternative insurance plan students may choose (see Healthcare Pages), also offers coverage to students for a certain period after they leave school.

6. What dental coverage is currently available under the Chickering plan? Will additional dental coverage be available in the future?

The current Chickering plan only provides limited coverage for injury to teeth or removal of impacted/unerupted teeth. This includes removal of wisdom teeth as long as they are impacted or unerupted.

Chickering recommends that you seek treatment for such conditions from doctors rather than dentists, since you may get better coverage from services obtained by doctors. For example, doctors that are part of the Aetna (the underwriter for the Chickering plan) network often accept reduced rates for patients that are part of an Aetna plan. Students can find appropriate doctors by going to http://www.aetnaushc.com/docfind, choosing "Doctors", specifying "Open Choice PPO" and then choosing the specialty "Surgery, Oral & Maxillofacial."

There are no plans for Chickering to offer a dental plan to BU students for the 2000-2001 academic year. Chickering does offer dental insurance (basic services covered by a premium) at some other schools and may pilot dental discount plans (discounts on services provided at participating dentists) at schools in the future. Whether Chickering offers a dental plan to BU in the future will partially depend on whether BU wants one or not (BU already has the Student Dental Plan through the BU Dental School).

7. Does the BU Student Dental Plan (through the BU Dental School) allow students to get services at other locations?

No. All services must be obtained at the BU Dental School in order to be covered under the Student Dental Plan.

8. What coverage for vision does the Chickering plan provide?

Since the 1999-2000 plan, the Chickering insurance has provided a vision discount program at no extra cost. This allows students to obtain discounts at participating vision retailers by showing their Chickering insurance card. There is no additional cost for this plan--it comes with the insurance (go to http://www.aetnaushc.com/docfind and choose "Vision One").

9. Is there a way to obtain a routine physical?

The state does mandate that routine gynecological exams are available and these may be obtained at Student Health Services. Those include basic pap smears and lab work (covered by the insurance). Mammograms are also covered for women beyond a certain age. Any other tests will not be covered unless they relate to a specific medical condition.

Commonwealth Medical Group, which houses a rotating group of doctors at 930 Comm Ave. (close to Student Health Services), does provide services at a lower cost. Thus, it represents an alternative for those that would like services not provided by Student Health Services and not covered by their insurance.

10. In 1999, Chickering mentioned its plans to provide an e-mail service. What is the current state of that system?

Chickering expects a system by which students can ask coverage questions by e-mail (through the Chickering web site, http://www.chickering.com) to be in operation by Fall 2000.

11. Are there plans to place information about Student Health Services online? What about being able to ask simple medical questions by e-mail?

Student Health Services is working on a web site that will list the services they provide. It may be available as early as Fall 2000.

Student Health Services does not have any plans to allow students to ask health questions by e-mail. Nonetheless, students may call Student Health Services with questions.

12. Some students spend part of the year out-of-state (e.g., if a student goes home for the summer). When away from BU, what needs to be done to get services covered?

The Chickering insurance, which is part of the Aetna/U.S. Healthcare network, has providers throughout the United States. When claims processors receive bills from out-of-state providers, they will not look for a referral. Referrals are only needed for services in the metro Boston area. (This does not mean you can skip going to Student Health Services when you are in Boston.)

Just as for services in Boston, hospital admissions do require notifying Chickering within a certain period of time.

In cases of car accidents or sports injuries, claims processors may need additional information (since those kinds of injuries are sometimes covered by other kinds of insurance). This information can be provided to Chickering after treatment is received.

13. What would be involved in amending the Chickering plan to allow Domestic Partners to enroll as spouses currently can*? Would there be any costs to BU or would increases in the premiums be required?

Chickering would not know for sure about increases to costs unless BU requested Domestic Partner coverage (as they are not the underwriter for the insurance). However, the Chickering representative said there would probably be no increase to premiums and no additional cost to BU. It would just be a matter of BU requesting that Chickering amend the plan to allow Domestic Partners to enroll.

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*Chickering offers plans with Domestic Partner coverage at some other schools.

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Chickering/Student Health Services (April 6, 1999)

1. What recourse do students have if they are having difficulty with a claim? Is there a specific person that should be contacted in such cases (rather than the general Chickering number)?

There is no specific person available to contact regarding difficulties with claims. The main explanation given is that it would be impossible to always have that one person available (due to vacation, sick leave, etc.) Instead, the claims department as a whole (currently 23 representatives) is familiar with the terms of the Chickering policy available to BU students. Chickering has begun using a "Student Accurate Response System" (software specific to BU's policy) in an effort to reduce misinformation given by representatives.

Beginning in Fall 1999, it will be possible to e-mail questions regarding claims to Chickering. To protect patient confidentiality, responses may be via phone. (As of August 10, 1999, the e-mail system had not yet been set up; however, it was expected to be functioning soon.) Access to that e-mail system will be through the Chickering web page (http://www.chickering.com).

In the event that you feel a claim was inappropriately denied, it is possible to appeal Chickering's decision by following the guidelines listed in the Chickering handbook.

As a last resort, contact Student Health Services to ask if they can either explain the claim, or clarify any misinformation.

2. During the process of being billed for medical services, patients may receive several bills for those services. Initially, the full charge is listed. Later, another bill for the same services may be sent reflecting reduced charges (due to the insurance coverage or doctor discounts). How is the patient to distinguish when the bill represents the final amount that they must actually pay?

Information regarding how to read an Explanation of Benefits (EOB) is available on Chickering's web site (http://www.chickering.com).

The doctor's office or hospital where you receive treatment should automatically send an itemized bill to Chickering. In the event that you receive a bill before receiving an EOB from Chickering, you should forward the bill to Chickering. Be sure and keep a copy of the bill for yourself. If you receive the bill more than once without receiving an EOB from Chickering, it is advisable that you contact Chickering. If you notice a reduction in the amount billed over several billing cycles, this is possibly due to the fact that some (though definitely not all) doctors' offices will accept whatever the insurance company pays as payment in full, and any balance that exceeds that amount is "written off".

If you do not understand the EOB once you receive it, first contact a Chickering representative for help. If you are still confused, contact Student Health Services. They may be able to provide an explanation.

3. The Supplemental Coverage purchasable under the student insurance plan only extends the aggregate maximum benefit. If students wish to apply for this supplemental coverage, how should they go about doing so, and what would you describe as the benefits of this additional coverage? Is there a way for the student to increase limits on specific classes of services like outpatient services and prescriptions?

Brochures with information on how to purchase the Supplemental Coverage are available at Student Health Services. If you purchase the Supplemental Coverage, you will not automatically be re-enrolled the following year. You must reapply each summer when the supplemental insurance policy becomes available. It is important to note that the supplemental insurance only increases the aggregate maximum, not the per service maximum. There is no way to increase the limits on specific classes of services through the Chickering policy that is available to BU students.

4. Some students are interested in additional policies that would cover dental (besides the policy offered through the Dental School) and optical for an extra fee. Are such policies available? How would an interested student go about applying for this kind of additional coverage?

Beginning Fall 1999, a Discount Vision plan will be part of the regular BU student plan for no additional cost. This plan is not an insurance plan, but it allows its participants to receive discounts on eye exams, contacts and glasses received from participating optometrists and businesses. Chickering is also working on putting together a similar dental package that can be purchased in addition to the regular medical insurance, but it is not certain when this will be available.

5. We have encountered questions about preventative medicine and Chickering's stand on this topic. For example, Chickering will cover the cost of treatment during illness, but it does not cover routine physical examinations. Would you please speak to this topic? Also, what wellness or preventative services do you provide or cover (e.g., flu shots)?

The policy available to BU students is designed to cover sickness and accidents. This serves to minimize the cost of the premium for students. The only preventive services currently available to BU students are 1) free flu shots for students who have access to Student Health Services and 2) annual pap smears for women. Things like well checks for men and immunizations are not currently covered under this policy. The only reason that the annual checkups are available to women is because it is mandated by state law.

6. In the process of referrals from Student Health Services to other care providers, is Health Services cognizant of how services and providers are covered so that a patient's benefits are maximized?

In order to maximize benefits it is necessary for students to receive all care from in-network doctors/facilities. It is possible that a physician who treats you at Student Health Services may inadvertently refer you to an out-of-network doctor/facility. If you receive a referral, always check the list of Aetna Open Choice PPO providers (available on the web at http://www.aetnaushc.com/docfind or in a directory available at Student Health Services) to be sure that you are being sent to an in-network doctor/facility. If you receive a referral with an out-of-network doctor/facility listed on it, you may choose to switch to an in-network doctor/physician as long as they are treating you for the same diagnosis listed on the referral.

Any referral issued is good for all services related to the diagnosis listed on the referral for the duration of the policy year. Thus, you should not need a new referral for every related test. It is also possible for the doctor to whom you were referred to send you on to another specialist using the same referral. The key is that it must be for the same diagnosis!

7. What are your future goals for improving health services and coverage for students?

As mentioned above, Chickering will be providing a Vision Discount plan beginning in Fall 1999 and they also plan to make it possible to contact them via e-mail for patients who prefer this method of communication.

Student Health Services is very limited in both space and financial support. There are no current plans for major changes, although they are in the beginning stages of computerizing their services, which will hopefully make them more efficient.

8. Does BU subsidize any portion of the student insurance premium? Also, do students pay a fee to use Student Health Services, i.e., how is the health center funded?

BU does not subsidize any portion of the student insurance premium. The reason for this is that only approximately 9,000 of the approximately 28,000 BU students purchase Chickering. They believe it would be unfair for such a small percentage of the student body to receive this kind of support.

A small portion (only $38) of the fees all students pay each semester (confirmed by Student Accounting) goes towards supporting Student Health Services. This is a very small fee compared to many other schools (e.g., Tufts).