Wednesday, October 22, 1997
Insurance group alters medical service policies
BENEFITS Flat fee of $10
to replace $200 deductible; mental health plan changed
By Kathryn Combs
Daily Bruin Contributor
Starting this quarter, benefits received by students through the
Medical Insurance Plan (MIP) have changed to better fit the mold of
managed care.
These changes affect the popular insurance plan twofold,
changing the way that prescriptions are paid for and redesigning
the delivery of mental health services to students.
Previously, students were required to pay a $200 deductible
before the insurance plan took over 90 percent of the costs
incurred, and students were required to submit receipts directly to
the insurance company for reimbursement.
Most students don’t spend over $200 a year on medication,
according to Cruz. So under the new plan there is an
across-the-board $10 copayment (which is the amount of the drug
price which a patient pays) to replace the $200 charge.
Then the remaining amount is billed directly to the insurance
company.
According to Michelle Pearson of Student Health Services, the
new system is less of a financial hassle for students.
"Before, you paid for the full cost of the medication and then
you had to submit it directly to the insurance company," she
said.
"They would reimburse you and you had to pay 10 percent. Now it
is a flat $10, regardless of how much the prescription costs,"
Pearson explained, adding that they would pay less than $10 if the
cost of the medication was less.
"This pharmacy change is very much to the student’s benefit
because often they are going to be paying less," Pearson said.
"Usually people don’t need the $200 deductible," said Tim Cruz,
a third-year medical student and graduate member of the Student
Health Advisory Committee.
"With all insurance plans, there is always a drawback for some
students," Cruz said.
"The point is, the majority of students are going to save money.
Students forget that they have had to pay back that amount before,"
Cruz said.
There have also been changes in the delivery of mental health
benefits under MIP. The primary change is in the referral of
doctors. Now, patients seeking mental health treatments will be
referred out to psychiatrists affiliated with UCLA.
The other major change is that mental health services will now
include treatment for chemical dependency. According to Insurance
Coordinator Linda Amicarelli, the new behavioral health program
gives UCLA a chance to offer students more comprehensive
treatment.
"It is now a separately contracted plan with the UCLA Mental
Health group, and Student Psychological Services is the entry point
into the program," Amicarelli said."Up until now we have always had
a very limited psychological benefit."
For those who use their student insurance to see psychologists
off campus, some students have expressed concern that they will
have to change doctors and seek out a UCLA professional.
But Student Health officials say that’s not to be feared. "These
people could be enfolded into the Neuropsychiatric Institute group
at UCLA," Pearson said.
"(Other doctors) can still see their patients, but only through
a different channel," she said.
"We changed these things because we wanted to encourage students
to use the health care that is available to them at a reduced
cost," Cruz said.
"Other pharmacies, including the medical center, charge more
than student health services. Sometimes four, five or even six
times the amount that student health charges," Pearson said.
"This essentially affects everyone. (Students) would spend more
if we continued the way that we were. It is important that care is
close to UCLA," Cruz said.