Why International Student insurance?
Medical care in the U.S. is very expensive. A simple office visit for a minor injury or illness can cost hundreds of dollars. Prescription medications you may be able to cheaply purchase at home may cost significantly more here in the U.S. Major injuries or illnesses are a significant financial burden, quickly reaching totals of hundreds of thousands of dollars in medical costs.
All international students enrolled at SUNY Potsdam and residing in the United States are automatically enrolled in the full SUNY health insurance plan for international students. This insurance is mandatory. This plan has accident/illness/medical coverage and evacuation and repatriation coverage. A full explanation of coverage is available in the most current program brochure, which is shared with all students after enrollment. For more information, please email international@potsdam.edu.
Exceptions
Some international families have United States health insurance coverage provided by a US-based employer; this is the only scenario in which additional international student health insurance may not be required. Please contact us at international@potsdam.edu if this is your situation to confirm that your insurance meets the standards set by the State University of New York.
Though it may seem like an enticing option, families cannot purchase a stand-alone US-based health insurance policy at a lower cost; lower-cost policies uniformly do not meet SUNY’s requirements for coverage under the Affordable Care Act.
Billing
Standard full-time student coverage is August – August. The fee amount varies annually per contract with the insurance company, and billing varies depending on when you begin studies (i.e., fall admits are charged the fee for August-December with the fall bill, and then charged again in the spring for January-August; spring admits are charged a prorated fee for January – August coverage; summer admits are also charged a prorated fee for May – August coverage.) Continuing students are billed each semester they are enrolled.
Frequently Asked Questions
(Adapted from resources developed by Stanford University)
Health care in the United States is very expensive. A single doctor’s office visit may cost several hundred dollars and an average three-day hospital stay can run tens of thousands of dollars (or even more) depending on the type of care provided. Most of us could not afford to pay such large sums if we get sick, especially since we don’t know when we might become ill or injured or how much care we might need. Health insurance is the solution that reduces such costs to more reasonable amounts that the average consumer can manage.
The way it typically works is that the consumer (you) pays an up front premium to a health insurance company and that payment allows you to share "risk" with lots of other people (enrollees) who are making similar payments. Since most people are healthy most of the time, the premium dollars paid to the insurance company can be used to cover the expenses of the (relatively) small number of enrollees who get sick or are injured. Insurance companies, as you can imagine, have studied risk extensively, and their goal is to collect enough premium to cover medical costs of the enrollees. There are many, many different types of health insurance plans in the U.S. and many different rules and arrangements regarding care.
One of the things health care reform has done in the U.S. (under the Affordable Care Act) is to introduce more standardization to insurance plan benefits. Before such standardization, the benefits offered varied drastically from plan to plan. For example, some plans covered prescriptions, others did not. Now, plans in the U.S. are required to offer several "essential health benefits" which include:
- Emergency services
- Hospitalization
- Laboratory tests
- Maternity and newborn care
- Mental health and substance-abuse treatment
- Outpatient care (doctors and other services you receive outside of a hospital)
- Pediatric services, including dental and vision care
- Prescription drugs
- Preventive services (e.g., some immunizations) and management of chronic diseases
- Rehabilitation services
For our international population of students who are accustomed to different models of health care, asking the question, "what does the plan cover" is extremely important. Another question is “who does the plan cover,” because one way that health insurance plans control their costs is to influence access to providers. Providers include physicians, hospitals, laboratories, pharmacies, and other entities. Many insurance companies contract with a specified network of providers that has agreed to supply services to plan enrollees at more favorable pricing. Canton-Potsdam Hospital and all the offices affiliated with it are in-network providers for the SUNY International Student Health Insurance. In addition, all SUNY Potsdam students have access to Student Health Services on-campus as part of their coverage.
If a provider is not in a plan’s network, the insurance company may not pay for the service(s) provided or may pay a smaller portion than it would for in-network care (see chart below). This means the enrollee who goes outside of the network for care may be required to pay a much higher share of the cost.
Understanding what insurance coverage costs is actually quite complicated. First, every student is billed for the premium to enroll in the International Student Health Insurance plan. This is an up front cost that is transparent to you (i.e., you know how much you pay).
Unfortunately, this is not the only cost associated with the care you receive. There is also typically cost when you access care. Such cost is called a deductible, coinsurance, and/or copays and represents the share you pay out of your own pocket when you receive care. As a general rule of thumb, the more you pay in premium up front, the less you will pay when you access care. The less you pay in premium, the more you will pay when you access care.
In negotiating for our standardized health insurance policy, SUNY has taken the approach that it is better to pay a larger share in the upfront premium to minimize, as much as possible, costs that are incurred at the time of service. The reason for our thinking is that we don’t want any barrier to care, such as a high copay at the time of service, to discourage students from getting care. We want students to access medical care whenever it’s needed.
In addition to the premium applied to the student bill, the SUNY policy for 2022-2023 has a $200 annual deductible, and $25 copays after the deductible is met. (see below). This means that for most medical expenses, the student will pay $200 for the first medical visit, and then will pay $25 per visit after that. This makes healthcare expenses much more predictable (and affordable!) for the student.
2022-23 SUNY International Inbound Insurance Benefits
(Includes COVID-19)
| Plan Design (Per Person, Annually) | In-Network Benefits | Out of Network Benefits |
|---|---|---|
| Annual Deductible | $200 (student pays this 1 time, annually, not with each visit) | $400 (student pays this 1 time, annually, not with each visit) |
| Coinsurance | 0% | 10% |
| Preventative Care Services | Covered in full (annual physical, OBGYN) | Covered in full (annual physical, OBGYN) |
| Primary Care Visit | $25 copay after $200 deductible is met | $50 copay after $400 deductible is met |
| Urgent Care Visit | $25 copay after $200 deductible is met | $50 copay after $400 deductible is met |
| Emergency Room | 0% coinsurance/copay after $200 deductible is met | $75 copay after $400 deductible is met |
| Ambulance | 0% coinsurance/copay after $200 deductible is met | 10% coinsurance/copay after $400 deductible is met |
| In-Patient Hospital Care | 0% coinsurance/copay after $200 deductible is met | 10% coinsurance/copay after $400 deductible is met |
| Prescription Drugs | $10 (tier 1)/$20 (tier 2)/$20 (tier 3) | $10 (tier 1)/$20 (tier 2)/$30 (tier 3) |
Questions about international insurance?
Email the Lougheed Center for Applied Learning directly at international@potsdam.edu or call the office at +315-267-2507.