Health Insurance letter

I guess it's nice to know that this KP policy has changed. It would have been a lot nicer to know BEFORE rather than after such a significant change happens. Perhaps those in the administration and those who are fortunate enough to have health insurance do not realize that some mids have no insurance at all. It would be a bit scary to be told after the fact that mids who were injured while out to sea have no insurance. Fortunately, our DS did not get sick or injured at sea, and I hope no one else's DS/DD has to find out about this policy change the hard way.
 
Mids injured at sea are still covered by the ship's company, or MSC, in much the same manner as the ship's crew. Time at sea counts as "in the line of duty" like injuries sustained while a member of a sports team. However, a broken leg from slipping on the ice at home over Winter Break is no longer covered. I'm not even sure when that change took place. I found out early in DD's 1C year. But she was aware of the change. Maybe KP assumed the mids would remember to tell their parents. :rolleyes:

At least the admin is correcting that and being clear this time.
 
Mids injured at sea are still covered by the ship's company, or MSC, in much the same manner as the ship's crew.

That's (good) news to me. I hadn't realized the insurance coverage changed for mids at sea until I saw posts on this forum; followed by the letter I received this weekend. I don't remember reading about that in any of the KP paperwork before.
Actually I'm somewhat surprised parents are in the loop at all. I believe instiutions like to use "privacy laws" to make their life easier by only dealing with 18+ year olds.
 
I had seen out of the corner of my eye this thread. NOW, we just received the letter everyone is talking about. I''m sure it would have been nice for many to get knowledge of the change before it was enacted. Our DS came in 09. We are lucky to be able to cover him under our insurance plan. Now to change the dental....if I can...:eek:
 
Oh yes, and has anyone else noticed we aren't told how to communicate w/ KP about our sons and daughters being on a family insurance plan? What do they do....just show an insurance card? To whom?
 
MM

THis is under the MMA Catalog and Handbook.

Health and Accident Insurance Coverage
Midshipmen actively enrolled in academic classes are provided basic medical, surgical and mental health coverage available through the Academy. The Academy’s Chief Medical Officer and/or Head, Department of Health Services, may authorize health services to be provided by local health providers affiliated with The North Shore/Long Island Jewish Health System (NS-LIJ).
Midshipmen are required to maintain continued enrollment in their existing family medical hospitalization and dental plan. If a midshipman has no access to family medical coverage, the Office of Admissions should be notified. It is important to note that while the Academy medical care is extensive, a midshipman is not entitled to unlimited care at government expense.

Coverage should always be provided by the parents - the academy already pays for their education and I am amazed how people feel that in addition to room and board that a free ride should be provided. This is why they are giving you the information and when your DS/DD comes home they should be covered at all times. Yes many coverages do not cover out of network and yes the expense will come out of pocket.
 
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Coverage should always be provided by the parents - the academy already pays for their education and I am amazed how people feel that in addition to room and board that a free ride should be provided.

Maybe parents are expecting medical care because through at least the class of 2013, parents were told that the mids were completely covered. But those same parents were never told that the policy had changed. Now they are getting a letter requiring proof of insurance and they are wondering what is going on. It seems like a perfectly valid question to me.
 
When reading the health insurance letter, I immediately went to my carrier to see if North Shore University Hospital was an in network hospital for my plan. I suggest that everyone do the same. While emergency visits are usually covered by most carriers, if your child is admitted to the hospital, those charges may partially rest with the parents if the hospital is not covered under the parent's plan and those charges can be very substantial. Having had a daughter at another college break her leg far from home, while the emergency visit was covered, the setting of the leg, etc. became our responsibility after the limited payment by the insurance company.

But there are many other questions to be answered here relative to traveling on sea year (whose responsible between ships for example.) Also, who will have say as to treatment options and which doctors will perform services. Up until now, it was our understanding that the school controlled all these decisions, even if the mid was home on vacation and something happened. The quote we heard was, "They are ours now." In fact, severe penalties could be incurred if a mid had a procedure done without the school's permission even though it was done through the mid's parents insurance. Will that change now?
Decisions about choosing a doctor and/or a facility all had to be coordinated and approved by KP. Is that changing? Will a mid be able to go home where the insurance will cover a procedure as opposed to having it done near KP?

There are many issues that must be clarified for the parents to make good health and financial decisions. Even if the mid has insurance through the parent, the parents might consider buying the "local" insurance the school is offering if local treatment will be mandated.
 
example of problem.....

KPMOM posted some good points- and I think we need clarification from the school on what exactly this Mandatory Health Ins Requirement means... b/c I question if "things have changed" with regards to what the school covers, and what it doesn't.

this is a true story-
a p/c got a rash. school tried to treat. rash came back. school made p/c skip morning classes (sigh- he had a Physics test the next day and couldn't go to the last class before the test)... and sent him "somewhere off campus" to a dermatologist. p/c was told that he had to pay for the appt- he also had to provide his own health insurance (p/c didn't have his ins card with him and had to call his mom in a panic to get the info). mother of p/c is up in arms b/c she doesn't know if dermatologist was on their ins. plan (or was out of network), and doesn't know if p/c paid $25 or $400 at the appt. she can't call her p/c to find out what happened at the appt/ find out how much he spent/ etc. (she is e mailing him asap and he will need to mail her all of the receipts so that she can follow up with her health ins).

if the school is going to make decisions and send our kids to specialists without consulting the parent (or anyone checking to see if the specilist is on the parents ins plan) then yes, this IS a problem. :thumbdown:
 
Go to the link below

http://www.ajfusa.com/ajfusa/help_college_students_user.php?ID=40

The above link will take you to the current medical and accident plan that the USMMA purchases for the benefit of all current Mids. It is quite comprehensive, but not totally comprehensive. Read the brochure and read the exclusions.

Sorry, but despite what anybody was "told" to the contrary, the USMMA never had a more comprehensive medical plan than this current plan in decades, if ever at all. So again. no policy changes here, just clarification of what the medical policy has been. Obviously, clarification was indeed needed, judging by how some seem truly shocked by what they perceive as a policy change reducing medical benefits occurring recently without notification.

What the Academy is doing now, is making certain that everyone has "gap insurance" for the instances when this policy will not cover a medical procedure.ie routine eye exams for contacts and other elective procedure. All listed in the brochure.

A mid can show evidence of other health insurance to fill the gap or purchase the gap insurance that the Academy has gone out and secured for the benefit of the Mids, so that each and everyone has total, complete medical insurance under any scenario, 24/7/365.
 
I believe this plan is ending or changing as of September 30, 2012 when the policy ends. It's the changes that we are questioning.
 
When a M/N has a treatment of any sort off campus and has paperwork to fill out what address are they to use. I have read previously it was important to use the 300 Steamboat Road address. I was under the impression the insurance from KP was primary and then our coverage from home was secondary. I believe I read if the MN then uses their Parent's home address the system cand take for ever to get sorted out. Where do we stand in that regard. Is our home insurance primary or secondary and which address is the M/N to use on medical forms filled out for some form of treatment?
 
Policy WILL Change- October 1st, 2012

I believe this plan is ending or changing as of September 30, 2012 when the policy ends. It's the changes that we are questioning.

Although nothing has changed yet, as some have thought, change is coming. From what I can glean, the Academy is dropping the sickness/accident policy with United States Fireman Ins Co. when it expires 9/30.

Come October 1st, each Mid will be required to use their own insurance as primary or pay the negotiated premium to United Healthcare for a primary policy. Details of what that premium is and what coverages it will include are supposed to be mailed this week, 8/13 (doubtful since the letter dated 8/3 just arrived 8/11 here).

The Academy says it will work with each and every family to ensure that every midshipman is appropriately insured. If this is true, and at the end of the day, everyone is fully covered and the Academy can save significant premium dollars that can go towards other pressing needs, this change may be beneficial to all concerned.
 
Can someone look in to the crystal ball and take a guess as to whether we can purchase the plan through KP as secondary to our primary plan here at home? I happened to call my own insurance about another matter last week but I was told my plan will only pay for emergency, accident or life endangering situations as we have no "out of network" coverage. ( say what?:thumbdown:, I didn't know that)

And what was the problem with that whole single payer-Medicare for all thing? I know, I know, it is not that simple and I actually have no idea how it all works. It is just frustrating.
 
Everyone should check their plans to see what is covered in New York. If NY hospitals and doctors are out of network, you might be asked to purchase the plan that the Academy is negotiating with United Health Care. In addition, if your plan is weak, you might also be required to purchase the plan through the Academy.

The cost is expected to be around $ 1400 per mid for the year. Parents may decide to take this policy even though their mid is covered at home. There are many questions yet to be answered and hopefully the Academy is seeking and obtaining the answers for the parents including who is making medical decisions, what doctors might a parent request, if the Academy will pick the doctors and/or hospital on your plan, would a mid be allowed to travel home for treatment if covered at home, who decides if a specialist is consulted,etc.
 
I hesitate posting on this thread as our DS already graduated and I have no first hand knowledge of the letter or the changes being proposed. That said our experience with the way the Staff at Patton handled things did NOT impress us and if our son was still at the Academy i would be aggressively seeking answers to the questions Lynpar and others here are posting as well as a lot more. We found cause to be quite suspicious of the relationships between Patton and Physicians at North Shore as well as the medical judgement of the Staff at Patton. While medicine is NOT my field of expertise it is my wife and sisters. Nothing occurred that couldn't be addressed with active, educated involvement of our son and family, so if this change means that will actually be more likely to occur then it will probably be a good thing. However, some of the way it could be handled without families whose insurance is now being explicitly required then I'd be concerned as well.

Also depending on the coverage $1400/YEAR doesn't seem at all out of line to me. We buy our own coverage for the entire family now and we are paying ~$1200/MONTH for the family for the health insurance.
 
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QUOTESorry, but despite what anybody was "told" to the contrary, the USMMA never had a more comprehensive medical plan than this current plan in decades, if ever at all. So again. no policy changes here, just clarification of what the medical policy has been. Obviously, clarification was indeed needed, judging by how some seem truly shocked by what they perceive as a policy change reducing medical benefits occurring recently without notification.

EXCUSE ME but yes the policy HAS changed from what parents of 2013 (and prior I'm guessing) were told when our mids started. We were told REPEATEDLY that our mids were covered by KP insurance for any accident or illness while at KP or performing a duty/responsibility for KP and the mids should NEVER present their own insurance card when being treated. PLEASE don't tell us what the policy was when our kids started. We were told this by the alumni association reps, parents group reps and KP coaches repeatedly.

Did we maintain our mid on our health insurance policy? of course we did!
Did we use our insurance for illnesses, accidents, and routine care outside of KP? Of course we did!
Should mids have been offered the health insurance coverage at taxpayer expense "since the school is free"(sort of free but not really) that isn't part of this debate.
The point of concern is that the policy has changed, we had no idea, and as is typical of KP, while we are NOW informed, the details are sorely lacking!

I'd like to thank our parents association for emailing us the letter (that everybody just received in the mail) several weeks ago. It gave us a little more lead time to check with our carrier about out of state and out of network coverage.
 
Please be happy that you are in the process of knowing where you stand with the insurance issues at KP. In the past , there were loopholes that no one was aware of. If out at sea and between ships , were cadets covered and by who ? The shipping company they left, the new company, KP. No one knew,and could never find the answers. There was also that distance from the academy question, and the use of your own doctor . At least , hopefully we will have some degree of clarification.
 
Please be happy that you are in the process of knowing where you stand with the insurance issues at KP. In the past , there were loopholes that no one was aware of. If out at sea and between ships , were cadets covered and by who ? The shipping company they left, the new company, KP. No one knew,and could never find the answers. There was also that distance from the academy question, and the use of your own doctor . At least , hopefully we will have some degree of clarification.

ts always good to get another perspective
 
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