Emily Wagner, MPH
Violence Prevention and Advocacy Specialist
Healthcare costs can be unexpected, confusing, and feel overwhelming even if you have insurance. I sat down with Alison Farr, Senior Nurse Practitioner in the Center for Health and Wellness to talk about healthcare costs that college students may encounter.
Students are required to have health insurance while at Middlebury. Do they still incur out of pocket costs if they use Health Services for healthcare needs? Should they plan to pay something when they show up for an appointment?
There is no cost to see a health care provider (Registered Nurse, Nurse Practitioner, or Physician) or counselor at the Middlebury College Center for Health and Wellness. Students will be charged or their insurance billed if they need to see a provider outside of Health Services or if they need lab/blood tests, xrays, or other services that Health Services cannot provide. The provider organization will bill the student’s insurance. Out of pocket expenses may include copays and deductibles not covered by their health insurance.
If a student is on their parents insurance and doesn’t want them to know about STI testing, what are some unexpected costs they would need to think about?
There are a few options for this. There are a few options for this. Students can call their health insurance company and ask them to directly send the explanation of benefits (EOB) to the student/patient rather than to the subscriber of the insurance. Keep in mind that every insurance plan is different, so checking in advance is advised. Another option would be to consider having the conversation with your parents if it feels safe to do so. It can be uncomfortable but may wind up being a supportive discussion about your health. Students can be identified as “self-pay” and insurance will not be billed. This can be quite cost-prohibitive for most people.
Specific information on the pricing for STI screening can be found on the Sexual and Reproductive Health section of the Health Services website (which also has a ton of other valuable resources!)
A note: if someone has experienced sexual violence/assault, all medical care as a result of that assault can be paid for by Vermont Crime Victim’s Services. This can include a forensic exam, STI screening, emergency contraception and a general medical evaluation. Insurance can be billed, but if there is a safety concern related to who will see the explanation of benefits, these services can be covered as noted above.
What types of contraception are available at Health Services and are all types covered by health insurance?
At Health Services, students can be prescribed pills, patches, rings, diaphragms, condoms, or depo provera (injections). Students can also meet with a Nurse Practitioner for a contraception consultation to figure out what type might work best for them.
If a student wants an IUD or Nexplanon, students are referred to Porter Women’s Health or Planned Parenthood. Planned Parenthood can especially be useful if a student has concerns about costs or doesn’t want to use their insurance. Students do not need a referral from Health Services to go to Porter Women’s Health or Planned Parenthood. If a student has a contraceptive consult at Health Services, and decides that an IUD or Nexplanon implant is the desired contraception, in most cases they can then call Porter Women’s Health or Planned Parenthood to schedule an appointment for same day insertion.
Many insurance programs cover the full cost of contraception as a preventive service. Out of pocket expenses may be a copay or deductible applied to a device insertion fee. The actual device is typically covered at 100%. Please keep in mind that every commercial insurance plan is different, so that best strategy is to call the insurance company (number on back of card) and ask what the coverage is for the contraception type that you desire.
Does Health Services provide speciality care? If a student is referred to a specialist, do their parents need to know?
Health Services provides mostly primary care but does offer significant discussions around sexual and reproductive care specifically. Health Services offers Transgender and Gender Nonbinary Care as noted in a previous CampusWell article. We also offer HIV pre-exposure prophylaxis for those at risk. Health Services can care for many student health needs, but students may require referral for specialty care to Orthopedics, Ob/Gyn, Urology, Otolaryngology, Dermatology, Neurology and others. Several of these specialty services are available here in Middlebury. Others may require visits in Rutland or Burlington.
Parents may find out about a referral if insurance is billed and they are the insurance subscribers. With each charge to health insurance, an explanation of benefits (EOB) is sent to the subscriber or guarantor (person responsible for the bill) indicating what is covered and what is not. A bill for any uncovered expenses will likely follow and may detail the specific charges.