Health insurance coverage: The 50-mile rule every international student in the US should know

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14 May 2020

For some international students in the US, the COVID-19 pandemic is exposing gaps in their student health insurance coverage, some with deep consequences on their ability to access healthcare.

Lubna Haddad is one of them. When trying to access healthcare in New York, where she studies, Lubna uncovered an important detail.

“I discovered that our plan only covers within 50 miles from Colombia University,” the PhD candidate from the Middle East told Study International.

“You can’t just go to any doctor. For Americans, this is normal as they are used to the health insurance policies.”

International students in the US are usually caught off-guard by this peculiarity. Like Lubna, they could be forced to relocate more than 50 miles away from campus just so she doesn’t have to pay out of pocket when she’s already insured.

Student health insurance plans are essential for the safety of students abroad. It’s important to know your plan thoroughly so you know where, when, and how to seek medical help.

If you are or plan to be one of many international students in US, here are five things to keep in mind.

More students may be attempting to access healthcare for various reasons during the pandemic. Source: Al Bello/Getty Images North America/Getty Images via AFP

International students in the US must sign up for student health insurance

This is a policy in most private universities, so be sure to factor a monthly premium into your student budget. They are called Student Health Insurance Plan (SHIP) in most American institutions.

Buying your university’s health insurance plan means you will be covered at the campus clinic. Plus, the premiums are usually lower to accommodate students.

“Only a few public universities allow students to get national or federal health insurance. Private universities condition you to buy [a health insurance plan],” Lubna shared.

Columbia University uses Aetna Student Health, which is one of the popular providers.

There are exceptions — check your visa

If your visa comes with student health insurance, you will not need to sign up for another plan with your university.

International students in the US who are covered by a US-based, employer-sponsored, group health plan (as a primary, spouse, or dependent) are also exempted.

Source: Stephanie Keith/Getty Images North America/Getty Images via AFP

You are typically only covered within 50 miles from campus

Lubna researched her options online when she needed to see a doctor. That’s when she came across the 50-mile rule.

This rule is seen in the UC Berkeley University Health Services waiver: “All plans must provide unrestricted access to an in-network primary care provider, in-network hospital and full non-emergency medical and behavioural healthcare within 50 miles of campus or the student’s place of residence while attending school.”

It took Lubna a while to figure out which doctor to go to: “We checked the network and I figured that the doctor I wanted to see is out of network, but approved by AETNA,” Lubna said.

Your doctor must be approved by your student health insurance provider

Another detail to keep in mind is that not all doctors within your 50-mile radius are necessarily accepted by your insurance provider.

This has kept Lubna from seeing a doctor in Brooklyn.

“If we move, we have to call the insurance office at the university and make sure that this doctor can be covered. Even in New York City, not all doctors are covered,” she said.

Thinking of moving away for the summer? Check your health insurance coverage first. Source: Franck Fife/AFP

According to a Columbia website, “Teachers College and Columbia University require ALL international students, regardless of credit or visa status, to enrol in the Columbia Student Health Insurance Plan.”

This means students will only be covered to see Columbia doctors, which Lubna says are often more expensive than other cities or states.

Prepare for out-of-pocket payments

Medical care is expensive in the US. Even with health insurance, patients may still have to cover a portion of the costs out-of-pocket.

“Under the university plan, we have to pay a certain amount for each lab or ultrasound work,” she tells.

“I paid US$2,000 on top of my insurance for my surgery. I also paid US$350 for the MRI before that out of pocket.”

So even if they are covered by a university plan, international students in US should build a back-up fund for expensive medical emergencies. Better safe than sorry, as they say.