University of Michigan student tuition will no longer cover testing for sexually transmitted infections at University Health Services.
This update is part of UHS and Michigan Medicine’s new policy of billing students’ personal insurance for “laboratory testing, radiology x-rays and ultrasounds and allergy injections,” as announced in a policy memo on July 15. Previously, these services were covered by the Health Service Fee, a mandatory fee of $199 included in the tuition paid by U-M Ann Arbor students each semester.
Under the new policy, all laboratory tests, including STI tests, will be sent to Michigan Medicine laboratories, and costs will be billed to students’ personal health insurance. There are still no fees for the Sexual Assault Exam at UHS, which may include an STI panel.
According to the U.S. Department of Health and Human Services, children can remain under their parent’s health insurance until the age of 26. The insurance policy holder 一 which for many students is their parents 一 may receive an Explanation of Benefits from the insurance company detailing the services received at UHS, including an STI panel.
If students are receiving services no longer covered by their tuition, they will receive a flyer detailing the billing change and information about an out-of-pocket payment option to avoid the EOB. A standard STI panel at UHS is $90 out-of-pocket.
Charging students’ personal health insurance allows UHS to create a revenue stream while cutting costs. In the announcement, UHS noted this change was necessary “to keep the health service fee unchanged this year, despite significant increases in expenses, including providing greater financial support to other student life units.”
Dr. Robert Ernst, executive director of UHS, said these billing changes come with an increased pressure to create multiple revenue streams for UHS.
“In the context of being asked to stay creative stay innovative and hold increases in the health service fees to a minimum, the easiest first step is to let the hospital bill what they’re doing, instead of us just paying for them,” Ernst said.
According to Ernst, before the policy change, more than half of UHS’ yearly laboratory testing costs were from student STI checks, which amounted to approximately $300,000.
According to the UHS website, for students who have Blue Cross Blue Shield, Medicare or any University of Michigan funded health care, bills should be covered. If a student has another type of insurance, coverage is not guaranteed.
“It is ultimately the decision of your insurance company whether they will pay UHS,” the website reads. “If we do not receive payment from your insurance company, UHS will bill you and you will be responsible for payment.”
UHS wants to help uninsured students enroll in Medicaid and has also released a new health insurance plan, Ernst said.
CSG Vice President Isabelle Blanchard, an LSA senior, said CSG is planning on releasing a list of other options for STI testing, as well as a survey to monitor student concerns.
“CSG has already begun communicating with students about this change, and plans to release a survey to the student body to learn more about how this might affect the student experience,” Blanchard wrote to The Daily in an email.
Alternative options for inexpensive STI checks include Planned Parenthood or the Washtenaw County’s Sexual Health Services building. Neither offer free testing.
Some students have expressed concerns about STI testing showing up on their parents’ EOB. A student who has requested to remain anonymous for this article said in a strict religious family such as her own, there would be consequences for her education if her parents knew she was tested.
“Billing such tests to personal insurance removes that sense of safety a student gets from knowing their parents don’t know about their sex life,” she said. “Personally, I come from a highly orthodox family and if they knew I was having sex I would face pretty serious repercussions, the lowest of which would be pulling me out of school.”
If students are concerned about their parents seeing the EOB for an STI test on the insurance bill, they should consider buying their own health insurance, Ernst said.
“If a student is seeking confidential healthcare that they don’t want their parents to be made aware of, they might be individuals who might be interested in exploring their own personal student health insurance plan,” Ernst said. “At just over $1,700 a year, it might actually be more affordable for them than the extra cost to stay on their parents insurance, and then it would be certainly very confidential.”
Parental disapproval is just one of the reasons students are worried about this new policy. Betsy Stubbs, Art & Design junior and SAPAC volunteer, said having free STI checks on a college campus eliminated barriers to getting tested.
“People are already very reluctant to get tested for STIs,” Stubbs said. “There is such a negative stigma surrounding STIs that it makes it very difficult to work up the courage to get tested. U-M was taking steps in the right directions 一 allowing testing to be free because that eliminated one more barrier. Handing out condoms can’t be the only thing this University tries to protect student’s sexual health.”
Rackham student Kaley Makino, who is passionate about sexual health advocacy, said this also adds financial barriers to students in addition to the stigmatization.
“Privatizing sexual health screenings will undoubtedly lower affordability and access to students who may or may not have personal insurance willing to cover the cost of the testing,” Makino said. “This will further discourage students to get STI screened because they will likely have to pay some portion out-of-pocket, which is an added expense many cannot afford."
All students interviewed for this article stated they were unaware these billing changes included the loss of STI tests previously-covered in their tuition. The anonymous student said she heard of the change from a reddit thread.
Correction: An earlier version of this article said UHS' yearly laboratory costs were approximately $300,000 when it was actually the STI test component that was $300,000.