Learn about healthcare for international students in the USA and the UK with this presentation from the NAFSA Region III Conference in Rogers, Arkansas in 2013. The presenters were Jane Clark and Victoria Troupe
2. Presenters
• Victoria Troupe – Marketing Specialist at International Student
Insurance
• Jane Clarke – Edge Hill University, US Director for Study
Abroad, Edge Hill University
3. Agenda
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Intro to the US Healthcare System
Intro the NHS System
Orienting Students to these Systems
Risk Factors to Watch Out For
Staying Healthy – Mind and Body
Conclusion and Interactive Forum
5. Introduction to the U.S.
Healthcare System
• Is Health Insurance Necessary? YES!
• Prepare to pay out of pocket
• No government assistance
• Using Health Insurance in the U.S.
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PPO Networks
Pre-certification
Pre-existing conditions
EME/Repatriation
6. Introduction to the U.S.
Healthcare System
• Why Students Seek Treatment
• Cold/ Flu
• General Sickness/ Feeling Unwell
• Acute Sickness/ Injuries /Emergencies
• Where Students Seek Treatment is Important
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Student Health Center
Doctor’s Office (Primary Care Provider)
Urgent Care Center/ Walk-in Clinic
Emergency Room
7. Affordable Care Act – Final Rule
• Student health insurance coverage is a written agreement between
an institution of higher education and a health insurance issuer and
provided to students and their dependents
• If coverage is sold directly to a student, then the coverage is
individual health insurance coverage.
8. ACA - What this means for you
Annual Limits:
Policy year September 24, 2012 until December 31, 2013: Annual
limits of no less than $500,000
Policy year on or after January 1, 2014:
No annual limits
Preventative Care: Student health coverage is required
to provide preventive services without cost-sharing.
Lifetime Limits: Plan may not impose lifetime limits
Pre-existing condition limitations: Plans may not
impose pre-existing condition limitation on those
younger than age 19.
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After January 2014, pre-existing conditions cannot be excluded
9. Clarity on the ACA
• IRS enforces individual mandate based on resident vs. nonresident alien analysis
• F, M, Q and J visa holders are exempt for 5 years from:
• maintaining minimum essential coverage
• International students can choose their plan:
• School’s group plan
• Individual health insurance
• State exchanges
• International students will still need to meet the US
Department of State (J visa) and their school’s insurance
minimums
http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-SharedResponsibility-Provision
10. Introduction to the U.S.
Healthcare System
• Introduction to the US Healthcare System Video
11. Introduction to the Britain’s NHS
System
History of NHS
• July 5, 1948 – NHS is born
• Central Principles
The NHS in the New Millenium
• How and when patients seek treatment
• Minor vs Emergency
• Health insurance
12. Orienting Students to their
Local Systems
• What Students Need To Know Before Arrival
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Routine Dental
Physical Exams
Eye Exams
Maintenance Drugs
Vaccinations/Immunizations
Insurance
13. Orienting Students to their
Local Systems
• What Students Need To Know After Arrival
• Orientation
• Student Health Center
• Advisors and Support Staff
• Re-orientation
• Campus/City Tour
• Nearby health providers
• Pharmacies
14. Risk Factors To Watch Out For
• Culture Shock
• Loneliness
• Depression
• Risky Behavior
• Sex
• Drugs
• Alcohol
15. Staying Healthy – Mind and Body
• Wellness and Prevention
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Vaccines/Immunizations
Social Interaction
Healthy Relationships
Manage Stress Effectively
16. Staying Healthy – Mind and Body
• Develop a Support System
• Advisors and Support Staff
• Mental health counselors
• Encourage a Healthy Lifestyle
• Exercise
• Eating
• Sleep
• Encourage the College Experience
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Intramural/Intercollegiate/Club Sports
School associations
Religious/cultural organizations
Gym and recreational areas
17. Acclimating to Different Cultures
United States
• Individuality and SelfReliance
• Time Consciousness
• Direct Communication
• Patriotism
• Personal Space
• Hygiene
Great Britain
• Customs & Ideas
• Preparing for British
weather
• Healthy lifestyle
• Personal Space
• The “Common Cold”
• Reverse Culture Shock
18. Conclusion
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Prepare students for expensive healthcare
Teach students how to seek treatment appropriately
Tell students what to expect before arrival
Orient students to their surroundings
Watch for warning signs
Develop a support system for students to maintain wellness
Always consider culture differences and boundaries
19. US Case Study
Henrietta Potter is an international student from the United
Kingdom at a Florida School. She is playing volleyball on the beach
with some friends and falls and breaks a collar bone. She doesn’t
have health insurance, what things should she consider prior to
seeking treatment?
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Student health center
Negotiating with the provider about non-insured cash discounts
Do not go to the emergency room, go to the urgent care center
Shop around for discount pharmacies
Buy insurance for the future
20. UK Case Study
Young Hwa Kim , a US scholar at Edgehill University in the UK was
diagnosed with severe paranoid schizophrenia. This is a condition
that usually manifests itself during late teen or early 20’s. She was
hospitalized in a psychiatric institution and was unable to continue
her studies, however she was also deemed unfit to travel without a
medical escort. What action plan does your school currently have to
deal with a situation like this?
- Have medical evacuation coverage and mental health coverage
on your insurance plan (travel health coverage not always
enough)
- Communicating with the natural family, provider, insurance, etc.
23. Interactive Forum
What support system does your school have in place to make sure
international students are safe and secure?
Hinweis der Redaktion
Make terms availableCarry your ID cardsEasy Access
Emergency rooms are expensive with long wait timesHospital is not the “go-to” for all treatmentIndividuals are expected to pay out-of-pocket at the time of treatment or provide insurancePrescription drugs and durable medical equipment can be costlyGeneral Sickness/ Feeling Unwell- unless your symptoms are severe, please DO NOT visit the Emergency Room for general sickness, but rather locate a provider using the online search tool to find a doctor in your area, call them up and make an appointment.Acute Sickness/ Emergencies- if you experience an accident or an acute illness that comes on very quickly and you need medical attention immediately please make your way to the nearest Emergency Room or call the emergency services in your country for immediate help and assistance. Doctor /Physician Office – Receives and treats patience typically by appointment. Concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of illness and injury. Also known as a primary care provider. Urgent Care Center/Walk in Clinics – An urgent care center means a facility separate from a hospital emergency department and a walk in clinic allows patients to be immediately treated for injury or sickness without an appointment. Typically labs and x-rays are done onsite so process is much quicker. Emergency Room – The department of a hospital that provides immediate treatment for acute illnesses and trauma. In some cases, there is an ER deductible if your visit for an illness does not result in being admitted to the hospital.
So how does the individual mandate apply to international students?F, M, Q and J =student/scholarIndividual mandate does not apply. Also exempt from paying the shared responsibility payment.
NHS was established on July 5, 1948 – under the central principle that all persons are entitled to health care, Costs are off-set by taxation!Students enrolled at a British university for a full-term (fall or spring) are entitled to limited coverage under NHS. Most universities will have a Health and Well-Being Centre on campus. On our campus doctors hold surgeries three times a week. Edge Hill’s Health and Well-Being Centre is staffed Monday – Friday from 8:30 – 4:30 p.m. No appt is necessary and the service is completely confidential.Urgent cases will be seen the same day but not always by the doctor or nurse of choice & there may be a wait in triage. Private insurance is strongly recommended. What a US student may consider an emergency may not be considered as such by NHS. At that time, the student with private insurance can still be treated by a physician but will have to pay upfront and submit a claim when they return to the US.
NHS coverage is not comprehensive, therefore routine medical issues may not be covered. For instance, most dental work is not covered for study abroad students, however, in the case of emergency care, they are generally covered.Students on regular maintenance drugs should bring a full three-month supply with them. Medications will not be allowed through customs so mailing from the US is not an option. Also, some medications may not be available in the UK or the compound may be different. There are no required vaccinations or immunizations for admission to a UK university. Again, private insurance is strongly advised.
At Edge Hill University we have a designated Health and Well-Being Centre. Study abroad students should identify where their health center is on campus before they need it. We have a mandatory orientation once students arrive and a representative from our Health and Well-Being Centre is introduced to them. They are also given handouts explaining what to do in case they fall ill or have an accident.As well, the staff in EHU’s Centre for International Education are available to advise students.Doctors are local – a short 10-minute walk from the campus. Pharmacies are also a great source of information and students should not hesitate to ask the local pharmacist for assistance.
Culture shock affects many students. Help is available. Universities have counseling centers on campus, if needed. Our staff in the Centre for International Education are a friendly lot and are always happy to have a cuppa with a lonely student. It’s important that students do not isolate themselves.Our experienced counselors with finding solutions to your problems. It’s free of charge & there are a range of services provided – relaxation sessions, workshops, group work & support groups.Students can get advice on contraception at the Health and Well-Being Centre or from a local Family Planning Clinic. You are entitled to free contraceptives and advice on birth control. Counseling for drug and alcohol abuse is available free of charge. It is important student disclose prior behavioral issues or mental health issues.
Should there be an outbreak, vaccines or immunizations will be made available free of charge through the Health and Well-Being Centre. Becoming involved with others on campus and within the community is key to a happy, healthy mind. Students are encouraged to join sports clubs, special interest groups, etc. As I mentioned before, extensive counseling services are available for students.
Individuality and Self-Reliance: American society tends to encourage people to think and act individually, to make their own decisions, and to rely on themselves. This does not mean that Americans do not also rely on family and friends for support, or that family and friends are unimportant. It means, rather, that Americans are encouraged to develop themselves and support themselves independently as much as possible. Time Consciousness: Punctuality is important in American society. People are expected to be on time for appointments, classes, and formal social events. Failure to be on time, especially in a professional setting, tends to create a negative impression. Direct Communication: Americans are more likely to deal with conflicts directly and openly than in some other societies. Saving face is still important in American society, but it is not as important as resolving conflicts and misunderstandings. People tend to communicate directly and openly as much as possible.