Short-term health insurance for fall semester away from home?

July 7, 2019 10:12 AM

I'm spending the fall semester in Western Massachusetts, where my health care provider (Kaiser, closed system) does not have facilities. Should I get short-term health care coverage -- and if so, what should I look for, and what should I avoid?

Hi, Folks.

I live in California and have an individual health care plan through Kaiser. Kaiser is a closed system with no facilities in western Massachusetts, where I'll be spending the fall semester. Kaiser will cover emergency care while I'm there, but I'm fairly sure I'm going to need care that they won't cover -- specifically, care for an ear infection that keeps coming back.

I could pay out-of-pocket at MA providers, I know, but that'll be $$$. So I'm wondering about getting short-term health insurance for the fall. Does anyone have experience with this? Things I should know? Things to avoid? Thanks!

posted by MelanieMichelle to Health & Fitness (10 answers total)

Best answer: My guess is that care fo an ear infection is going to be less than the cost of health insurance that will cover the chance of very expensive major medical (which is already covered by your Kaiser plan). Maybe call the urgent care center in the town where you'll be staying and asking how much they would charge?
posted by metahawk at 10:57 AM on July 7, 2019 [3 favorites]

If the short-term insurance is mainly to aquire an antibiotic prescription, I would probably just let the Doctor know you will be traveling and ask if you could get an extra prescription or supply of antibiotics. I don't know the protcol on this but they may give you the prescription/supply since it appears to be a recurrent issue. In the past I've been able to send messages online to my Kaiser Doctor/their office so you may be able to even get answers to questions without a visit.
posted by mundo at 11:10 AM on July 7, 2019

Your school should offer it affordably. (My son's Boston school actually required it, saying that it was required by law that he have access to primary care, not just urgent care, locally.)
posted by metasarah at 11:16 AM on July 7, 2019

Response by poster: Thanks, everyone! A couple of clarifications:

1) I'm not in school or associated with any school. I'm an independent professional.
2) The treatment is not an antibiotic but a three- or four-visit appointment with an ENT who has to drain the ear and insert an anti-fungal.

I'll call some ENTs in Western Mass, thanks.
posted by MelanieMichelle at 11:44 AM on July 7, 2019

I was going to suggest that you try some "doc in a box" services. When we had a long term visitor, he found that seeing doctor associated with the pharmacy at our local grocery store was far, far cheaper than someone at the large clinic the my family uses. Also wanted to suggest GoodRx if you are stuck trying to fill a prescription without insurance. However, in your case, I don't think either will help.

In your case, before you call the ENT, check out the pricing on a couple of short term plans. Then you also checkoff the ENT takes the plan you are considering and also how long you have to wait for the first available appointment. For some specialists, the only way to get seen n a reasonable time is to come in through urgent care or a gp and get a referral for urgent services.
posted by metahawk at 11:55 AM on July 7, 2019

One more thought. - I think Kaiser has tele-medicine options at most of their sites now. Is there a way you can get "seen" by your usual Kaiser doctors who know the situation and might not need to actually look in your ear to confirm?
Edit: no wait, you need the doctor to insert the medication, right? Oh well
posted by metahawk at 11:57 AM on July 7, 2019

Have you spoken to someone at Kaiser about this? You can’t be the first member with ongoing health needs who’s spending a lengthy period of time away from Kaiser’s service area. I wouldn’t be surprised if they have a referral system already in place for this kind of thing (not because it makes their members’ lives easier but because it helps them keep the money close).
posted by jesourie at 12:09 PM on July 7, 2019 [2 favorites]

Best answer: Has Kaiser told you that you won't be covered? They do cover you when you're out of their coverage area, but you may need to pay, then get reimbursed. I would absolutely clarify your situation before you pay for an additional policy.
posted by sageleaf at 12:09 PM on July 7, 2019 [5 favorites]

Response by poster: I had talked to Kaiser, yes. The woman in Member Services had said that they cover emergency care only and that if I needed anything that wasn't emergency care, I could travel to the Washington, DC area, where Kaiser has facilities. But I see in that link that they do reimburse for urgent care as well, hmm. That's a great sign. I'll look further into it, thanks!
posted by MelanieMichelle at 1:12 PM on July 7, 2019

FYI, there are very few ENTs in most of Western MA (unless you are okay driving to central MA/Worcester area) and they have long wait lists for new patients. You'll want to call and get those appointments set up ASAP.
posted by john_snow at 12:54 PM on July 8, 2019