I recently wrote a post about the discriminatory practices by Dewar Insurance -- a company that offers insurance for tuition reimbursement in case illness prevents a college student from completing the semester. For some schools, the reimbursement is less and the standard of proof is higher if the illness is a mental disorder.
The issue was originally brought to my attention by Maryland psychiatrist (and parent) Dr. Mark Komrad, author of the book, You Need Help, wrote back with what he learned at freshman orientation at his son's college.
A couple of weeks ago I discovered the lack of mental health parity in the tuition reimbursement insurance available through my son's college. And a few of us did research and found this parity problem common to many colleges, including in Maryland, but not all. Withdrawals for mental health reasons have tuition reimbursement at a lower percentage than "medical" withdrawals. Also, unlike medical withdrawals, mental health withdrawals require two days of hospitalization as part of the eligibility criteria to pay out.
I'm moving my son into college, and had a meeting about this with the directors of Student Accounts and a representative from the Dewar insurance company, the underwriters. I thought I would share some notes from that informative meeting:
- -My son's school is on top of this issue and next year the tuition reimbursement insurance will have full parity for mental health, WITHOUT requirement of hospitalization!!!
- -No family at this college has ever complained before about lack of parity until I raised this--neither prospectively as now, nor when a policy had to be used for mental health reasons! So there was no incentive to change, although the fairly new director of student accounts was troubled and was already taking initiative to change it before I got involved
- -Only about 100 families buy a policy, most don't think they'll ever need it. So there is much interest here and elsewhere in making the policy automatically included as part of the bill next year, but with an option to opt-out. Like with all insurance, the more people who participate, the less expensive the premiums are.
- --There has been a steep rise in withdrawal for mental health reasons nationally just in the last 4-5 years. The majority--about 70%-- of health withdrawals nationally now are for psychiatric reasons. Prior to that they were the minority reason. Nobody is quite sure why that is.
- -Dewar would actually like to offer parity policies but many colleges have not been interested. Again, this is not a particularly popular product so colleges haven't paid much attention to the non-parity status quo that goes back several decades. Many are just starting to notice the non-parity issue now, and are moving to correct it. Dewar is happy to try and make that possible for any of its college customers.
- --This policy places NO extra financial risk on colleges. That is NOT the reason colleges haven't sought parity.
- -Dewar doesn't really challenge doctors notes vigorously. Docs have to fill out a form. There are no internal "medical consultants" that review and deny coverage--unlike health insurance companies. With the policies that require psychiatric hospitalization, that requirement has been waved in many cases. It's a holdover from many years ago when these policies were first crafted.
- -For the business model to work for parity, psychiatric (now the most common cause for intra-semester withdrawal) and medical can't BOTH be covered at 100%. So policies that now cover medical at 100% and psych at 60% will need to be restructured for the two the meet in the middle. Losing that 100% for medical may be one of the inhibitors to change
So, if we are going to go after this parity issue in Maryland, my sense is that it needs to be on a college by college basis to increase their consciousness about this issue, and, for those who have contracted with Dewar, to let them know that this can be potentially corrected.