PSG pushes pharmacy benefits

The Student Health Benefits Plan currently covers only prescriptions at Boynton.

Raj Chaduvula

On a Friday evening during her first year as a law student in 2013, Mary Scott was in pain. 
 
Scott ran to the University of Minnesota Medical Center, and after surgery to remove her appendix and a weekend hospital stay, she tried to fill her prescription at the hospital’s pharmacy.
 
She soon learned that for her, and all University students who purchase the Student Health Benefits Plan, pharmaceutical prescriptions aren’t covered anywhere else besides Boynton Health Service’s pharmacy, so she paid for the drugs out of pocket.
 
And though University health officials say it’s unknown how many students have problems like Scott’s, the Professional Student Government is trying to include more pharmacies under the student insurance plan.
 
Susann Jackson, senior administrative director at Boynton, said she met with PSG leaders to discuss pharmaceutical coverage issues.
 
“We are planning a meeting with Fairview to talk about what can be done,” Jackson said. “But when we get an anecdotal example of one student, it’s hard to address the problems for one incident,” she said.
 
Kyle Kroll, PSG’s president, said Boynton being the only pharmacy that is covered isn’t a big problem because most students on the plan live near the school. He said the University originally covered only Boynton’s pharmacy to keep costs low.
 
But Kroll said the group wants to make sure the University’s Medical Center’s pharmacy is covered in case of emergencies. 
 
For the 2015 academic year, the student health insurance plan costs $999, and Jackson said the plan is relatively cheap.
 
But an expansion in coverage might result in a cost increase for the plan, Kroll said, adding that based on conversations he’s had with Boynton, it wouldn’t increase by much.
 
Kroll said the Medical Center hasn’t determined how the cost would change if pharmacy benefits were expanded.
 
“If it does add cost, it would [be] so insignificant. I don’t think anyone would notice it,” he said.
 
To alleviate costs, Boynton started reimbursing up to 50 percent of pharmaceutical payments outside of Boynton this year, Jackson said.
 
Kroll said he also wants the plan to cover more drugs.
 
Scott fractured her leg last summer and went to Boynton for care. A few months later, after experiencing pain in her leg, she went to get it checked out and found out she had a blood clot.
 
When doctors prescribed her a drug to help with the clot, she found out again that her plan didn’t cover the drug and she would have had to pay $700 to $800 out of pocket, she said.
 
But doctors had a social worker take on the payment for her, a practice they told her is rare.
 
“I felt really badly about that. … I have health insurance and couldn’t pay for it,” she said.
 
PSG has heard from students who said they wanted to get an HIV-prevention drug, Truvada, that wasn’t covered by the plan, Kroll said. 
 
Adding Truvada to the plan would increase the cost significantly, Jackson said. It would make up nearly 18 percent of the plan’s total cost if it was added, she said.
 
Jackson said she generally tries to get student benefits established by March.
 
“People have emergencies, weird things happen and they happen on the weekend,” Scott said. “I feel as though because the health plan only covers prescriptions from
Boynton, it’s kind of like they’re saying, ‘Well if you are not fortunate enough to be injured in the middle of the week between 8 a.m. and 4:30 p.m. when Boynton is open, then too bad.’ ”