Insurance Benefits for Students:
Help or Hindrance in Obtaining Mental Health Care?
BY BRIAN ST. HILAIRE
As authors of institution-endorsed student health insurance and benefits programs, university administrators and
student health insurance advisory committees possess unique opportunities to architect programs that serve the
specific needs of their respective campus communities, including access to behavioral health care. The desire by
many institutions to balance the most robust benefits with the most reasonable annual student plan premium rates often creates
the dilemma of whether or not to limit plan benefits to save costs. While limiting a plan’s exposure to risk may save up-front
student premiums, it may also leave students subjected to increased out-of-pocket exposure, potentially undermining the protec-
tion that insurance programs are meant to achieve.
Depending on whether or not an institution elects to
include annual behavioral health care visits or dollar limits,
Aetna Student Health has observed that student behavioral
health plan usage generally represents 10 to15 percent of a
plan’s total expenses as measured by claims dollars paid, inpatient and outpatient combined, excluding behavioral health
prescription drugs. Costly behavioral health medications—
labeled antidepressants according to generic product identifier
(GPI) classification—typically represent 16 to 20 percent of
prescription drug costs. The percentage is actually higher
when drugs classified under other GPI categories,
such as anticonvulsants, are prescribed to treat
depression. Antidepressants represent between six
and eight of the top 10 drugs prescribed annually
under any one plan offering a prescription drug
benefit followed by medications for asthma,
allergy, and birth control. Care provided for
conditions considered “biological” represent
25 percent of behavioral health usage compared
to 75 percent for “non-biological” conditions.
This realized demand underscores why it is
important for administrators to deliberate seriously when designing a benefits program meant
to adequately serve the needs of a student body,
especially since every campus is unique.
7 percent of students in non-urban settings. Community
provider visits for students enrolled at urban campuses average
13. 5 annually, compared to 8. 8 percent for those enrolled at
non-urban campuses.
Because of varying campus needs, administrators should
consider factors that influence student use during the annual
review of insurance plan benefits:
Mandates. Understand the impact of state legislation, such
as mental health parity, which may dictate minimum benefits
requirements for behavioral health care.
Factors Influencing Insurance Use
Aetna observes, for instance, that between 8
and 12 percent of students enrolled in university-sponsored plans at campuses located in
urban settings access the plans’ behavioral
health benefits, compared to between 4 and
