Andrew: How are health insurance policies for U.S. students and international students different from one another?

They aren't always very different, but visa requirements require repatriation coverage in case of illness or death, so the student can be sent home. And that's included in the coverage. Domestic students don't have that. American students' insurance contracts don't have that, but international students' contracts are required to have that, so that's one of the biggest differences. On our policy here at SPU, international students have different limits on their coverage, and it's actually greater for illness or hospitalization or medication.

Lu: One thing that's interesting is that when they come to this country, they don't know the different levels of health care providers. They usually have only one health care provider in most other countries, and they've just now gotten nurse practitioners in Europe. They are really kind of hesitant when they see the different levels: nurse practitioner, PA (Physician's Assistant), MA (Medical Assistant), nurse. To them, a nurse is a bedside nurse, period. Not clinic, not anything. Having that explained is something that is really helpful.

Andrew: So, do international students generally have to pay more for health insurance than domestic students?

Lu: That is correct. They pay more at home and then bring that coverage here or the particular program that they are involved in will require that they access a particular type of insurance; therefore they have to pay more. Or they feel it is best to buy an American policy in addition to a foreign policy, and it doubles the price.

Jean: This particular university requires that they have insurance with a policy that's readable in English or an English access such as a toll-free telephone number, or they must have an American policy. The difference between the international student policy and the domestic student policy is about $30 per academic term (SPU uses a the quarter system).

Lu: When they get bills from the health center or private provider, it's important that they get an itemized bill, so that they can submit that to their insurance company. I know that our insurance company requires that when students submit their bills, it has to be an itemized explanation of bill, benefits, and so forth. Otherwise, if they just submit "Hello, I was there; this is my appointment card," it's going to get bounced back, and it's not going to be paid for. They need to make sure that they go in there with a little list so that they make sure that their checklist is in place: instructions on how to take their medicine, getting an itemized list of what happened, and anything else they need to address.

Jean Brown, R.N., works as the Nurse Manager in Health Services at Seattle Pacific University.

Luana V. Joslin, ARNP, works as a Family Nurse Practitioner in Health Services at Seattle Pacific University.