Insurance and Hidden Costs

Insurance

• Often extra money for health insurance plans is taken out of paychecks at the end of the spring semester. Also check on the pay period schedule in relation to the semester schedule. For example, you may not get paid June-October depending on the way the semester is scheduled at your institution.
• Many programs do not pay over the summer or offer summer teaching that is very competitive or gets awarded by seniority. Scheduling decisions are usually made early, so ask early (January or so). Don’t wait until April before you try and figure out how you’re paying rent and bills for the summer
• This depends on the program: mine pays a small amount in the summer, but it's not equivalent to what you get paid during the year so you have to add up your total income and divide it over 12 months as the basis for your budget.
• My stipend was paid across the entire year, equal pay over summer months as academic year. What we didn’t know is when we would receive our last paycheck once our stipend ran out- good to know that info so you don’t get caught by surprise.
• Our TA and RA stipends were paid September 30 through April 30--that is, no paycheck for almost five months, rather than just over “summer”--be aware that this is a common practice for state institutions that work on a mandated fiscal cycle and plan accordingly, because any fees/tuition/other expenses you’ll have will come due at the beginning of the term, over a month before your first paycheck. A lot of people in our department would take out student loans to cover the cost of Fall tuition, fees, other expenses, then pay those back over the year once their stipends started. You can almost always find some kind of work on campus over the summer as an RA, or in a center or office, if teaching isn't an option. Check with campus employment and/or the Graduate school for summer job opportunities available to students.

Cost of Healthcare

• Know what will be covered and what is not. At many institutions, you will not have prescription, dental, or vision coverage. On the other hand, many health plans may cover 1 vision check per year (that will give you a free prescription for glasses), even though they do not cover vision.
• For eye glasses, Warby Parker is a stylish and cheap option, most of their frames + lenses are $95 total. They have a few brick and mortar stores where you can also get a prescription (never done it, not sure how much it costs) and try on the glasses. If you're not close to a store, you can pick 5 frames to try through the mail for free!
  
  
• I learned the hard way that our campus insurance did not cover wisdom teeth extraction, for instance.
  • Depending on the town check to see if there’s a dental school where you can get care discounted
  • Also for prescriptions, it's worth finding out which pharmacies you can use. Mine only lets me use my school pharmacy, and some restricted medications only let you transfer the prescription once so you have to get it right the first time.
    • good point! On the flip side, many schools with their own pharmacy will give you (usually small amounts) of otc meds for free or cheap. Especially if you're already there, this is worth doing.
    • Heads up that in many cases, your school’s student health center and pharmacy are the least expensive options for healthcare, and many times the services and prescription prices are free or seriously reduced in cost if you are on student health insurance, so definitely check into that. They also have free or seriously reduced-cost mental health services, like psychologists and group therapy sessions; some colleges also offer holistic therapies through student health services. Check into and take advantage of any such programs, because graduate school is wildly stressful, especially so when you are not familiar with how everything works.
  • If you have a chronic disease or are having medical issues, it's important to know the medical leave policy should you become too sick to continue. You want to know whether or not you can come back if your health improves.
    • YES--many have a very terrible sick leave policy and/or no family leave.
  • Find out everything you can about the clinic on campus. Most larger R1 universities will have free basic health services for students (both grads and undergrads). Find out about the amenities your campus offers as you consider which school to attend.
  • Many university health services have a small fund to help cover medical bills for graduate students. Mine for example can offer $300 per student per year.
  • If you are trans, university health services are often as good as or a better bet than local doctors for transgender health care needs.
  • Considerations for reproductive health:
    • Consider switching to an IUD before you go off your parents health care or the healthcare you may have had from your previous job. Insurance may cover the whole cost of the device (around $1000) but then there are no other costs for the next 5-10 years.
    • Campus clinics tend to offer most preventive care, STD testing, and contraception counseling. Often these clinics can offer contraception for very cheap (sometimes cheaper than going through a campus prescription plan).
    • Ask for the generic version of your birth control of choice. Under ACA, most health care plans now must cover some forms of generic birth control, so it’s almost guaranteed that you will have some “free” (no copay) options. Plan B should also be one of the forms of birth control covered.
    • Your university may have offices that offer free condoms. Check the health clinic, local LGBT center, etc.
    • Planned Parenthood is incredibly helpful and affordable for those of us whose health care packages through grad school were less than excellent. And most PP offices will provide scaled charges for annual exams and pills!
    • If you are considering starting a family while in school, pay very close attention to what is--and what is not--covered by your school’s healthcare provider.
      • Also look into the accommodations that your department, college, and campus institution make for graduate students who start families. Policies can vary widely from campus to campus.
      • Also, do not be afraid or ashamed to apply for government assistance for your children’s healthcare; you will almost certainly qualify and that’s one less major expense out-of-pocket. We are in North Carolina, and our girls were in the state healthcare program for all four years of my degree program. They received excellent medical, dental, and vision care, and we never experienced any stigma for it. This is a temporary state for you and your family while you work towards a secure job with benefits--exactly what such programs are intended to support.
  • If you wear contact lenses, buy them online or at Costco. Can almost guarantee they will be cheaper than buying them from the optometrist.
  • Look into a Costco membership (if you have a really strong Rx). For $55/year, you can use their optician and get a pair of eyeglasses for $100-200.
  • Costco’s online mail-order pharmacy will fill prescriptions even if you’re not a member. And their prices are often cheaper than what your co-pay might be. Ask your doctor to prescribe three or six months at a time to get bulk discounts, too.
  • Sources for cheap Rx glasses (you need a prescription:
    • www.cheapglasses123.com__
    • www.eyebuydirect.com/
    • Use Zenni optical online. I can’t believe I paid what I did for my first pair of bifocals, which of course I needed to survive grad school. Unless your prescription is super strong or really odd, try Zenni first. You will need your prescription, and that means visiting an eye doctor/optician. Do not be embarrassed to ask for a written-out prescription. It is your medical data and you are entitled to it. Ask that they write down your pupillary distance (PD). You will need that, though Zenni has a workaround involving little rulers and the camera on your computer/phone. If you are embarrassed, call the optician afterward and have them fax/scan and attach your prescription to you. But don’t be embarrassed. Eye doctors/opticians live on those outrageously over-priced shops attached to their offices. 500% markup. Say no.

• Be aware that even if health insurance is included as part of your assistantship, you might be expected to pay for insurance during the summer months.

  • In regards to this note: My particular insurance plan "ended" in May (once the semester ended as well) -- and it appeared that I was not receiving coverage. However, I had to call my insurance and re-enroll for the next year - and send in my medical bills from over the summer to their claims department. A bit of extra work, but definitely find out the terms for your own plan.

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• Definitely see if you are able to receive free healthcare. This is something I wish I could have found out years ago when starting grad school, because MOST grad students qualify for free healthcare - based on income (or lack there of). If I had known about this, I would have saved thousands of dollars on the cost of plans, appointment co-pays, medication co-pays, etc.