By Jake Indursky (MIA ’23)

When one student at SIPA began experiencing abdominal pain towards the end of the fall semester, they followed the textbook approach to navigate the Columbia Health system. 

“I started developing a medical issue primarily related to reproductive health, and I was just very uncomfortable and in pain for about a month,” said the student, who requested anonymity due to disclosure of personal health details. The student is referred to as Sam for the remainder of the article. “The issue started at the tail end of December and started really flaring up in the first week of January.”

Sam quickly hit several dead ends in their search for treatment — an appointment at Columbia Health left them with no answers because proper diagnostic equipment was unavailable, and a prescription for medicine that did little to alleviate the pain. 

Upon referral to a clinic that specializes in reproductive health, Sam was told that the clinic was not accepting new patients at that time.

“I kind of hit a wall, and had exhausted my Columbia options,” Sam said. “For context, I’m an international student and not as familiar with the American health care system.” However, Sam added, “with some research, I did end up finding a clinic that seemed like a really good option for me because it offered more of the screening and testing that I wanted to get.”

When they arrived at the clinic and handed over their insurance card, they were confronted with more bad news. According to Sam, the front desk turned to them and said, “your insurance card is expired. If you want to go ahead with the appointment, the cost will come to $500.” 

“I was already so frustrated at that point, I immediately burst into tears in the waiting room,” Sam recounted.

After double-checking the Aetna website, Sam saw that their insurance had expired on December 31, and that it would not renew until January 17 after officially registering for the spring semester.

In an email to The Morningside Post, a representative from Columbia Health explained, “The Spring coverage period starts on January 1. Even if a student registers after this date, the coverage will be retroactive to 01/01/2022. During the first few weeks, there might be a slight lag time between registration and Aetna reflecting eligibility, but…there will be no lapse in coverage and no time that the student is uninsured.”

While seemingly inconsequential, this time lag can leave students seeking immediate care unsure of what will be covered and what will not. The Columbia Health website provides some information, but for students going through a health crisis — and especially for international students unaccustomed to the American healthcare system — navigating these processes can quickly become overwhelming.

“I wasn’t even sure if the insurance would have kicked in retroactively, maybe that’s something I should have asked,” Sam said. “But in the moment, the palpable feeling of ‘you don’t have insurance, so we can’t help you’ was at the forefront of my mind.” 

Unfortunately, this type of incident — a sick student overwhelmed by the intricacies of the health insurance system — is not particularly rare. Another student at SIPA, who is immunocompromised, detailed their frustrations with the inability to access treatment when they caught COVID towards the end of the fall semester.

“My health was very critical because my immune system was not that strong,” said the student. “I tried to call Columbia [and] nobody was around because of the holidays.”

Additionally, this student was unsure of their insurance status. “I didn’t have any sense,” they said of their coverage over the break. “I know they change every semester, but I assumed January will be part of the old [plan] or the new one, and I feel like that’s also not clear.”

Ultimately, this student, given their weakened immune system and uncertainty around care and coverage, ended up returning to Minnesota for treatment.

In Sam’s case, while they successfully made an appointment on January 17 and received a diagnosis and treatment plan, they later received the alarming information that the outcome could have been very different if they waited just a little bit longer to receive care.

“I vividly remember the clinician [saying], ‘if you had waited a couple more weeks, this could have been really bad, but I’m glad we caught it now,’” Sam recounted. “That could have really jeopardized my ability to return to school [and] compromised my health in a big way.”

Jake Indursky is a contributing editor and a first-year Master of International Affairs student concentrating in Urban Policy.