Name: (JOY LELEI) Favorite fall beverage: (Mint tea)

🏥 Access to Care - Investigating Health Insurance & Public Health (9 points)

Health insurance has a big impact on an individual’s access to healthcare -- and the health of
communities. This assignment asks you to navigate real insurance documents and tools, define and apply key
terms, and reflect on the impacts of health insurance.
This applied assignment has four (4) steps in which each step has multiple parts and questions. It includes
a variety of connected content and processes. It is designed to take 3-5 focused hours total, depending on the
student and preparation. You will engage with new resources.
Examples and guidance are provided throughout the assignment. Contact instructors as early as possible
with any specific questions, or come to Just Ask to check in! Instructors will respond to emails within 24 hours on
weekdays and 48 hours on weekends.

The assignment is designed to be completed in the order it is written. Reading Chapter 11 from your textbook and tak
This is an individual assignment.

Instructions:
❏ Download or make a copy of this document so you can work within it and save it.
❏ Submit to Canvas as a doc, docx, or PDF file.
❏ You may type your responses in dark green color to help them stand out (optional)
❏ Proofread your writing for flow, spelling, and grammar.
❏ You must include in-text citations when indicated in the assignment.
❏ Electronic sources: (Name or source of webpage, p# or N/A, date)
❏ Example with no page numbers or date available: (Healthcare.gov, N/A, N/A)
❏ Example with page number and date available: (SHBP Brochure, p. 5, 2024-25)
❏ Textbook: Insert (PH 101, p#) after your response and include the page number or numbers.
❏ Example: (PH 101, p.7).
❏ Points will be deducted for lack of proofreading and/or incorrect or incomplete use of references and
citations as explained above. This is an individual assignment.

Real health insurance resources you will use to complete this assignment:
● Summary of Student-Only Insurance Benefits & Coverage (2023-2024, 24-25 coming soon)
● SHBP Brochure (2024-2025)
● SHBP Enrollment Form (2024-2025)
● SBHP Dates & Costs (2024-2025)
● Blue Cross Blue Shield Preferred Drug List
Note that “SHBP” stands for “Student Health Benefits Plan”.

Assignment Table of Contents with Planning Guide:

STEP 1: Health Insurance In Your Real Life……...............…..…..…..………40-60 minutes, 2.6 points
STEP 2: Key Terms & Your Insurance…..…..…..…..…..…..…..…..……….....60-90 minutes, 3 points
STEP 3: Costs & Public Health Connections…..…..…..…..…..….........................30-50 min, 2.5 points
STEP 4: Your Journey Begins…With An Ambulance…..…..…..…..…..…...............30-50 min, 1 points
 Scenario: Chapter 1...Life Changes
You are a UMR student (duh) and you used to be on your family’s health insurance plan. ⚕️🏥.
Unfortunately, your family member lost their job ☹️and their former health insurance plan is no
longer an option for you ❌. You find out you can get on the UMR Student Health Benefit Plan as an
individual. 📝✅ This plan is offered by UMR through Blue Cross Blue Shield, one of the oldest health
insurance companies in the United States.

Guess what? You’re about to have a glassware-related accident in Gen Chem 2 Lab. 🧪 Let’s
get to know health insurance a bit before your accident happens. 🫣

STEP 1: Health Insurance In Real Life

Estimated time 40-60 minutes, 2.6 points total

Step 1 Question 1: 📚Even though the U.S. has a “literacy rate” of 99-percent, the average reading
grade-level in the U.S. is 7-8th grade. Half of U.S. adults are unable to read a book on the 8th grade
level. 📚

This is usually not an individual person’s fault - social determinants, school funding, life circumstances,
resources, etc, impact our opportunity to learn to read and to practice reading. But…navigating health
insurance often requires health literacy and technological literacy. 🧠 Can you sense some connections
with health outcomes? 🧠

Use the articles embedded in the questions below to dig deeper.

● Most health information and websites are written far above an 8th grade level. The National
Institutes of Health recommends health information be written at a 6-7th grade level. Use the tips
in this How to Write for an Eighth-Grade Reading Level to rewrite the passage below. Re-write
it at an eighth grade level or lower but retain the essential meaning.

Original Passage: “Your ophthalmologist will commence seeing you Friday, with
subsequent appointments biweekly. It is advised that you contact your health insurance
provider immediately to request pre-approval for treatments.”

○ Your revision of the passage to an 8th grade reading level: (2-3 sentences, 0.2 points)
Your eye doctor/surgeon will start meeting with you on Friday. You will have checkups with them
once a week for follow up treatment. Please call your healthcare coverage company soon and ask
them if they are willing to help you pay for your treatments.

© 2024 Barnett, All Rights Reserved

 ● Review the CDC’s Health Literacy - Understanding Literacy and Numeracy resource. Take a
screenshot of the most interesting thing (to you) from the resource and insert it below. (Need
help? Here’s a how-to screenshot for Windows, and a how-to screenshot for a Mac.)
○ (Insert screenshot here, 0.1 points)

○ Then, explain why this is most interesting and how your content may connect to health
(3-4 sentences, 0.3 points).

I found this most interesting because it highlights the domino effect of weak literacy and
numeracy skills stemming from childhood into adulthood health status. It is so sad to see that
there is a correlation between a child not being well supported academically and their life and
healthcare outcomes long into adulthood. This reminds me of WtEds in which Dr Mona
illuminates readers on the vicious cycle of lead contaminated water that results in both adverse
academic and health outcomes for children raised in poorer inner cities like Flint, Michigan.

S1 Question 2: The documents you will use for this assignment are real UMR student health insurance
documents and tools. For Step 1 Question 2 (S1 Q2) of this assignment, you are not required to deeply
read -- just get familiar with the documents. S1 Q2 should take you 30-40 minutes.
Open and briefly explore the hyperlinked resources below. Pinpoint one piece of information of note or
that interests you. Copy/paste it (or summarize it) into the format below. Then write a 2-3 sentence
“why” explanation about your interests. Remember, this is not a race in answering these questions. This
assignment asks you to take a deep breath and let yourself be curious about the learning materials.

SHBP Brochure (2024-2025)

● Information of note or interest (screenshot, copy/paste, detailed summary): (0.2 points)

● Why is it of note or interesting to you? (2-3 sentences, 0.2 points)

© 2024 Barnett, All Rights Reserved

The SHBP brochure has pictures of students looking happy and healthy which underscores the
requirement of health insurance for all college students. This is because access to medical care
helps maintain good health which is essential for academic success. I find this so true and
appreciate the foresight and social justice of UMN for taking onboard the Affordable Care Act
framework and providing 100% coverage of essential benefits for those in need of coverage via
SHBP.

SBHP Dates & Costs (2024-2025)

● Information of note or interest: (0.2 points)

Vs
● Why is it of note or interesting to you? (2-3 sentences, 0.2 points)

It is interesting to note that local students must pay for coverage in one lump sum fee of $1,795/
semester whereas international scholars under the SHBP are given the flexibility of paying $320 /
month. I wonder if this is the assumption that locals without their own employee-based or
parentally acquired insurance are higher risk policyholders and so charging them once is a form
of security for the insurance company and school.

SHBP Enrollment Form (2024-2025)

● Information of note or interest: (0.2 points)

● Why is it of note or interesting to you? (2-3 sentences, 0.2 points)

It is interesting to note that adding a child is more expensive than the primary member’s
own coverage. I thought maybe because a child has a need of more specialized care and
medications that are very specific to their tender needs. Conversely, the high premium
could make the student-parent less willing to add a child through the school and may
instead seek employment that provides this benefit at a lower cost.

Summary of Student-Only Insurance Benefits & Coverage (2023-2024, 24-25 coming soon)
● Information of note or interest: (0.2 points) It is of note that the SHBP offers prenatal care at
no additional charge and postnatal care at only 20% coinsurance.

© 2024 Barnett, All Rights Reserved

 ● Why is it of note or interesting to you? (2-3 sentences, 0.2 points)

This is awesome and shows the implementation of the social justice law Title IX of the Education
Amendments (1972) which prohibits discrimination in educational programs and activities based
on sex, including pregnancy and parental status. I'm glad to see women have the option of
starting/expanding their family while in University; and that they are supported with free (in-
network) prenatal care.

Blue Cross Blue Shield Preferred Drug List

[Additional instructions to access this list more fully will be included later in the assignment -- if you
notice a perceived roadblock, that’s okay - can you get around it? If not, use the potential roadblock to
answer this question.]
● Information of note or interest (0.2 points): This site has very exclusive membership requiring
sign up credentials to access.

● Why is it of note or interesting to you? (2-3 sentences, 0.2 points)

This is of note to me because it seems that only people with chronic illnesses who are on the
SHBP would be able to access this feature. The website also has middle-aged to elderly men
of color advertising services which may indicate that MyPrime’s target audience is not
college aged youth but rather an older demographic. My question would thus be, why
would this feature be included in SHBP? And how would it be accessed by the everyday
student who may need it.

STEP 2: Key Terms & Your Insurance

Estimated time 60-90 minutes, 3 points total

© 2024 Barnett, All Rights Reserved

Since you’re on the UMR student health insurance plan now, it’s time to see what Key Terms mean -- both in
general (Definition) and specifically within the UMR insurance context (Applied Meaning). You’ll fill in the table
below to become an expert!

How to do Key Term Definitions:

Use your textbook and/or the internet as resources to locate the general definition for the ter
paraphrase or summarize
it without using AI, do not use a direct quote). Remember t

How to do Key Term Applied Meanings: Critically examine the actual UMR health insurance resource
documents to determine what the Key Term means specifically - for example, instead of defining “deductible”
you’d locate what the actual deductible amount is for your Applied Meaning. The Applied Meaning is what the
term “really” means in real life in the UMR plan. An example, an amount, a real life meaningful piece of
information about health care (Be careful to avoid the dental care info! Look at health care, not dental care, for
this assignment.
). Remember to cite in every box using the instructions on the first page of this assignment.

Some boxes are already completed in gray as examples. These are “free” spaces you do not need to complete, and
the examples show you the required depth and quality of work for this section of the assignment.

(12 table sections at 0.25 = 3 points total)

Key Term Definition Applied Meaning

Premium How much money you (and maybe The premium for UMR students is
your employer helps you) pay to buy $299/month or $1,795/semester with an
health insurance. This can be charged additional $403 and $312- $473 if one’s
each month, every 3 months, yearly, or
spouse and children are added to the
at another interval. (Healthcare.gov,
N/A, N/A). insurance, respectively.
(SHBP Brochure, 2024-2025, p. 7)

Deductible The monetary amount that the person The amount paid before BlueCross
or family must pay for their healthcare BlueShield coverage is $250 for the
before the insurance company begins individual’s medical in-network and out-of
to “cover”/pay for their care or medical
network combined.
bills (Public Health 101, p. 224).
Deductibles typically are in the amount (SHBP Brochure, 2024-2025, p. 7)
of hundreds of dollars up to many (Summary of Student-Only Insurance
thousands of dollars, depending on the Benefits & Coverage (2023-2024, 24-25
insurance plan (HealthMarkets, 2022, coming soon)
N/A).
Coinsurance This is the percentage of medical For UMR student health care at the
charges that the insured is responsible Campus Health Service (the Skyway
for paying. Clinic), it seems there is no coinsurance
(you pay 0%, your insurance pays 100% of
(PH 101, p.224)

© 2024 Barnett, All Rights Reserved

 the bill). For providers not at the Skyway
Clinic, the coinsurance is 20% so you
would pay 20% of the cost of care - and the
insurance company pays 80% of the bill.
This coinsurance can vary for mental
health care, if you’ve met your deductible,
and the location of care. (SHBP Brochure,
2024-2025, p. 5)
Copay This is the amount in medical charges According to SHBP there is no given copay
that the insured person is responsible but only the $250 deductible and 20%
for paying even if the service has been coinsurance. After researching UMN Twin
covered by insurance. Cities campus, I learned that the Gopher
Quick Clinic has a $15 copay for Medica
(PH 101, p.224) insurance’s Elect plan, and a $20 for the
Medica’sChoice National plan.
Medical Plans | University of Minnesota
Office of Human Resources, N/A, N/A)
Out-of-pocket In one year, the most you can pay for The max is $6,250 per person in-network
limit (also your health care. The dollars you spend and out-of-network medical services and
called “max”) for your deductible, copayments, and prescription drugs.
coinsurance bills count toward the (Summary of Student-Only Insurance
OOP max (the OOP max does NOT Benefits & Coverage (2023-2024, 24-25
include premiums, out of network coming soon)
costs, or non-covered care)
(Healthcare.gov, N/A, N/A)
Provider A health insurance plan can contract This health plan has three different
network with a predetermined list of providers categories. It looks like the plan offers
(like hospitals, doctors, etc) that will most “coverage” for the Campus Health
serve the plan’s customers/patients. Service and Participating Providers (“in
These predetermined providers are network”), and offers good coverage for
often noted as “in network”. They are other Nonparticipating Providers with
usually “covered” by the insurance some exceptions or differences. For some
plan. (WhatYouShouldKnow, 2022, things, you will pay more for care from
N/A) out-of-network providers. (SHBP
Brochure, 2024-2025, p. 5-6)

Preferred PDLs are a list of brand-name and For generic preferred drugs, insurance will
drugs generic medications that federal states cover $15.00/prescription copayment for
encourage providers to prescribe over retail drugs. It will not cover for mail
others as a means of negotiating higher service or 90 day Rx retail drugs. On the
supplies and reduced costs to the other hand, for brand preferred drugs,
policyholder. insurance will cover $25.00/prescription
(State Health Facts | KFF, 2019, N/A) copayment for retail drugs. It will not cover
for mail service or 90 day Rx retail drugs.

© 2024 Barnett, All Rights Reserved

 (Summary of Student-Only Insurance
Benefits & Coverage (2023-2024, 24-25
coming soon)
Non-preferred This is a more expensive and These are not covered by the SHBP
drug sometimes less effective (at treating the insurance plan.
condition) prescription drug that is not (Summary of Student-Only Insurance
included in an insurance plan. Benefits & Coverage (2023-2024, 24-25
(Prescriptions: Why They’re So coming soon)
Complicated | AAFP, 2002, N/A)

Specialty drug Also known as biologics, these drugs These are not covered by the SHBP
are usually derived from living insurance plan.
organisms and are specifically (Summary of Student-Only Insurance
formulated to treat complex or rare Benefits & Coverage (2023-2024, 24-25
chronic conditions like: cancer, coming soon)
rheumatoid arthritis, hemophilia,
H.I.V. and IBD, making them quite
expensive. They may also require
special handling and are ordered
through a specialty pharmacy.
(Understanding prescription drug
benefits | Blue Cross MN, 2024, N/A)

STEP 3: Costs & Public Health Connections

Estimated time 30 - 50 minutes, 2.5 points total

Step 3 Question 1: You will now explore the costs of healthcare…and why costs in the U.S. are so high and vary
so, so much (based on the type of insurance you have, where you seek care, etc). You have “private insurance”
through the UMR Student Health Benefit Plan. Just FYI.

Click the video link at right to watch it: “Why Medical Bills in the US Are So Expensive” (14 min)
As you watch, take notes in the space below to document and process what you’re seeing. (2-3 sentences of notes
for each of the eight bullet points, 1.6 points)

1. Little Luca’s lung transplant cost in excess of $4 million. His family had to fundraise soon
after he was born and began receiving surgeries and treatment for his chronic illness.

2. In 2017 one-third of GoFundMe donations (of the total 650M+ raised) went towards
medical bills. This shows the immense outcry for lowering medical treatments in the USA.

© 2024 Barnett, All Rights Reserved

 3. Bluecross and Blueshield were the earliest health insurance and started off after World
War II in the 1940s as a way for employers to offer benefits as an alternative to raising
wages. What started out as a serendipitous charitable venture, has now become a multi-
billion dollar industry that is more concerned with maintaining its profit margins than care
for the most vulnerable in society.

4. To prevent themselves from being sued for medical malpractice, it is common for
American healthcare providers to order several diagnostic tests which may not be essential.
This lack of trust in healthcare policies to protect the interest of both the physicians and
their patients results in wastage of resources and time.

5. Unbundling and coded billing construct results in inefficiency and confusion. This often
results in overwhelming, unnecessarily detailed paperwork in America’s medical bills.
This is relative to the more concise European healthcare systems billing methods.

6. Exorbitant drug prices for chronic illnesses due to the monopoly in the market of one
company in the name of fundraising for further research and drug development.

7. Medical emergencies are chaotic and health insurance is confusing. Much like one wouldn't
negotiate with a firefighter if their loved ones were burning alive in a building, caregivers
are so fatigued and stressed by the traumatic medical ordeal that they acquiesce to
treatment, whatever the cost.

8. As of 2018, 30 million Americans were uninsured which was 25 million less than before the
Affordable Care Act in 2010. This is an improvement although the USA still lags behind in
insurance rankings when compared to countries like Japan and UK.

Step 3 Question 2: This assignment takes an individual view of the UMR student health insurance, but
health insurance often affects families and communities. We can look at health insurance (or more
broadly the cost of healthcare) as a public health issue.

Choose one (1) of the two resources below to explore:

● APHA’s “Provide Quality Health Care for Everyone” Page
● Healthy People 2030’s “Access to Health Services” Literature Summary

After exploring the resource of your choice (one of the two, not both), select one paragraph from it that
resonates most with you personally. Follow the instructions below.

Insert a screenshot of the paragraph you chose here: (0.2 points)

© 2024 Barnett, All Rights Reserved

 Why does this particular information resonate most with you personally? (2-3 sentences, 0.3 points)
As an African woman who delivered a child in Minnesota within the last 3 years, the disparity in
gestational mortality rate along racial lines is so concerning. I was fortunate enough to have a
great healthcare provider and to receive hospital subsidies on my medical bill postnatally through
my husband’s Bluecross Blueshield insurance policy. I hope more can be done by the federal
government to facilitate social justice through healthcare coverage accessibility for vulnerable and
minority demographics.

How does this paragraph connect with public health? (3-4 sentences, 0.4 points.)
It relates to public health because the disparity is a matter of social injustice and its impact on
population health of vulnerable demographics. With most poor and single family households being
uninsured, systemic racism in the pain management of black women, and the majority lacking
employment benefits to take time off during pregnancy (if the need arises), it makes sense that the
mortality rate of such affected women would be on the rise. It is a public health issue because all
people who are equally citizens/ residents of this nation, should be entitled to the same accessible,
affordable and quality healthcare- especially during pregnancy.

STEP 4: Your Journey Begins…Ambulance or No Ambulance?

Estimated time 30 - 50 minutes, 0.9 point total

Scenario: Chapter 2...Ouch

You have not sought medical care using your UMR student health insurance plan so far, but
now you need to. Today, you were in General Chemistry 2 Lab and while you were using a volumetric
flask 🧪, you accidentally dropped it! 🤯 Somehow, a piece rebounded from the lab station and hit your
left eye! Your eye has been cut! 🥺 It hurts so terribly. You wonder if you need ambulance transit to a
healthcare provider, or if you should walk or try to drive yourself. 🏥

Step 4 Question 1: Use the article, “Need a ride to the hospital? Depending on the state, it will cost you” to
answer the questions below:

● How much can a typical Minnesotan expect to pay out-of-pocket for an ambulance ride? (0.1 points)
It costs $1,133 from out-of-pocket to pay for an ambulance ride.

Step 4 Question 2: Calculating…calculating…💸

© 2024 Barnett, All Rights Reserved

Your lab instructor is really concerned about you -- and wants to play it safe by calling an ambulance 🚑 to take
you to the Mayo Clinic St. Mary’s Emergency Department (1.1 miles away).

Your friend says “NO!🙅 Last year I slipped on ice behind Cafe Steam and had to go to St. Mary’s by ambulance.
The transit cost was $1040! 💸 I’d opted out of the student insurance so I had to deal with paying it all myself!”.

Now you’re worried about getting a $1040 ambulance bill.

Use the SHBP Brochure (2024-2025) and your critical thinking skills to estimate how much of the $1,040 you
would pay to cover the ambulance cost (remember, you have insurance).

● Insert a screenshot of the relevant content from the SHBP Brochure (2024-2025) that you used to inform
your ambulance ride cost estimate. (0.2 points)

With the SHBP insurance, it would cost a UMR student 20% of $1,040 which = $208

● In 3+ sentences, explain how much you would likely pay out-of-pocket (meaning you pay from your own
money, not what the insurance company will pay toward the bill) of the $1040 cost. Note that you have
not paid any money toward your $250 deductible at the time of your lab eye accident. Note that St.
Mary’s is not the Campus Health Service, but is likely “in-network”. Clearly explain your rationale and
show your calculations. (0.6 points).
First of all the student would need to pay the SHBP deductible of $250 to access the ambulance
through insurance. They would then qualify for the 80% coverage after deductible up to the
out -of-pocket limit (max= $6,250). Therefore, the out-of-pocket for this ambulance ride
would be $250 + (20% of $1040) which is $458. This is all under the assumption that the student
has not opted out of the SHBP.

You did it! This is a huge step! Take a moment to affirm yourself!

© 2024 Barnett, All Rights Reserved