Undergraduate Health Insurance Begins $50,000 Cap On Prescription Drug Coverage

Demand for Expensive Biological Drugs Forces CSU to Implement Spending Limit

NewsErika Morris — Published August 24, 2018

CSU General Coordinator Sophie Hough-Martin said the StudentCare plan’s membership, with its insurance company, was being put under financial stress after seeing a rise in “expensive biological drugs.”

“It has put us in a bit of an ethical question because sometimes these are life saving drugs,” said Hough-Martin at the meeting.

“But someone could register as a Concordia undergraduate student just to use the plan and we would have to cover their drugs. It puts us at risk of an incredible increases in our plan costs in the next few years should anyone in that situation come onto our plan.”

Costs for prescription drugs has been unlimited until now–though dental coverage, eye exams, prescription glasses, psychological services, chiropractic services, and physiotherapy already have a cap on how much can be covered.

In the past two years there have been only two instances of students claiming over $10,000 worth of coverage. The insurance company sees that $50,000 is a way to close loopholes and act as a safeguard.

According to a case study put together by ASEQ, the CSU has so far been able to afford the costs of the occasional large prescription drug claim. But with recent developments in pharmaceuticals and an increase in students using the plan, the CSU had to reassess.

Some biological drugs can cost $20,000 a month and the CSU plan would be responsible to cover them. Hough-Martin said the cap should prevent large increases in the CSU’s membership costs for ASEQ.

“While the risk of this happening is abstract, it is still a possibility and this 50k maximum is a precaution,” said the case study by ASEQ.

Finance coordinator, John Hutton, addressed concerns about redirecting students who need coverage beyond the health plan. He said in the meeting that pharmaceutical companies typically have “compassionate care plans” to ensure that people with severe conditions would be covered.

“Having a maximum coverage in many ways ensures that instead of relying on the [CSU], the onus gets put on these companies themselves in these instances,” he said.

“The few people who have very large and serious conditions won’t be left out in the cold with this decision.”

While $50,000 is a large number considering that the largest amount claimed in the last five years was $33,572, as pointed out by councillor David Ferraria, it was the number suggested by ASEQ.

“If they’re comfortable with it we can safely assume that it’s safe,” said Hough-Martin.