Campus student goes without treatment after difficulty navigating university health insurance

Tang_MDrummond_file
Michael Wan/File

Related Posts

On Aug. 24, Rolando Gutierrez, a campus junior, visited the Tang Center and Direct Urgent Care, but left both without receiving treatment for severe dehydration.

Gutierrez could have accessed the care he required, but said he was never given the information he needed to navigate after-hour health emergencies with a university health insurance plan. Like Gutierrez, more than 22,000 UC Berkeley students have Student Health Insurance Plan coverage.

Early Wednesday morning, Gutierrez called the Tang Center’s advice nurse for help after being unable to keep food down for several hours, who recommended he call 911. Firefighters tested his vitals before advising him to visit the Tang Center at his convenience.

Because it was the first day of the fall semester, Gutierrez decided to go to his classes despite his condition.

Once classes ended, Gutierrez said he went to the Tang Center to receive treatment and arrived 15 minutes before the center closes at 6 p.m. Without time for full treatment, the center offered him intake and referred him to Direct Urgent Care on Telegraph Avenue.

When he arrived at Direct Urgent Care, the receptionist asked Gutierrez for his SHIP insurance card, which he did not have or know how to access. The Tang Center does not require students with SHIP to show proof of insurance because they can look them up in the university’s database.

Unlike many health insurance contractors, SHIP does not provide students with insurance cards and requires them to download and print the card themselves. Six days after Gutierrez became ill, University Health Services sent an email to all SHIP members reminding them to print their card.

According to UHS spokesperson Kim LaPean, the Tang Center no longer provides students with medical insurance cards because they are expensive and many people never picked them up.

Without proof of SHIP, Gutierrez could have paid the clinic’s fee out of pocket, but he believed he could not afford it. Gutierrez had other options that night, but in the frenzy of finding care, he said he was never told what resources were at his disposal.

Caesar Djavaherian, president and chief medical officer of Direct Urgent Care, stressed that anyone who comes to urgent care before 8 p.m. will receive full treatment and said there must have been some miscommunication that evening.

Gutierrez could have called the Tang Center advice nurse from urgent care to access his information or used Direct Urgent Care’s prompt-pay menu to receive his treatment for $175 and retroactively applied his insurance for a refund.

Instead, Gutierrez decided to rest until the Tang Center opened at 8 a.m. the next morning, where he was then treated for severe dehydration with intravenous hydration.

“This is something that should never have happened,” LaPean said.It’s always a good precaution to have your card on you … (but) they can always call the next day for verification.”

The Tang Center’s 24/7 advice nurse is available to help students navigate their SHIP information and UHS encourages students to download the Anthem mobile app for instant access to their insurance policy.

In case of a medical emergency, the Tang Center recommends students seek treatment in the emergency room, which is required by federal law to take all individuals regardless of insurance policy.

“At the end of the day I’m told I could have done this and I could have done that, but how am I supposed to know that off the bat?” Gutierrez said. “I feel like it should be more accessible.”

Maya Eliahou covers student life. Contact her at [email protected] and follow her on Twitter at @MayaEliahou.