After several days of fever and achiness to start his sophomore year at Georgetown University, Niels Ruigrok (COL ’22) visited the Student Health Center on Sept. 10, 2019, where a doctor diagnosed him with mononucleosis and strep throat. Ruigrok was prescribed medication for his strep and advised not to exercise for four to six weeks, in addition to not attending classes for one week because of the mono diagnosis.
A day later, Ruigrok’s roommate found him on the floor of their room, shaking and unable to form any words. Ruigrok was immediately rushed to MedStar Georgetown University Hospital in a Georgetown Emergency Response Medical Service ambulance. Blood work done at the hospital revealed Ruigrok had neither mono or strep, but instead had a common virus.
“It was terrifying. My throat completely closed and I couldn’t breathe at all,” Ruigrok said in an interview with The Hoya. “Whatever medication I got from the Student Health Center, it wasn’t the medication I was supposed to have. It definitely had an adverse effect.”
Ruigrok, who is enrolled in the Platinum Premier Plan — the university’s only health insurance option — had to pay $2,500 out of pocket for a visit to MedStar Hospital on a bill that totaled $3,250. The Premier Plan, which costs $2,895 annually, only covered $750 of that medical bill.
Ruigrok’s experience is one among many student concerns about the quality of care provided at the Student Health Center. Student reports of inadequate care provided by the health center are coupled with student concerns about health insurance accessibility and cost. Students’ insurance must be compliant with Georgetown’s policy, which can pose challenges for students unable to afford insurance or those whose existing insurance does not satisfy the university’s requirements.
Inadequate Health Care
Since its creation in 2003, students have vocalized their dissatisfaction with the Student Health Center, citing both long wait times and poorly managed urgent health scares. In 2014, when Georgetown confirmed a case of bacterial meningitis on campus, some undergraduate students who had difficulties booking appointments at the Student Health Center opted to seek treatment elsewhere.
During the 2019-20 academic year, problems relating to accessibility and quality of treatment, such as those in Ruigrok’s case, still pervade student sentiment about the Student Health Center.
Elise Chapman (SFS ’23) had been dealing with neurological issues for two years before coming to Georgetown and was diagnosed with multiple sclerosis after the start of her freshman fall semester. When her condition worsened in November 2019, she immediately visited the Student Health Center, where her primary care physician told her that her symptoms were only the result of stress, according to Chapman.
“They referred me to CAPS, and kind of just didn’t really seem to care too much about my symptoms or what was going on even when I told them about my background of neurological issues,” Chapman said in an interview with The Hoya. “I feel like they’re not really well equipped to treat anything other than, like, a cough, or like — I don’t know — normal college student diseases.”
Long wait times for treatment and limited clinical hours make health care at the Student Health Center inaccessible for the majority of students, according to several sources.
The Student Health Center opens on weekdays between 8 a.m. and 9:30 a.m. and closes between 4 p.m. and 5 p.m., depending on the day. Some students experience difficulty when receiving treatment on weekends, as the clinic is only open for three hours Saturday mornings, and is closed Sundays. For urgent health problems after hours, the Student Health Center advises students to speak with the clinic’s on-call physician over the phone or visit the emergency room at MedStar Hospital.
Limited clinical hours affected Ethan Williams (SFS ’23) when he visited the Student Health Center during the fall 2019 semester after developing a 104-degree fever, only to miss the clinic closing by five minutes, he said in an interview with The Hoya.
The Student Health Center’s hours are inconvenient for students, especially those who have commitments outside of classwork, according to Williams.
“If I had just met with somebody from Student Health Services for like 10 minutes, they could’ve told me what was wrong,” Williams said. “Instead, I had to wait in the hospital waiting room for about four hours with my friends to even meet with any kind of doctor or nurse.”
The Student Health Center operates on a triage system, which involves assessing the severity of a student’s illness to determine the priority of their treatment. Triage systems are often used in hospital emergency rooms to address sick patients according to their need for medical assistance.
The system will not always be convenient for students because it seeks to prioritize more serious cases, according to Assistant Vice President of Student Health Services Vincent WinklerPrins.
“There may be times when a student wishes to have an appointment that the student health center may not immediately be able to accommodate but we have a nursing triage system in place to help address urgent student needs,” WinklerPrins wrote in an email to The Hoya.
The clinic can often feel short staffed, however, because not all Student Health Center employees work on the same days or at the same times, according to Jenia Davis, a receptionist at the Student Health Center.
“It probably is a little — it gets a little hectic because not all the providers work in one day,” Davis said in an interview with The Hoya.
Georgetown requires all undergraduate students to have health insurance that meets university standards and is compatible with the Affordable Care Act. Students are automatically charged for and enrolled in the university’s Premier Plan unless they waive the health insurance before the start of the school year.
Forty-five percent of Georgetown students are enrolled in the Premier Plan, according to Laura Hardman Crosby, director of the Student Health Insurance Office.
Although a large proportion of the student body is enrolled in the plan, some students have found it difficult to navigate what the plan does and does not cover. Elliot Mack (SFS ’22), a student enrolled in the Premier Plan, visited the Student Health Center with painfully impacted wisdom teeth, only to be redirected to a website to find a dentist on his own.
“It hurt so much, and I went to the Student Health Center and they literally like gave me a phone number to call,” Mack said in an interview with The Hoya. “I had to go on the website, find a dentist, call them and then found out that I wasn’t covered.”
Wisdom teeth removal is not covered by the Premier Plan, despite urgent wisdom teeth removal constituting a medical emergency, according to Mack. Although it is listed on the website that the Premier Plan does not insure dental or vision care, Mack claimed this was not made clear to students and expressed a desire for more student insurance options.
“I wish they had more transparency and more options, like if you want to get dental you can get dental,” Mack said. “It’s a kind of a one plan fits all, and they don’t give you a summary that helps you figure out what you’re covered for. We have an orientation for every little thing at NSO, but for health care the university doesn’t help you understand it at all.”
The insurance office makes itself available to students by phone, walk-ins and appointments to address health insurance coverage-related questions, according to Hardman Crosby.
Emily Graul (NHS ’20), a founding board member of Georgetown University Students for Health and Medical Equity, a club that raises awareness for the availability of health care services, echoed Mack’s concerns about the university’s lack of transparency and accessibility in informing students about the Premier Plan.
Graul was concerned that the 85-page document listing which situations are eligible for coverage is not sent out to students along with the health care waiver.
“When do we look at that when we sign? We’re filling out a Google Form when we waive or we don’t waive [the Premier Plan],” Graul said in an interview with The Hoya.
The university can improve at informing students about their health care coverage, according to GUSHME President Grace Keegan (COL ’21)
“It is the responsibility of the university to cover what isn’t covered for students. I don’t think it should be our responsibility to fight for that or to even have to address those issues,” Keegan said in an interview with The Hoya.
Health Care Costs
For students who arrive at Georgetown without existing insurance plans and students whose health care coverage is deemed insufficient by the university, waiving the Premier Plan may not be a viable option.
Even with the university mandate, some students may go uninsured for several reasons, according to Missy Foy, director of the Georgetown Scholars Program, which supports low-income and first-generation college students on campus.
“Some low-income students are on Medicaid in their home state which typically doesn’t translate to coverage in the District,” Foy wrote in an email to The Hoya. “I understand how that can be confusing, and the result is a student may not be insured when they’d likely be eligible both for GU insurance and financial assistance to help with the cost.”
Eligibility requirements for Medicaid, a federal program that provides discounted health care for low-income families, differ in each state. Out-of-state Medicaid does not necessarily meet Georgetown’s requirements for adequate health care coverage because it often does not extend to the Washington, D.C. area, according to Hardman Crosby.
Health insurance can be covered by financial aid, as it appears on the fall semester’s tuition bill.
GSP assists students with getting financial aid to cover insurance costs, informing them about options that can cover health insurance costs if students do not already have coverage, according to Foy.
“Incoming students may, understandably, worry about the cost of health insurance, and I would encourage them to reach out to the Financial Aid Office, to speak to their financial aid counselor, and ask what funding options are available to them to meet the insurance requirement,” Foy wrote.
Despite the Student Health Center’s shortcomings in health insurance coverage and medical assistance, some students, like Williams, will continue using the Student Health Center because of its convenient location on campus.
“If I’m dealing with a pressing medical issue, I can’t really just go off campus to try to find the nearest clinic, or go to the hospital to wait four or five hours,” Williams said. “So it’s really the only option.”