Lifetime Caps

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UC Student Health Plan Slips Through Loophole in Affordable Care Act

A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)

A UC Berkeley student discovered the limits of his UC student health coverage after a cancer diagnosis.(Studio H (Chris)/Flickr)

If you are a student at any of the UC campuses — or a family member of one — you might want to pay close attention to the case of Kenya Wheeler at UC Berkeley. A year ago he was “healthy as a horse,” the San Francisco Chronicle reports and biked to school every day.

But everything changed when he was diagnosed with cancer. He had health insurance through the UC Student Health Plan. But as medical bills mounted, he closed in on the $400,000 lifetime cap of the policy — caps that were made illegal under the Affordable Care Act.

Illegal, that is, except for self-funded college health insurance plans, such as the one UC has. In its self-funded plan, UC bears the financial risk of medical coverage. From the Chronicle:

Universities have long offered student health coverage to make sure their students have access to health care. Most college health plans purchase a group policy from a health insurance company and must adhere to the new federal requirements. Continue reading