Healthcare & Insurance in the U.S.
Healthcare in the U.S. is not administered or funded in any centralized way, as it is in many other countries. The healthcare system in the U.S. is essentially made up of healthcare providers, insurance companies, billing departments/companies, and you, the insured person who pays for all healthcare costs in the form of insurance premiums (cost to enroll in coverage), co-pays, co-insurance, and deductibles (portions of bills that are your responsibility to pay).
Insurance companies keep approximately 20% of your premium for their operating costs (employees, supplies, buildings) and the remaining 80% pays all insured clients’ medical bills. This means that insurance plans with higher premiums will cover more potential medical bills and vice versa.
If medical bills are paid by insured people, why is insurance important? Unexpected emergencies are extremely expensive in the U.S. To give a real example, a student who fell and broke her arm between classes would have paid over $20,000 for tests, treatment, and ongoing physical therapy, but with insurance she instead paid her $2,000 premium, plus several $40 co-pays – significantly less.
It is important to do the following to reduce your out-of-pocket expenses:
- Review insurance policy brochures thoroughly BEFORE enrolling/buying insurance to understand both what you are paying to enroll and what portion of emergency medical costs you will pay yourself. Please ensure the policy you select meets FSU Insurance Policy Requirements.
- Carry a paper insurance card with you always, so that emergency personnel can bill your insurer, rather than you. Otherwise, you may miss important claim filing deadlines.
- Know your in-network hospitals, urgent care facilities, and general doctors before you need their services.
- Keep all bills and statements to ensure that you receive all benefits you should from your insurance. Sometimes billing agencies don’t receive your insurance information.
- Ask questions if you are in doubt about what you are being billed and why.
Some important terms that will help you review your plan brochure:
Premium vs. Benefits – You will pay a premium or a payment associated with enrolling in any insurance plan to cover possible medical bills you may incur while insured. If your insurance premium is low, you will pay more (deductible, co-pay, co-insurance, and excluded services) when you need emergency medical care and vice versa. No plan covers 100% of all medical costs.
Eligibility – Insurance plans limit who may enroll in their plan. If a plan requires that the insured person be enrolled for a certain number of credit hours each semester, and the insured person is not a student or not enrolled for that number of hours when an emergency occurs, the cost may not be paid. Dependent coverage often requires a student to be insured in the same plan.
Exclusions – All insurance plans have excluded conditions or treatments that will be completely your financial responsibility. Common exclusions are routine eye care and all dental treatment. Low premium plans often exclude injuries related to sports (intramural, club, or informal), injuries that happen while consuming alcohol, injuries that happen during dangerous activities like riding a scooter, and follow up care for conditions, injuries, or illnesses that occurred prior to the start of the plan (pre-existing conditions).
Provider Network - This is the list of doctors, hospitals, specialists, and laboratories that have contracted (at some point) to provide service for the insurer. In-network providers charge a predictable cost for services to the insurance company, and your portion of that bill is lower. Out-of-network providers can charge anything, and you will pay a higher percentage of their bill. Your insurance provider can help you find current in-network providers in the areas in which you are living or visiting to lower your cost if emergency medical services are required.
Students can find more information about the state's requirements for enrolled students in F and J visa status and resources at studentinsurance.fsu.edu.
University Health Services (UHS), Florida State University's fully accredited primary care facility located in the Health and Wellness Center (HWC building) on campus, provides a full range of medical services and outreach programs.
UHS strives to be a national leader in college health and wellness providing health promotion, prevention, and medical services. Emphasizing healthy lifestyle decisions, self-care, and academic success, the mission of UHS is to facilitate and contribute to the well-being of FSU students and the community.
Health Care Services include primary care, priority care, gynecological services, travel clinic, immunizations, allergy clinic, psychiatric services, diagnostic imaging, physical therapy, and a medical response unit at the Health and Wellness Center (HWC). UHS provides family practice-type services and priority care services (minor suturing, splinting, intravenous therapy) for acute injuries and illnesses.
FSU students and visiting scholars who have FSU insurance can access the Health and Wellness Center (HWC) with no copay. Individuals with non-FSU insurance will have the option of visiting HWC or a provider in the community and will be charged any applicable insurance co-pays.
The Center for Health Advocacy and Wellness (CHAW) encourages students to make healthy lifestyle decisions that facilitate academic success and lead to life-long health and wellness. CHAW provides nutrition counseling, confidential HIV testing, wellness coaching, sexual health consultations, alcohol and drug harm reduction programs, and tobacco cessation sessions. Other outreach topics include interpersonal violence prevention, eating disorder prevention and body image programs.
Many Community Partners share our space in the HWC building to provide extended services to students. These include specialists in dermatology, allergy, endocrinology, neurology, psychiatry, dental and chiropractic, and massage.
UHS also assists with Admission Health requirements that include immunizations and health insurance.
There are two hospital systems in Tallahassee, and it’s important to know which is in your network prior to an emergency sitation.
Tallahassee Memorial HealthCare
Founded in 1948, Tallahassee Memorial HealthCare (TMH) is a private, not-for-profit community healthcare system committed to transforming care, advancing health, and improving lives with an ultimate vision to elevate the standards of our healthcare practice, quality and innovation in our region. Serving a 17-county region in North Florida and South Georgia, TMH is comprised of a 772-bed acute care hospital, a psychiatric hospital, multiple specialty care centers, three residency programs, 32 affiliated physician practices and partnerships with Doctors’ Memorial Hospital, Florida State University College of Medicine, University of Florida Health, Weems Memorial Hospital and Wolfson Children's Hospital.
Visit www.tmh.org for more information.
Capital Regional Medical Center
Capital Regional Medical Center (CRMC) has been serving the Big Bend community for more than 40 years and is an HCA-owned facility. As a fully accredited healthcare facility, CRMC strives to provide the latest in state-of-the art technologies and best practices to our community with more than 1100 employees and 500 physicians.
Visit capitalregionalmedicalcenter.com for more information.
Non-emergency Health Care in the Community
Emergency room visits are very expensive and should only be used for serious issues.
In the event that UHS is closed, students should explore local urgent care clinics, such as Patient’s First, before going to the emergency room for non-life-threatening emergencies.
Mental Health Resources
University Counseling Center
The University Counseling Center (UCC) provides mental health counseling services and prevention programming to currently enrolled FSU students free of charge.
UCC assists students with questions and concerns like homesickness, struggles with relationships, sexual identity and gender questions, cultural issues, eating and body image, substance use, worries, and depression. Licensed and professionally-trained staff offer counseling to those currently enrolled at FSU in a variety of ways: through one-on-one sessions, couples sessions, group sessions and walk-in services for urgent situations.
Visit counseling.fsu.edu for information or call 850-644-TALK (8255).
The EAP is a free, confidential program that provides a professional support system for the faculty and staff of the university.
Visit eap.fsu.edu or call 850-644-2288 or 877-246-4679 (toll free number).
Recreation & Fitness
Campus Recreation Department provides quality recreational programs, services and facilities that maximize opportunities for lifelong learning, personal development and leadership through varied recreational endeavors.
FSU’s Campus Recreation operates two fitness facilities: Dr. Bobby E. Leach Student Recreation Center and the Fitness & Movement Clinic. These facilities contain free weights to selectorized equipment, ellipticals to treadmills, training spaces, sport courts, pool and spa areas free for current students.
With FSU’s Rec App, you can sign up for fitness classes and check the crowds before you visit.
Non-FSU students can purchase memberships here.
Ready to explore the outdoors around the region? Join a low-cost Outdoor Pursuits adventure trip and join us for a group hike, bike, climb, float, and more!
View upcoming adventure trips and sign up here.
The FSU Rez Waterfront Park and Retreat Center is a great place to relax and enjoy the outdoors. And, it’s FREE for FSU students! You can visit anytime we’re open and plan your adventure from sand volleyball to swimming, kayaking to stand-up paddleboarding. But, check out these special events when the Rez will have even more for you to enjoy.
For more information, visit campusrec.fsu.edu/outdoors.
Play intermural sports at FSU, join a sports club, or take advantage of FSU’s outdoor sports facilities. Read more here.
For more information about all of Campus Recreation’s services, visit campusrec.fsu.edu.
There are many community resources available to keep you and your family healthy as well. Here are just a few (check your insurance exclusions before participating in sports):
- Tallahassee Parks, Community Centers, and Sports
- Warner Soccer
- Florida Trail Association
- Florida Blue Center Events (many are open to the public)
- Capital Health Plan Resources and Events (members only)
- Bond Community Health Center
- 211 Big Bend Crisis Support
- Leon County Extension Center
- Mental Health Recovery Center