In the heart of midterm season, students are concerned about more than just papers and exam results. Though health care is frequently taken for granted, some students are finding it hard to access the care they need.

The University of Toronto has a network of insurance plans and service options available to students depending on their enrollment status, faculty and campus.

Full-time undergraduate students, professional faculty students, and Toronto School of Theology students at the St. George and Mississauga campuses are covered, by default, by a Green Shield Health insurance plan administered by the University of Toronto Students’ Union (UTSU).

Part time students are covered through the Association of Part Time Undergraduate Students (APUS), while UTSC students have a plan through their own students’ union.

International students are not covered by the Ontario Health Insurance Plan (OHIP) and are required to purchase the University Health Insurance Plan (UHIP).

According to May Nazar, spokesperson for Ontario’s Ministry of Training Colleges and Universities, said this is because international students have a temporary immigration status which puts them outside of the scope of the Ontario health system.

“It is the responsibility of individual colleges and universities to ensure that international students have a health insurance option,” Nazar said.

Uneven birth control coverage 

Many students cite access to safe, reliable birth control as a top health concern.

This has specifically been an issue for women looking to use a progesterone coated intrauterine device (IUD).

The device, which works by releasing the hormone progesterone from inside the uterus, is described by Toronto-based gynecology clinic Meridia Medical Group as “the safest form of birth control” in preventing pregnancy. However, it does not prevent sexually transmitted infections.

The progesterone-coated IUD costs around $420 and lasts five years. In the UTSU insurance plan, $250 per year is allowed for oral contraceptives and contraceptive device claims.

This is enough to cover more commonly used birth control methods such as the pill and the shot, because the cost of these methods is distributed over several years. The one-time cost of an IUD, however, means that the student must pay the difference between the insurance coverage and the cost of the device upfront.

Yolen Bollo-Kamara, president of the UTSU, said that contraception and reproductive health coverage is a crucial aspect of the UTSU plan, but that the $250 limit is a matter of compromise.

“The plan provides basic coverage for a number of procedures and services in order to meet the diverse needs of the membership while remaining affordable,” said Bollo-Kamara.

Jennife Poole, a third-year bioethics and health studies student, said that the plan’s limits constitute a notable omission, and that all methods of birth control should be evenly accessible. “Not everyone is the same; everyone has different lifestyles. It can be hard to take the pill every day,” she said.

Poole made the transition to the Depo-Provera shot after a recommendation from a physician at Health Services based on her lifestyle.

“You can’t pick and choose between which method is covered,” she added.

Erin Bionda, a third-year Rotman commerce student, echoed Poole’s remarks. She said that it is reassuring to take a pill every day, but it is not without its risks and sideeffects. “It can be a challenge to find a pill that works well with your body,” she said.

Bionda switched pill type three times due to side effects. She cited this as evidence of the importance of options.

Rachel Costin, public relations representative at the U of T Sexual Education Centre, said that the university has a responsibility to thoroughly take care of its students’ health needs, which includes providing a variety of birth control options.

“There are people who can’t take the pill because of side effects or can’t use the patch or anything like that…” Costin said.

“It would make them more responsible if they covered more than just the standard forms,” she added.

Athletic treatment a waiting game

Some students also cited rehabilitation therapy as an issue.

For Catelyn*, a fourth-year English specialist, the convenience of Athletic Centre (AC) physiotherapy sessions has been undermined by the burdensome process leading up to actual treatment.

Rehabilitation therapy at the AC is available on an unlimited basis for students who have paid their athletics incidental fees. For the 2014–2015 school year, that amount is $314.14.

When Catelyn went to University Health Services this September with a dislocated shoulder, she thought she could get a referral directly to the David L. MacIntosh Sports Medicine Clinic, which is associated directly with the University of Toronto Faculty of Kinesiology.

However, she discovered that she wouldn’t receive physiotherapy treatment there until she consulted with a doctor at the same clinic.

The clinic has a mandate to treat sport-related injuries in the U of T community.

When Catelyn called the clinic, she was told it would take a month to get an appointment. Having used this route for physiotherapy treatment before, she decided it wasn’t worth the wait. “I knew from experience that after that appointment, it would probably take another month just to get to see a physiotherapist,” she said.

About one-third of the clinic’s therapy appointment times are set aside for varsity athletes.

Catelyn describes herself as fortunate for having been able to access treatment at a physiotherapy clinic off-campus. She has a private health insurance plan that covered the cost of this treatment.

Due to the closeness of the off-campus clinic, and the fact that the doctors readily accepted her referral from Health Services, Catelyn said she saw no advantage to using the university’s health system.  “It was so much easier,” said Catelyn of her off-campus health care experience.

For students that rely on the UTSU health insurance plan through Green Shield, however, this option may not be financially viable.

A session with a physiotherapist is covered up to $30 per visit under the UTSU plan, and is capped at 20 visits per year. A 60-minute session in downtown Toronto can cost $100 or more, leaving students to pay the rest out of pocket.

Even though athletics incidental fees cover treatment itself, the David L. MacIntosh Sports Medicine clinic can also prove expensive for students. There is a $60 annual administration fee, and summer membership is extra for those who aren’t in summer school.

Poole cited her reliance on the UTSU plan and her awareness of the AC’s services as major factors in her decision to seek treatment at the David L. MacIntosh clinic.

Poole started receiving treatment in the summer for a hip flex strain from running.

As she was not registered in summer courses, Poole had to purchase an AC membership for a $90 charge. She waited only a week for her initial appointment, but has since noticed that the volume of patients is higher in the fall semester.

Once connected with a physiotherapist, Poole said that the treatment was highly beneficial, and her physiotherapist was knowledgeable and professional. She also had no trouble scheduling enough appointment time. “There was a while where it was really bad so [my therapist] had me coming in two, three times a week,” said Poole.

According to Catelyn, the resources that the AC provides should be more easily available to students. “I think it is something that universities should be providing for their students.” She expressed concern that her own experience with physiotherapy on campus is reflective of a broader access problem.

*Name changed at student’s request.