Lucas Holter, Senior Photographer

The financial aid package Alejandro Ortega ’23 received from Yale did not just support his enrollment. He also gained health insurance — for the first time in his life. 

But since Ortega elected to take a leave of absence this semester, his $0 family share financial aid package no longer gives him access to Yale Health’s Hospitalization/Specialty Care coverage. And because he would have to pay $3,666 for a term of Yale’s affiliate plan, he has opted to go without.

“I hope nothing happens as I don’t have health insurance this semester. It is a gamble,” Ortega said. 

Having grown up learning to “deal with it” or pay a doctor out of pocket, Ortega said it was a “gamechanger” to schedule regular appointments at Yale Health without worrying about the bill. But frustrated by a challenging fall semester online, Ortega is joining a contingent of low-income students whose leaves from school during the pandemic have also left them vulnerable to high healthcare costs. 

All Yale College students enrolled in residence are supposed to carry medical insurance for hospitalization and specialty care, according to Director of Undergraduate Financial Aid Scott Wallace-Juedes. Those who don’t have valid coverage through existing insurance must therefore enroll in Yale’s own health coverage plan. Students who qualify for a $0 family share financial aid offer receive that plan at no additional cost. 

“Because federal regulations and institutional policy require that a student be enrolled to receive grant assistance, students taking a leave of absence do not qualify to receive the coverage — or other parts of their financial aid award — during the time they are on leave,” wrote Wallace-Juedes in an email to the News. “The office of undergraduate financial aid does not have the authority to award insurance coverage — or any other form of grant aid — to a student who is not enrolled.”

When students take a leave of absence, they are no longer eligible for Yale Health’s basic plan, which includes access to primary care and mental health and counseling services. Most students taking a leave who stay on their parents’ insurance are unaffected. Those without a backup coverage plan are frequently first-generation, low-income students. 

Students on leave can still pay to receive healthcare through Yale, but they are no longer eligible for student rates. Instead, they have to shoulder the costs of an affiliate plan, which includes basic services, along with hospitalization and specialty care. At $7,332 for a full year, it is nearly triple that of the student price. 

“I might have made a more informed decision about taking a leave had I known about the costs of healthcare,” Milo Tamayo ’22, who is an FGLI student on Yale’s specialty care coverage, said. He explained that learning about the affiliate plan came as a surprise. “I did all the math thinking the Yale health plan would cost $1,200 a semester.”

He paid for emergency health insurance through personal savings and federal tax credits last semester, but since he is earning less this spring, he decided to forgo that plan. Now, Tamayo catches himself wondering if he should stop going on bike rides or hikes — which, in case of injury, might subject him to substantial out-of-pocket medical fees. 

“The mentality is, unless you’re dying, don’t go to the doctor,” Natalia Taylor ’22 said.

Taylor, who identifies as FGLI and is taking the year off, said that she has been working a full-time job at home in Colorado and is saving an emergency fund for unanticipated healthcare expenses. But between paying for her car, rent, utilities and groceries, she has not made enough to see a doctor to address a lingering ear infection.

For Josie Steuer Ingall ’24, a student on leave who lives with a rare connective tissue disorder, the affiliate plan would be twice the cost of her rent. 

But when her father lost his job in the spring, losing the family’s health insurance plan in the process, she was confronted with a “terrifying set of options.” Even if she purchased Yale’s affiliate plan, it would not have sufficiently addressed her needs: with the connective tissue disorder, Ingall would likely need outside referrals anyways. Yale Health is considered a closed-panel Healthcare Management Organization, meaning that coverage only extends to providers within the Yale Health system and is not compatible with a national insurance carrier. 

Ingall’s father found a new employer in September, averting a crisis, but during the summer, while living in a densely populated area of Manhattan that had been one of the COVID-19 hotspots, Ingall was left uninsured. 

Even students with chronic conditions who have found alternatives to their Yale plan found that changing providers disrupted their continuity of care. Deciding to take time off this year meant that Akweley Lartey ’23 needed to find new physicians, therapists and psychiatrists outside of Yale. Lartey, who identifies as transgender and disabled, applied for Medicaid over the summer, but the approval process was slowed down by administrative errors. And resources at his community mental health center are stretched thin — getting an appointment to see a therapist, he was told, would take between three and six months. 

“All of Yale Health is one building,” he said. “Here, outside of DC, I have to do a lot of individual research and coordinate between different offices.”

For Lartey and others, the pandemic has revealed a challenging reality: that coming to college can defend students against unaffordable healthcare, but leaving — even if just for a semester — may return them to a precarious state of limbo. 

“Both my parents are immigrants,” Tamayo said. “My mom and dad don’t have a clue about how to deal with it, and I don’t have anyone really to contact. Looking for health insurance is such a daunting task that I’ve been putting it off.”

The four-story Yale Health building on Lock Street is currently open to in-person appointments. 

Emily Tian | emily.tian@yale.edu