Who Pays for a College Athlete’s Health Insurance and Medical Care?

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If as a college athlete you don’t expect to make enough money from the Name, Image, and Likeness (NIL) rule to cover your own health insurance, don’t expect the NCAA to be picking up the tab. All college athletes are required by the NCAA to have healthcare insurance. The NCAA does not mandate colleges to pay the healthcare costs for athletes. Should a player be injured, the parent’s insurance is considered the primary insurance for paying for the athlete’s injury costs. This shouldn’t come as a surprise since the term “student-athlete” was created so that colleges wouldn’t be held liable for sports related injuries.

Dr. David Geier explains the significance of this difference:

For example, if a football coach breaks his leg while standing on the sidelines as a player barrels into him, his immediate and long-term medical expenses would likely be paid completely by the school through a workers’ compensation plan, since the coach is an employee of the university.

If a player on that same team breaks his leg during that same game, his personal insurance would likely have to pay. He would probably have to pay thousands of dollars on his own since he is a student-athlete and not an employee of the school.

That’s why families like those of Cal Schaefer end up paying $30,000 to $35,000 in medical bills rather than the university. And that’s how the system is usually set up.

Athlete’s Health Insurance is Optional

The NCAA provides a Catastrophic Injury Insurance Program with a $90,000 deductible. However, it doesn’t require colleges to provide insurance coverage for the deductible–it’s up to the schools to decide. Some may find it surprising that the organization that specifies the number of phone calls recruits can receive to whether or not athletes can accept rides to school doesn’t specify college athlete’s insurance requirements. Why not? According to Paul Haagen, “Because a better system would cost a lot.”

Currently, the type and cost of healthcare an athlete will receive will depend on the school and according to Jon Solomon, that’s not something that is easy to find out:

When the NCPA (National College Players Association) surveyed Division I athletics departments in 2009 to disclose specific medical policies the association was seeking, about 90 percent of the schools refused. The NCPA wants more states to pass legislation requiring public universities to provide additional transparency about how they care for injured athletes.

Derek Helling reports that a 2016 survey by the NCAA found that 30% of its member colleges do not provide any health insurance for their athletes. If you’re thinking the 30% represents D3 schools, think again. This was a survey of D1 schools only. At the D2 level, 80% of the schools surveyed were providing some form secondary insurance for athletes.

Think of it Like Playing Intramurals

Why the push for more transparency? Because as reported by The Atlantic Monthly, “after an incoming student signs a letter of intent binding him or her to a university, many schools have no contractual obligation to treat injuries or strains that result from playing for that college.” Furthermore, while players can’t lose their scholarships because of injuries suffered while playing, the school isn’t obligated to renew their scholarships for the following year.

So how does the situation differ from a student playing intramurals and a student athlete playing for his school? Karen Weaver explains what this looks like for a track athlete injured at an away meet:

He called his family. They told him because he was outside of their health network, they could not afford for him to get the treatment he needed. He was told to get out of the ambulance and take the team bus home to get treatment.

The difference? At least the student-athlete had a ride home.

The cases of Stanley Doughty of the University of South Carolina and Kyle Hardrick of the University of Oklahoma may be extreme, but they are examples of what happens when colleges get to decide what sort of medical coverage they provide.

Some Improvement in College Athlete’s Health Insurance

Medical coverage has been improving for athletes, although some schools are improving more than others. The New York Times reports

Ellen J. Staurowsky, a professor at Drexel who is studying health care policy at universities in the five wealthiest conferences, said coverage varied widely. Some universities, she said, guarantee medical care only as long as an athlete is in school, while some provide it for an extra year.

Steven Yahn brings up some issues that aren’t something you think of when considering college sponsored secondary insurance programs. Coverage will not include “student-led practices, individual workouts and conditioning sessions outside of the official season.” Furthermore, families need to be sure not to let their primary insurance lapse because it’s possible for athletic injuries to be considered pre-existing conditions.

Some conferences, such as the Big 10, are including medical insurance as part of their plan to provide more benefits to student-athletes. In California, universities that generate more than $10 million in revenue from athletic programs are required to cover healthcare costs of a sports-related injury for up to two years after a student leaves the university. The City of Boston is working on passing a student-athlete’s bill of rights that would include covering long-term medical expenses.

Maybe conferences will start offering more medical benefits as a way to attract recruits.

One thing to keep in mind is that just because the NCAA comes up with some new rules that are designed to protect the athlete’s health, doesn’t mean that they are being enforced. In 2016, the NCAA created a rule that is supposed to provide medical staff with “unchallengeable authority” over medical treatment. However, according to Senator Chris Murphy’s report, Madness Inc., How College Sports Can Leave Athletes Broken and Abandoned:

a survey of college athletic trainers found that 80% were employed directly by the athletic department and fewer than 10% at big-time programs indicated there was a way to report issues outside the department. Not surprisingly, 36% reported a coach had been able to influence the hiring and firing of medical staff. Of those who reported influence, 58% reported being pressured by a coach or administrator to make a decision “not in the best interest of a student-athlete’s health.” Most troubling, one in five reported that a coach played an athlete who had been deemed “medically out of participation,” putting them directly at risk for severe injuries.

This explains how athletes like Sedona Prince are still on the hook for medical bills even when her supervised “rehabilitation” was the likely cause of further injury. Yet, the University of Texas didn’t agree and so the NCAA forced her to sit out a year after transferring to the University of Oregon.

College Athlete’s Insurance is Not Something that Comes Up During the Recruiting Process

A few states are pushing colleges to disclose more information to prospects in the recruiting process. Both Connecticut and California have Student-Athletes Right to Know laws that require schools to provide recruits with information on what medical expenses are covered. However, until all colleges and universities specify their college athletes insurance coverage and medical treatment policy, it is up to student-athletes and their families to ask for the information as part of the recruiting process.