Injuries are pretty much unavoidable when college athletes regularly submit their bodies to excruciating stress. With those injuries can come some monumental medical expenses.
From the 1988-89 school year through 2003-04, more than 182,000 injuries were reported among college athletes during competition and practices in 15 major sports, including football, men's and women's basketball, men's baseball and women's softball. That's according to data published in 2007 in the Journal of Athletic Training for schools in all divisions of the National Collegiate Athletic Association (NCAA). Among the injuries cited were ankle ligament sprains, knee injuries and concussions.
Since 2005, the NCAA -- the governing body for major college sports -- has mandated athletes be covered by health insurance, whether it's through a school, an athlete's parents or even a publicly subsidized insurance program. But while a coach, parent or athlete might assume a college will cover medical expenses following an on-the-field injury, there's no legal requirement for colleges to do so.
This means there's a gap in health care coverage for college athletes -- a gap that's practically as big as a football field. There's also an information gap when it comes to health care for college athletes: No one interviewed for this story had any hard data on insurance coverage or health care costs for college athletes.
Many schools, many plans
At the University of Cincinnati, Bob Mangin says members of the football team don't have a clue about what happens after they're hurt on the field. Mangin, the school's football athletics trainer and the football program's chief negotiator with health care providers, says the university picks up the tab for any injuries that students in any sport suffer in practice or competition. The University of Cincinnati is in the NCAA's top tier, known as Division I.
"There are 120 Division I schools and probably 60 different ways they are covering their medical costs," Mangin says.
The NCAA covers the bills for injuries, usually through a "catastrophic injury" insurance policy with Mutual of Omaha, when medical expenses for an injured athlete at a top-tier school exceed either $75,000 or $90,000, depending on the college or university. Those are the financial thresholds for a catastrophic injury, such as a brain or spinal cord injury or a skull or spinal fracture. At smaller four-year schools and two-year junior colleges, medical expenses that surpass $25,000 typically are covered.
The NCAA's Catastrophic Injury Insurance Program pays a lifetime maximum of $20 million for the care of an athlete injured in a single accident covered by one of these Mutual of Omaha policies.
Many colleges also pay for secondary insurance, which fills the void between the basic insurance carried by a student and the monetary threshold for catastrophic insurance.
At San Jose State University, a Division I school in the Western Athletic Conference, the school teams up with most of its counterparts in the California State University system to ensure athletes' health insurance needs are taken care of. The schools pool money and administrate claims for student-athletes, in essence creating their own secondary insurance program, says Scott Shaw, director of sports medicine at San Jose State and vice chairman of the system’s athletic injury medical expense committee.
Twenty-one schools in the 23-school system, including a handful with Division I football programs, cover all of the medical expenses for two years for any student-athlete injured in supervised practices or competitions.
Overall, Shaw says, colleges do "a pretty good job" of caring for their athletes, "even though you hear the horror stories."
Some of those horror stories were documented in a 2009 story in The New York Times that profiled several former college athletes who were stuck with big medical bills. The story painted a picture of students being abandoned by their colleges and by insurance companies. The report cited a woman rower saddled with $80,000 “because of the way her condition was diagnosed” and a football player who “learned that he still owed $1,800 in unpaid medical bills when he went to buy a car six years after his injury.”
Mangin says that contrary to the Times story, schools like the University of Cincinnati have a duty to cover expenses for sports-related injuries. “We … feel the responsibly to know the kid will not graduate with a huge medical bill," he says.
Some major schools even go beyond that. At UCLA, for instance, medical care for athletes is handled at the university's own medical facilities.
A lack of transparency?
Ramogi Huma, founder and president of the National College Players Association, a nonprofit advocacy group for college athletes, disagrees that schools are so caring and says there's an imbalance regarding how college athletes are valued.
According to a September 2011 report published by the association and Drexel University, the fair-market value of football and basketball players at major schools is $120,048 and $265,027, respectively. Yet room-and-board provisions under a full athletic scholarship mean 85 percent of players living on campus and 86 percent of players living off campus are classified as poor, the report says. Such circumstances can make health care that much more of a concern for athletes.
Figuring out how colleges and universities deal with student injuries is tough.
Huma says colleges should be more upfront about how injured athletes are treated. In 2009, his organization polled colleges on their medical guidelines for athletes; only 10 percent of the schools responded. Connecticut and California have passed legislation requiring public colleges and universities to be more open about how they care for injured athletes.
The Connecticut law takes effect this year, and the California law takes effect in 2012. Huma says those are the only two states with such laws.
An NCAA insurance official declined to be interviewed without approval from the organization's media affairs office; calls placed to that office were not returned.
Taking the middle ground
James Amalfitano, senior vice president of Bollinger Inc., which provides athletic medical insurance to 140 colleges and universities, says he thinks that given the large number of student-athletes who recover from injuries without being hurt by financial problems, some student-athletes being hit by medical bills "is probably not a huge problem."
Amalfitano, who played football at Georgetown University, says some students may face big medical bills because they're taking awhile to heal and the clock runs out on their insurance benefits before they're completely treated. The typical benefit period for college athletic plans is one or two years from the time of the injury, he says.
"What might be the truth that makes sense from both perspectives is when an athlete is no longer covered by the college's insurance, the college will not pay for expenses beyond that period," Amalfitano says.
Lincoln Kennedy, a Farmers Insurance agent in Arizona who played football at the University of Washington and in the NFL, acknowledges that college athletes receive top-of-the-line medical care. He points out that as a college football player, almost all of his health care was paid for by the university, even the removal of his wisdom teeth.
Considering that debilitating injuries or normal wear and tear affect college athletes long after they hang up their uniforms, they often find it hard to buy individual health insurance, Kennedy says. Just as soldiers are eligible for stipends for service-related injuries, Kennedy says some people wonder whether the same sort of treatment should be extended to former college athletes, especially since they help rake in revenue for college sports programs.
“It is shame that a kid who that is on a team and injures themselves has to struggle for the rest of his life," Kennedy says.