Health Coverage For Volunteers Often Limited An increasing number of young adults are choosing to volunteer. Most organizations provide health insurance to the volunteers, who effectively live at the poverty level, but the benefits are not usually as complete as employer-provided insurance.
NPR logo Health Coverage For Volunteers Often Limited

Health Coverage For Volunteers Often Limited

AmeriCorps members help recovery efforts after summer hurricanes hit Florida. M.T. Harmon/AmeriCorps hide caption

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M.T. Harmon/AmeriCorps

An increasing number of college graduates and young people are choosing to volunteer their time in a wide variety of ways. A number build homes in areas hit by natural disasters, others teach in underprivileged areas, and some work in family clinics and juvenile detention centers.

Since 2002, one organization alone, AmeriCorps, has seen a 69 percent increase in applications from young adults. The group has 75,000 volunteers.

But during their time of service, many of these volunteers live at poverty level themselves — which frequently means living with only basic health insurance. Basic health insurance doesn't cover everything; treatment for pre-existing conditions or follow-up doctor's visits sometimes do not fall within these plans.

Programs such as the Jesuit Volunteers Corps (JVC), AmeriCorps and the Peace Corps pay a living stipend — ranging from $960 to $11,000 per year. They also make sure the full-time volunteers get basic health insurance, either directly or through groups they are placed with.

Getting Basic Care

For a young adult evaluating different volunteer options, negotiating the health care plans can be tricky because, for the most part, volunteer organizations like AmeriCorps and JVC farm out the coverage requirement. Often, they require the organization that receives the volunteer to provide health coverage that meets minimum requirements. So every volunteer's health coverage works differently depending on how the organization chooses to meet the minimum health insurance requirements.

All AmeriCorps volunteers in VISTA — which is dedicated to fighting poverty— and in the National Civilian Corps — which is focused on disaster response — are covered by a government-contracted limited benefits plan. The plan is funded by tax dollars and administered by Seven Corners, a company that also sells travel, immigrant and student insurance. This plan serves the 8,000 VISTA and NCCC volunteers and provides basic coverage through a preferred provider organization (PPO) network.

But the plan doesn't cover pre-existing conditions or certain treatment costs. For example, if a volunteer needs emergency surgery to have an appendix removed, these costs are covered under the plan. But, after the patient is released from the hospital and considered stable, then any follow-up visits or additional tests are not paid for, says Jim Krampen, executive officer of Seven Corners.

Taking Care Of Those Who Serve

One AmeriCorps VISTA volunteer, Meghan MacNeil, says that her volunteer year working at the Rhode Island juvenile detention facility as the arts program coordinator was a rewarding experience. But, she says, sorting out finding a doctor when sick and scheduling routine check-ups wasn't always easy.

"It covered me for what I needed, but the waits were really long, and you had to really scramble to get coverage you needed, " says MacNeil.

For gynecological check-ups, MacNeil said, she didn't want to wait the months it would take to see a doctor on the preferred list, so she went to Planned Parenthood instead. Her volunteer stipend put her in the low-income bracket, so she qualified for care at Planned Parenthood and could apply for reimbursement from AmeriCorps.

Compared to college, where the health center was right on campus, it took some adjusting to navigating the PPO system.

"It was a real shock to the system to have to scramble to find a doctor when I really needed one, but I was grateful to have some insurance," says MacNeil. "Coming out of college so idealistic about everything, the idea of living below the poverty line didn't seem like a big deal."

Coverage Limited Compared To Employer-Provided Plans

While the Seven Corners plan offered to VISTA and NCCC volunteers offers basic care, it doesn't provide the same protections as a group market plan, says Jennifer Libster, a lawyer and analyst at the Georgetown University Health Policy Institute. Some of the limitations, like not having much access to a doctor unless something serious happens, are similar to what you see on the individual market, she says.

Specifically, she says, the definition of pre-existing conditions under the volunteers' plan is particularly broad; the plan doesn't appear to limit how long a pre-existing condition can be excluded or how far back in your medical records it can look, which would not be permitted under federal law in the group market. And, the limitation on non-emergency doctor visits and the 21-day cap on inpatient hospital care seem rather restrictive, Libster says.

Other full-time AmeriCorps volunteers who aren't in VISTA or NCCC receive similar benefits to the Seven Corners plan. AmeriCorps member organizations are required to provide, at minimum, coverage for illness and injury, emergency room visits, most prescription drugs, limited-time hospital room and board, and an annual limit of $1,000 out of pocket. Pre-existing conditions are not covered.

"Most of the problems we hear about are not specific to our plans, but are complaints that apply to health care in America in general," Sandy Scott, director of media relations for AmeriCorps, writes in an e-mail. "Many of our members are young and are dealing with the health care system in America for the first time and don't need to access the health plan because they are in good health."

Living With Less

Former JVC volunteer Rachel Forte said that living at poverty level was an important part of her volunteer experience. Forte, who is now a paid JVC staffer, worked full-time for Family Support Network, an organization in Billings, Mont., that supports children removed from their parents' homes.

In exchange for getting a full-time volunteer like Forte, partner agencies who take JVC volunteers are required to pay the volunteer's rent and food costs and provide them with basic health insurance. Agencies are not required to cover prescription costs for pre-existing conditions, though they can extend additional coverage if they choose to.

Forte, 23, has had polycystic ovarian syndrome since her junior year in high school. Her condition requires that she take birth control shots to keep cysts from forming and to prevent painful tissue lining growth outside of the uterus. Forte says that in her case, Family Support Network was willing to help pay some of the prescription costs, but she chose to stay on her mother's health insurance plan out of convenience. She visited her hometown doctor before moving to Montana and then again at Christmas break to stock up on her prescriptions.

Forte says she did use her agency-provided health insurance when she fractured her finger in a car accident. She says the health insurance covered the costs of her clinic visit and follow-up appointments, and, as is required, her agency reimbursed her for the co-payments.

Forte says that many young people considering applying to the program are happy to learn that insurance is provided.

"Insurance is definitely a big factor," she says.