When international student Maria Karlsson came to the UA, she was surprised to learn that she had to spend an extra $600 on health insurance.

Even more surprising, she said, was the fact that the charge was mandatory, even though she already had insurance through her home country of Sweden.

Since fall 1993, international students at the University of Arizona have been required to purchase the university's Campus Health Partners insurance plan. While there are several reasons Partners may be the best insurance for most international students, the requirement has forced others to purchase a plan that costs more and covers less than their original insurance plans.

Karlsson, a media arts junior, said she is angry the university automatically charges international students for the Partners plan when regular students can choose their own health insurance.

"We do not choose it," she said. "Just because I'm not a U.S. citizen doesn't mean I shouldn't have the same choice."

The wording change in the 1993-95 and 1995-97 general catalogs records the shift in university policy regarding international students.

The 93-95 catalog states international students "may be required" to obtain health insurance through the university, even though the Partners plan became mandatory during the fall 1993 semester. The 95-97 catalog states all non-sponsored international students and scholars "are required to purchase" the university's supplemental health insurance.

The policy change stems from federal regulations involving student visas, said Murray DeArmond, director of Student Health and Wellness. When the federal government was outlining health care guidelines for international students on certain visas in 1993, the university decided to equalize health coverage for all international students by requiring them to purchase the Partners plan, he said.

"The bottom line is to make sure that all international students are covered," said DeArmond.

The Partners plan provides on-campus services through the Student Health Service and covers costs for specialists in the Partners network should the student need to see an outside specialist.

Under the Partners plan, students pay a $500 deductible for off-campus or non-Partners care. They also pay 40 percent of expenses to the first $4,000 and Partners pays the rest of the care up to $50,000. Partners also offers benefits such as bike helmet and health club discounts.

According to a Campus Health Partners pamphlet, one year of 1995-96 health insurance costs $606 for a single university student.

"It's a very good policy for the price," said Jessie Deyoe, an administrative assistant with student health.

Mary Silfies, office manager with Tucson insurance company The Insurance House, said the Partners plan appeared to be a comparable policy to other health insurance policies.

A plan she quoted offered a lower deductible, a maximum payable benefit of $1 million, and coverage in any hospital at a monthly premium costing $2.50 more than the Partners plan for males and $10.50 more for females.

"You get more coverage for about three more bucks," she said.

However, Silfies said health insurance depends on the specific person. The plan Silfies mentioned offers more coverage, for example, but has no maternity coverage, whereas the Partners plan covers students if they have a child.

"I wouldn't say it's not competitive," she said. "On the female end it's probably better. It just depends on how you look at things."

Other university students purchase the Partners plan through R.S.V.P. and have the option to cancel the insurance up to 14 days after the first day of class each semester.

International students are not given the opportunity to cancel the coverage, said David Currey, international students adviser with the Center for International Students and Scholars. If international students do not pay the Partners fee, their classes are cancelled and their registration is blocked, he said.

According to Campus Health Partners statistics, about 5,600 students enrolled in the Partners plan during the fall 1994 semester. Deyoe said there are usually about 5,000 students enrolled in the spring and about 5,300 enrolled in the fall.

David Currey, international student adviser with the Center for International Students and Scholars, said as of 1995, there were 2,150 international students at the University of Arizona. Of the 1,315 graduate students and 835 undergraduate students that make up that amount, 322 are sponsored students eligible for exemption from the otherwise mandatory Partners plan.

Sponsored students are students who receive financial help from an outside source such as a corporation or their country, said DeArmond. These students are often covered by their sponsor's insurance and are exempt from obligation to the Partners plan, he said.

Karlsson obtained sponsorship from her home country and is now exempt from the plan, she said.

Deyoe said there are currently 1,610 international students enrolled in the Partners plan, which makes up about 30 percent of the total Partners enrollees.

The majority of incoming international students accept the Partners plan, said Currey, but some students may not want the plan. These students usually come from a country with cheaper health insurance such as European countries with socialized medicine.

Currey said that "there have only been a few" cases where international students have been against the mandatory health plan.

The admissions packet for international students makes the university's mandatory policy clear, he said.

"There hasn't been the momentum to change anything," he said. "Generally, I don't see a change in the mandatory policy."

Engineering mathematics senior Ryuji Arai disagrees.

"Almost everybody is complaining about it," he said.

When Arai came to the University of Arizona from Japan in fall 1993, he had his own international health insurance.

"When I came here they ask me to pay (for Partners)," he said. "They told me you had to pay."

Arai said he enrolled in Partners and but says it isn't as good as his original health plan. His original plan was more expensive, he said, but covered him no matter where he went. Arai said he dislikes the Partners plan because it doesn't cover out-of-town costs.

"Fortunately, I'm healthy," he said.

Claude Duchesne, computer science engineering sophomore from Quebec, said his original health insurance was cheaper.

"It didn't have the same fees," he said. "They didn't want to look at my insurance from Canada."

Arai also criticized the Partners plan because it does not cover University Medical Center care.

"It's so stupid," he said. "How come we can't go to (the) medical center? They just try to get the money."

Michael Letson, spokesman with the Health Partners System, said Partners does not pay for UMC care because UMC is not contracted with the health networks Partners uses. Partners uses the Group Health Medical Associates Network as well as the Health Partners Physician Network, and UMC is a member of the United Physician's Inc. Network.

Lori Piper, insurance coordinator with UMC, said that the hospital is currently a provider for care of a Partners student's spouse or children but not the student.

Karlsson said she understands why few international students challenge the mandatory requirement.

"As an international student you're very vulnerable. You try so hard to do the right thing and you trust the university a lot," she said.

Karlsson wrote a proposal criticizing the university's policy for her business writing class and is now creating a petition against the mandatory policy, she said.

Currey said one of the reasons the UA doesn't want to open up international students' health care options is that the possibility of students with inadequate or no health care would be too great.

"If we didn't have a mandatory policy I doubt some students would have any insurance," he said.

The university would "probably have to create a whole new department" to handle the problems raised in dealing with so many foreign policies, Currey said.

Karlsson said she thinks the university should give international students the same health care choices as regular students.

"I'm paying $8,000 to go to school here and if they can't afford to treat us the same ... I just think it's unfair," she said.

"I'm not asking to be treated differently because I'm a foreign student, just equally."