Health Insurance Help Guide for College Students Provider Options, Where to Start, & Questions Answered

College students who may be making health decisions for the first time in their lives should not let the complexity of health insurance deter them from making sound
insurance decisions. Whether staying on a parent’s insurance plan or getting insurance through school, college students have many options for health insurance. This
guide is designed to help make health insurance less confusing for students by providing information on the types of coverage that is available, how to choose and sign up
for insurance, and what to do about health care when studying overseas.

Health Insurance Choices for College Students

College students have several options for health insurance coverage, which they can choose based on their individual needs and circumstances. According to Hector De La Torre, Executive Director of the Transamerica Center for Health Studies, students have several options available to them, including the following:

Parents’ Insurance

Eligibility

Beginning in 2014, children up to age 26 can stay on their parents’ employer plan even if they have another offer of coverage through an employer or a university.

Advantages

Whether or not the parents claim the adult child as a dependent has no bearing on the ability of the child to join or stay on their parents’ health plan. In most cases, students are allowed to stay on their parents’ insurance plan even if they get married, have a child, or move out of their parents’ home. This also gives students the opportunity to see doctors that they may have built relationships with over years.

Disadvantages

If a parent loses his or her job, students will be left without insurance. Also, those who attend colleges out of state may not be able to receive health services if the physicians are considered to be out of network. Students should work with their parents to find out what their provider’s rules are. If they cannot get health care services where they attend school, it’s best to schedule doctor’s appointments during breaks.

Parents can generally add their children to their insurance plans during either the open or special enrollment periods. Those who are applying for coverage through the Marketplace for the first time can add their children to their application.

Student Health Insurance Plan

Eligibility

Most universities require that students have health coverage. More than half of colleges offer a Student Health Insurance Plan (SHIP). Four-year schools are more likely to offer SHIPs than two-year schools. Most schools enroll students into their SHIP and require that students opt-out if they want to get coverage elsewhere.

Advantages

This can be a convenient option for students, as the premiums are considered part of education costs, which allows them to pay for insurance with their student loan. Also, they may not have to leave campus to get medical care.

Disadvantages

Coverage may not be comprehensive, but that is changing. With updates to federal health care laws, schools are required to cover services like preventive care and hospitalization. However, certain services may not be available as schools make this transition. In addition, some schools may drop students from a plan if they fall below full-time status. Also, plans may not cover visits to off-campus doctors.

This information should be included in your enrollment packet, or you can find more info at the school’s enrollment office.

Subsidized Obamacare

Eligibility

Obamacare subsidies allow students to get financial assistance with their health care coverage, depending on their income level. In most cases, those who earn under 400 percent of the federal poverty level can receive a subsidy.

Advantages

Students may be eligible to receive tax credits that can significantly reduce their monthly premium payments. There are also cost-sharing subsidies available, which can lower students’ out-of-pocket costs.

Disadvantages

Students who choose this health insurance option may have fewer choices of providers, as some insurers have decreased their networks. Costs may be higher than other plans.

Signing up for subsidized Obamacare is done through each state’s marketplace during the open or special enrollment periods. For more information, log on to Health Care Marketplace.

Individual Health Insurance via Employment or Healthcare Marketplace

Eligibility

Students who cannot get services through their parents’ insurance plan because they attend school outside of the network area can buy individual insurance to get the coverage they need. They may even have access to insurance through an employer. In addition, they may be able to receive more care options than school-sponsored insurance provides, as well as more provider choices than are available through subsidized Obamacare networks. For example, other insurance options may not offer dental or vision coverage.

Advantages

Students can purchase an individual plan either through the Exchange or the traditional individual market—subject to the relevant open enrollment period.

Disadvantages

Individual insurance plans can be much pricier than other options.

Log on to healthcare.gov to find health providers.

Medicaid

Eligibility

Many states extended Medicaid coverage to all individuals making less than between $11,880 and $15,654 per year. However, students in non-expansion states rarely qualify because they are not eligible as non-disabled adults. Former foster youth can access Medicaid coverage until age 26 regardless of income (this is new under the ACA).

Advantages

Students can receive free or low cost health care coverage through Medicaid.

Disadvantages

Eligibility is determined based on family income. As a result, students who are claimed as dependents on their parents’ income taxes may not be eligible to participate in the program. In addition, not all states joined the expansion, so depending on where students live, Medicaid may not be available to them.

Contact your state’s Health Insurance Marketplace.

Catastrophic Care

Eligibility

Students who are under 30 years old may be able to participate in catastrophic health care plans, which are designed for those who live in states that don’t have the Medicaid expansion or those who cannot find coverage that costs less than 8 percent of their income.

Advantages

Catastrophic plans have low monthly premiums. Catastrophic plans help students meet the individual mandate requirement of the ACA, but they may not qualify as insurance under their school’s coverage requirement.

Disadvantages

These plans have high deductibles. For example, in 2016, the deductible amount was $6,850, so students would be responsible for paying medical costs themselves up to that amount. Coverage is limited, so students can only get three doctor’s visits and certain types of preventive care at no cost. Also, tax credits cannot be used to pay for the monthly premiums on this plan.

Contact your state’s Health Insurance Marketplace.

Obamacare Demystified

In response to the fact that millions of Americans lacked even the most basic health care coverage, on March 23, 2010, President Barack Obama signed The Patient Protection and Affordable Care Act—which is commonly known as Obamacare—into law. As a result, in 2014, the requirement that everyone in the country have health care coverage was enacted and under Obamacare, several options for insurance opened—from Medicaid to college coverage to plans that are run through health care exchanges.

10 Things for Students to Know About Obamacare

Under the Affordable Care Act, everyone is required to obtain at least the minimum level of health care coverage—including college students. There is no exemption for those who are in school, and students who don’t sign up for insurance will be subject to a monthly fee on their federal income taxes.

Insurance plans with limited benefits, like dental and vision coverage, do not meet the minimum essential coverage standard. Likewise, short-term insurance also does not count.

In order to receive a health care subsidy, students must file taxes.

When young adults who are covered by their parents’ health insurance turn 26, a 60-day special enrollment period is automatically triggered so they can sign up for their own plan. Other special enrollment periods can occur when students get married or have a child.

Those who are studying abroad qualify for a minimum coverage exemption if they are out of the country at least 330 days in a one-year period.

In 2016, the fee for adults who do not have health insurance is $695 or 2.5 percent of their income, whichever is greater.

Sixty percent of young adults qualify for health coverage with a monthly premium of $100 or less. This age group gets the lowest prices on insurance than any other demographic.

College students who are suffering from serious long-term illnesses do not have to worry about losing their coverage because under Obamacare, there are no lifetime insurance caps.

International students who are in the country on worker or student visas can get coverage through health care exchanges.

Those who lose employer-based health care coverage can buy a plan outside of the open enrollment period.

Steps to Getting Health Insurance for College Students

Signing up for health care can seem like a daunting process, especially for students who are already juggling school responsibilities and adjusting to campus life. In this section, the steps to obtaining health care coverage are explained.

1 Understand why health insurance is important.

Many college students have never had to think about the importance of having health care coverage—oftentimes because they could count on their parents to handle it for them. However, there are many important reasons to get health insurance—irrespective of the penalties incurred for failing to sign up. Not having insurance can have serious financial consequences, given the exorbitant costs associated with hospital stays and emergency room visits. In fact, those who get into a serious accident that requires hospitalization, or develop an illness, can end up getting saddled with bills that oftentimes cost tens of thousands of dollars—an expense that may lead to bankruptcy. Signing up for health insurance mitigates the cost of emergency care and protects patients’ finances.

2 Learn common health insurance terms.

Part of what makes health insurance so confusing is the myriad of terms that most people outside of the health care industry do not necessarily understand. In order to make an informed decision about health insurance, it’s imperative to learn the jargon. To help readers do this, the next section of this guide defines the most common health insurance terms.

3 Understand insurance options.

Many students who enter college will already be covered by their parents’ insurance plans. However, if they attend school away from home, they may not be able to receive coverage from their parents’ plan because the doctors near campus are out of the insurance network. Similarly, students who receive health insurance through their college may not be covered for providers that are off campus. Given all of the variables associated with what may or may not be covered in a plan, students should get information about what they have—and what they don’t—in order to make a decision about what kind of coverage is best.

4 Weigh the options.

Once students understand what they have in terms of health insurance coverage, they should weigh that against what they need. In order to do this, they need to factor in their budget, any treatments and medications they need to receive, and what type of doctors they must visit based on their needs. During this process, get quotes from different insurance providers and read consumer reviews to get a clear picture of what specific companies have to offer.

5 Fill out an application.

After getting the facts about different insurance plans, it’s time for students to put in an application. Get information about the application process and be sure to fill out paperwork completely and accurately. You’ll need basic personal information and may also need to gather up medical info and information on past insurance you’ve had.

6 Know what to do after graduation.

Depending on their circumstances, students may need to go through the process of signing up for insurance again after graduation. For example, those who are too old to be covered by their parents’ insurance plan and those who received coverage through their school will need to understand their options as they transition to post-graduation life. Some insurance options after graduation include short-term insurance plans and catastrophic coverage.

Insurance Glossary for College Students

It’s nearly impossible to weigh through your insurance options when insurance lingo is so prominent in the information you receive. Here are some basic insurance terms and definitions that are crucial to know as you review your insurance options.

Benefit

The amount an insurance company pays for your medical expenses.

Claim

A request made to an insurance company to pay for services. This can be made by a patient or health care provider.

Coinsurance

The amount you are obligated to pay for certain covered health services after the deductible has been reached. For example, a company may pay 50 percent for a certain type of procedure, leaving the patient responsible for the other 50 percent.

Copayment (copay)

The fixed amount that you pay for a specific health care service covered by a policy, such as a doctor’s visit or medication refill.

Deductible

The yearly amount that you must pay before an insurance company covers medical claims.

Effective date

The date an insurance policy begins.

Maximum out-of-pocket expense

This is the yearly maximum costs that you must pay toward health claims. This may be reached through copayments and deductibles, and after that, insurance companies pay full charges for medical expenses.

Network

The doctors and health care facilities that have contracts with an insurance company in order to provide lower rates.

Out-of-network provider

A health care provider or facility that is not part of your insurance company’s preferred providers. When you go to out-of-network providers, you pay more for services.

Pre-existing condition

A health condition that someone had before signing up for health care coverage.

Premium

The amount you pay to a health insurance company every month.

Provider

A person or facility that provides medical care.

Student Health Insurance from the Expert

Hector De La Torre

Executive Director at the Transamerica Center for Health Studies, a nonprofit organization

How can students choose the best insurance for their health care needs?

First, students should think about where they live and where they are going to get care. A student that stays on their parents’ plan and goes to school out-of-state could face higher costs when accessing care because they will be out-of-network for that local health coverage. On the other hand, if students want to keep their family doctor, staying on their parents plan and getting check-ups during breaks from school is an option. Find out if your parents’ plan has hospitals near your school for any needed emergency care.

SHIP plans are often a good option for full-time students because many SHIP plans allow the student to get care right on campus or with providers affiliated with the school. Four-year schools are more likely to offer SHIPs than two-year schools, and the coverage is often included in the regular schedule of tuition and fees students pay at the beginning of each semester. Most schools enroll students into their SHIP and require that students opt-out if they want to get coverage elsewhere.

What steps are involved when students obtain insurance?

Many full-time students will be automatically enrolled in the SHIP plan at their school. Once the student is enrolled at the school, they are typically auto-enrolled in the SHIP plan and pay for it when they pay tuition and fees. They then receive an insurance card and description of benefits from the school. Students may opt-out of that plan, which often requires them to show proof of alternative health insurance to the school. If students do opt-out of a SHIP plan, they can enroll in private insurance, stay on their parents plan until age 26, apply for a government plan either through an Exchange or Medicaid, or buy a plan in the traditional insurance market. If you are opting out, make sure you know when the deadline is because it is often early in the semester or quarter.

What mistakes do college students make when obtaining insurance and how can they be avoided?

One mistake is thinking they do not have coverage. Many students will be automatically enrolled in a SHIP plan through their college or university and have access to the school’s health care providers.

Another mistake is not using the health plan that they do have. Students, like everyone else, should get yearly checkups and not think of insurance as something they use only when they are sick. Many preventive services are free.

What are the most important things that students should keep in mind when getting insurance?

They should keep in mind that they are required to have coverage, have many options for obtaining coverage, and should use any the free services offered to them.

If buying a plan, think about your monthly premium and your out-of-pocket expenses. Your premium is the amount you pay for insurance every month and your out-of-pocket is the amount you have to pay when you go to see your doctor, caregiver, or go to the hospital. Often the higher the premium, the lower the out-of-pocket costs you have and vice versa. Think about how often you use care or the cost of prescription drugs you will be taking and pick a plan that covers your needs.

When using care, check if the provider you are seeing accepts your insurance. There is a price difference between “in-network” and “out-of -network” health care providers. If the doctor, hospital, or health care facility you visit is part of your insurance company’s network, you will get your health care at lower prices.

Lastly, take advantage of the mental health services offered. College students today report experiencing anxiety and depression at much higher rates than previous generations. Eating disorders and substance abuse also affect many college students at much higher rates than other groups. The good news is that mental health services are much more available. Services include behavioral health treatment, such as psychotherapy and counseling and may include mental and behavioral health inpatient services and substance use disorder treatment. Additionally, many colleges provide on-campus mental health services to their students at no cost. Some examples of these services include: peer support groups, counseling centers, counseling hotlines, stress relieving programs, and social activities.

International Student Health Insurance

As they immerse themselves in a country’s customs, students are able to explore academically, culturally, and socially in ways that they’re not able to at home. However, they still need to be prepared for unforeseen problems—like having an accident or getting ill—which means students need to obtain insurance for their adventure abroad.

U.S. College Students: What to Know About Study Abroad Insurance

Although the health care systems in foreign countries as much different from the one in the United States, American students studying abroad can still get the coverage they need through the following ways.

Existing Coverage

In some cases, American insurance plans actually cover health care services obtained during international travel. Some policies may impose out-of-network rates or up-front payments prior to a trip.

Travel Insurance

When students buy travel insurance, they receive short-term health care coverage that generally includes treatments for illnesses and accident injuries. In addition, this type of coverage provides referrals for local pharmacies and hospitals, and the medications that are available in a specific country.

School-based Coverage

Just as students have the option to receive health insurance in the United States, when they enroll directly in a program abroad, they may also be able to sign up for insurance through their host school. Some of the services that students may be able to receive include emergency services, mental health treatments, prescription drugs, and hospitalization.

Using Health Insurance Abroad

When using travel insurance for health care needs, expect to pay upfront. Even countries that have universal health care expect their visitors to pay for medical treatments with cash. Students are then able to get reimbursed for their care when they return home.

Insurance for International Students in the U.S.

Students from foreign countries who come to the United States to study are expected to obtain health insurance just like their American counterparts. They are legally required to buy a health insurance plan, which is generally done through the school they’re attending.

Why must they have insurance?

There is no single payer system in the United States, so the government does not pay for medical expenses. Students who do not sign up for health insurance in this country may put their college enrollment at risk.

What are the requirements?

International students must sign up for insurance plans that cover at least $100,000 for accidents and illnesses. In addition, insurance must provide mental health and medical evacuation coverage.

When should they get it?

Students are required to have health insurance for every semester they’re enrolled in an American school.

Where should they get it?

Students can either get health insurance from the college or university they’re attending, or directly from companies that provide international student coverage.

Student Health Insurance Resources

It’s important for students to familiarize themselves with as much information about health insurance as possible. In this section, readers can find a myriad of resources to help deepen their understanding and provide them with the information they need to make an informed decision about their care.

Campus Student Health Center

Students can use the student health center to get information about their school’s insurance plan, as well as receive health services. Some of the patient care students can receive include mental health, women’s health, chiropractic, and internal medicine services.

Financial Aid Office

Students can visit their campus financial aid office to find out information on how signing up for school-based health insurance may impact their financial aid. In addition, they can obtain information on applying for their school’s health insurance, as well as for loans, scholarships, and grants.

Community Local Medicaid Office

Students can speak to someone at their local Medicaid office to find out information on eligibility and how to apply for insurance.

Local Events

Depending on where they live, students may be able to attend local events that explain the Affordable Care Act and how to apply for benefits. These programs may be held at health care centers, community centers, or the local chapter of the United Way. Information can be obtained at the state health care exchange.

Online Information and Help Affordable Care Act – Medicaid.gov

Includes detailed information on how the Affordable Care Act has impacted Medicaid coverage.

Catastrophic plans – HealthCare.gov

Provides information on catastrophic health care plans including coverage and cost.

COBRA

The United States Department of Labor provides insight on the Consolidated Omnibus Budget Reconciliation Act and the types of health insurance available through COBRA.

Finding Health Insurance – USA.gov

Outlines the types of insurance plans available under the Affordable Care Act, as well as how the law impacts long-term care needs.

Health Insurance 101: A Step by Step Guide for College Students and Recent Grads

This report includes information on health care reform, how students can assess their health insurance needs, and the different kinds of health care plans.

Health Insurance Marketplace – HealthCare.gov

Allows users to search for health care coverage in their state.

Health Plan Options for College Students – Obamacare Facts

Explains coverage options, Obamacare benefits, and the logistics of signing up for health insurance. This is geared specifically toward college students.

Health Reform in Action – The White House

This White House site includes in-depth information about Obamacare and addresses common misconceptions about the law.

In school? Student health plans – HHS.gov

Has information on how students can enroll in the health Marketplace or get coverage through their school.

Insurance Providers for Overseas Coverage – Travel State

The U.S. Department of State provides information on obtaining health insurance when travelling to foreign countries.

Medicaid.gov

Includes information on the benefits students can receive, eligibility, and how to apply for Medicaid.

State Health Insurance Exchange

Has in-depth information on what State Health Insurance Exchanges are and allows users to search for states that have Exchanges.

Studying Abroad – Travelers’ Health

This page of the Centers for Disease Control and Prevention has information on what international travelers should know about remaining healthy during trips, as well as insurance options.

Young Adults – HealthCare.gov

Provides information about health insurance specifically for those under 30 years old.