Navigating Health Insurance Options for College Students
College is often considered one of the best times in a person’s life, filled with new experiences, friendships, and personal growth. Amidst the excitement of higher education, it's crucial for students to prioritize their well-being, and health insurance plays a vital role in this. Many colleges require that students have health insurance. And it makes sense, right? That’s a lot of people in one place, especially for students who live on campus. This level of proximity makes it easier for germs to spread, like respiratory illnesses and the flu. If you were to get sick, injured or need additional support, it’s better to have health coverage. Yes, health insurance can be affordable for students, and there are a lot of different ways to be insured. A good plan doesn’t have to break the bank. So, where can you get started? There are many simple, flexible health insurance options for students to choose from - but what will work best for you? It all depends on what kind of coverage you need and what type of plan you’re eligible to enroll in. Understanding the available options and making informed decisions can ensure that students have access to the care they need while managing their finances effectively.
Understanding the Landscape of Student Health Insurance
Understanding the intricacies of healthcare systems in the United States can be daunting. Studies have shown that adults between the ages of 19 and 34 have some of the highest uninsured rates (15.6% uninsured) of any other age group in the United States, according to the United States 2019 American Community Survey. In 2010, the federal Patient Protection and Affordable Care Act, amended by the Health Care and Education Reconciliation act was signed. Within what is commonly known as the Affordable Care Act (ACA), are several provisions intended to expand access to healthcare and insurance programs and emphasize health and wellness among individuals. One of the provisions found in the ACA directly affects individuals between the ages of 18 and 26, who tend to have the highest rates of being uninsured. Prior to the ACA, several health plans and insurers were able to remove adult dependents, regardless of higher education enrollment by the age of 18, as they were deemed adults. However, the ACA now requires insurers to offer coverage for dependent individuals until the dependent reaches the age of 26. This has allowed families and students who would otherwise age-out, to continue to receive coverage much further into their undergraduate or graduate experience, or even until after graduating college. Most colleges and universities require their students to carry some form of health insurance. As such, this raises concerns for students who may or may not be able to opt into their parent’s health insurance plan for other reasons. There are several opportunities for health insurance coverage to meet various needs of students. Many universities offer campus health insurance that is separate from their university’s mandatory health fee.
Key Considerations for Students
When understanding the best healthcare option for students, we need to consider a few areas: How can we help support students who are independent or are unable to be on a parent or guardian’s policy? Is the student studying out of state? Is a student eligible for Medicaid due to tax reporting procedures? How does maternity and contraceptive coverage play into choosing between a parent-sponsored plan vs a school-sponsored plan? Is the student going to be studying abroad? These are just a few of the factors that we need to think about to understand how higher education can affect the healthcare options available to a market that is typically considered the most uninsured. Let’s consider the example of a 20-year-old student, who is studying out-of-state. If this student is claimed as a dependent on their parents’ or guardians’ taxes, and if they are also insured as a dependent, they may technically meet the minimum requirements for health insurance coverage by the school. This example is complicated however, because most of the hospitals or clinics at the out-of-state university would be considered out-of-network. If providers are considered out of network for the student, this can lead to soaring medical costs for even routine doctor visits. This means that the student needs to weigh their options and determine if it makes sense to purchase the school insurance plan, in addition to their current coverage. There are several regulations surrounding Medicaid policy that may allow an individual to be eligible. If an individual is claimed as a dependent on their parents’ tax returns, that individual may not be able to claim Medicaid as the parents’ income would not be included in their application for eligibility. If the student was not listed as a dependent for tax-purposes, they may qualify for Medicaid depending on their income level. What if they don’t qualify for Medicaid? If they don’t qualify, then the student needs to look at purchasing the school’s health insurance plan, or a potential private health insurance plan that offers in-network providers for that area.
Health Insurance Options for College Students
1. Staying on a Parent's Health Plan
For some students, you might be able to stay on your parents’ health plan if you're under 26. If available to you, this is a great option, since you don’t need to take any action - most likely, you’re already covered. The Affordable Care Act (ACA) mandates that insurers offer coverage for dependent individuals until the age of 26, regardless of their student status. This provision allows many students to remain on their parents' health insurance plans, providing a seamless and often cost-effective way to maintain coverage.
However, if your family is on a plan that’s very network-focused, and your care providers are local to your hometown or home state, that can put you in a bit of a bind if you choose a faraway school. To see if your parents’ health plan is still the best option, you can sit down with them to go over network limitations and benefits. Or you can call your insurance provider to ask more direct questions.
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Considerations:
- Network Coverage: Evaluate whether the parent's plan offers adequate coverage in the student's college town. Out-of-network care can lead to significantly higher costs.
- Plan Type: HMO (Health Maintenance Organization) plans often require students to seek care within a specific network of providers, while PPO (Preferred Provider Organization) plans offer more flexibility but may have higher out-of-pocket costs for out-of-network care.
- Cost: Compare the cost of staying on the parent's plan versus other options, considering premiums, deductibles, copays, and coinsurance.
2. Student Health Insurance Plans (SHIPs)
Since many universities require that you have health coverage to attend, schools sometimes offer their own student health insurance plans. Both private and public colleges can offer health insurance by partnering with a private health insurance provider. Many of these plans are compliant with the Affordable Care Act (ACA), ensuring you get basic insurance coverage. These plans aren’t limited to age - as long as you’re a student, you can enroll.
Most student health plans are regulated by the ACA, and thus cover the ten essential health benefits set forth by the ACA. However, it’s important for students to understand that some of these student health plans are deemed a short-term policy and therefore don’t have to be ACA compliant. These student health plans are set by their institution and can vary widely with some plans offering comprehensive coverage to others offering limited benefits accompanied by high deductibles and out-of-pocket costs.
Considerations:
- Coverage Details: Scrutinize the plan's coverage details, including what services are covered, the deductible, copays, coinsurance, and any limitations or exclusions. For instance, does my plan cover prescription drugs? Routine doctor visits? If that seems a little overwhelming, don’t worry. But what about cost? Are university insurance offerings more affordable?
- ACA Compliance: Ensure the plan meets the minimum essential coverage requirements of the Affordable Care Act to avoid potential tax penalties.
- Enrollment Requirements: Understand the enrollment deadlines and procedures for the student health plan.
3. Health Insurance Marketplace Plans
For more coverage options, you can look at what plans your state’s health insurance marketplace offers. HealthCare.gov is a valuable resource for exploring these options.
However, many health insurance marketplaces also offer what’s called a “special enrollment period.” This is when a qualifying life event makes you eligible to enroll in coverage outside of the typical enrollment period.
Considerations:
- Eligibility: Determine eligibility for subsidies or premium tax credits, which can significantly reduce the cost of coverage.
- Plan Options: Compare different plan tiers (Bronze, Silver, Gold, Platinum) based on their cost-sharing structure and coverage levels.
- Enrollment Periods: Be aware of the open enrollment period and any special enrollment periods that may apply.
4. Medicaid
Medicaid is an affordable health insurance option for college students with no or a low income. If you aren’t considered a dependent on your family’s tax return, and you make less than a specific amount per year, you may be eligible to enroll. But what about student loans - can they be considered income?
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However, Medicaid can be a little tricky. In most cases, you must live in the state that provides your Medicaid plan. Moving out of state to attend college could compromise your access to coverage. Also, since Medicaid insurance eligibility varies depending on where you live, it’s possible that you might have other qualifying factors to consider.
Considerations:
- Eligibility Requirements: Understand the income and residency requirements for Medicaid in the student's state of residence.
- Coverage Limitations: Be aware of any limitations on covered services or provider networks.
- Application Process: Familiarize yourself with the Medicaid application process and required documentation.
5. Medicare
For some students, like non-traditional students over 65 or those with specific disabilities, Medicare may be a coverage option.
Considerations:
- Eligibility: Determine eligibility for Medicare based on age, disability, or other qualifying factors.
- Coverage Options: Understand the different parts of Medicare (Part A, Part B, Part C, Part D) and their respective coverage benefits.
- Enrollment Periods: Be aware of the Medicare enrollment periods and any potential penalties for late enrollment.
6. Employer-Sponsored Health Insurance
What about working students or students who are over 26 and can’t be on their parents’ plans? An employer-sponsored health insurance plan is a solid option. Students who are offered health plans through their employer most likely work full-time while going to school. For part-time employees, although some businesses may offer insurance plans, you may not be eligible and might have to look elsewhere - like an individual health plan.
Considerations:
- Eligibility: Determine eligibility for employer-sponsored health insurance based on employment status and hours worked.
- Plan Options: Compare different plan options offered by the employer, considering premiums, deductibles, copays, and coverage details.
- Coordination of Benefits: Understand how employer-sponsored coverage interacts with other health insurance plans, such as a parent's plan or a student health plan.
7. Spouse's Health Plan
If you’re married, you may also be able to jump on your spouse’s employer-sponsored or marketplace health plan. However, the same may not be true for unmarried domestic partners.
Considerations:
- Eligibility: Verify eligibility for coverage under the spouse's health plan.
- Coverage Details: Understand the coverage details of the spouse's plan and how it meets the student's healthcare needs.
- Cost: Compare the cost of coverage under the spouse's plan versus other options.
Additional Considerations
Religious or Moral Objections
Private colleges and universities that are religiously affiliated are exempt from providing certain procedures and coverage, such as access to contraception. This was upheld by the Supreme Court in Little Sisters of the Poor v. Pennsylvania in 2020, where it established that colleges and universities may avoid offering types of contraceptive coverage if they have a religious or moral objection. This creates another obstacle that some students need to understand and think about when they are researching their college’s respective student health insurance plan.
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Aflac and Tier One Insurance Company
Aflac coverage is underwritten by American Family Life Assurance Company of Columbus. Accident: In Delaware, Policies A38100DE - A38300DE & A382OFDE. In Idaho, Policies A38100ID - A38300ID. In Oklahoma, Policies A38100OK - A38300OK & A382OFOK. In Virginia, Policies A38100VA - A38300VA & A382OFVA. Cancer/Specified Disease: In Delaware, Policies B70100DE, B70200DE & B70300DE. In Idaho, Policies B70100ID, B70200ID & B70300ID. In Oklahoma, Policies B70100OK, B70200OK & B70300OK. In New York, Policies, NY78100-NY78400. In Virginia, policies A75100VA-A75300VA. Critical Illness/Specified Health Event: In Delaware, Policies B70100DE, B70200DE & B70300DE. In Idaho, Policies B70100ID, B70200ID & B70300ID. In Oklahoma, Policies B70100OK, B70200OK & B70300OK. A74000 series: In Delaware, Policies A74100DE, A74200DE & A74300DE. In Idaho, Policies A74100ID, A74200ID & A74300ID. In Oklahoma, Policies A74100OK, A74200OK & A74300OK. Tier One coverage is underwritten by Tier One Insurance Company. Tier One Insurance Company is part of the Aflac family of insurers. Accident, T37000 series: In Delaware, Policy T37000. In Idaho, Policies T37100ID, T37200ID, & T37300ID. In Oklahoma, Policy T37000OK. In Virginia, Policies T37100VA, T37200VA, T37300VA, T37400VA & T37600VA. Cancer/Specified Disease plans, T70000 series: In Delaware, Policy T70000DE. In Idaho, Policy T70000ID. In Oklahoma T70000OK. Critical Illness, T71000 series: In Delaware, Policy T71000. In Oklahoma, Policy T71000OK. Coverage/plan levels may not be available in all states, including but not limited to NJ, NM, NY, VA or VT. Benefits/premium rates may vary based on plan selected. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period.
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