Navigating Health Insurance Options for Graduate Students

Choosing a health insurance plan is an important step for graduate students. Understanding the available options, benefits, and enrollment procedures is crucial for ensuring access to essential health resources throughout your academic journey. This article provides a comprehensive overview of health insurance options for graduate students, designed to help you make informed decisions about your healthcare coverage.

Understanding Student Health Plans

A "student health plan" is a specialized health insurance policy offered by colleges and universities to their enrolled students. These plans are recognized as health insurance under the Affordable Care Act (ACA). Fully insured student health plans must cover the 10 essential health benefits mandated by the ACA, including:

Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder services
Behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Services for children, including dental and vision care

These plans generally offer contraceptives without cost-sharing, meaning no copays or other out-of-pocket expenses. However, it's important to note that if a student health plan is "self-insured," it may not be required to cover all essential health benefits.

Key Considerations When Choosing a Plan

When selecting a health insurance plan, several factors should be taken into account:

Coverage Network: Consider the plan's coverage network, especially if you attend a school far from your parent's home. Your parent's health insurance may not cover medical services while you are away at school.
Cost: Evaluate premiums, deductibles, copays, and out-of-pocket maximums to determine the overall cost of the plan.
Benefits: Ensure the plan offers the benefits that are important to you, such as mental health services, prescription drug coverage, and specialist access.
Eligibility: Understand the eligibility requirements for different plans based on your student status, employment, or fellowship funding.

Student Health Insurance Plan (SHIP)

Many universities offer a Student Health Insurance Plan (SHIP) designed to meet the unique needs of students. These plans often provide comprehensive coverage and access to on-campus health services.

Read also: Funding Your Graduate Education

Colorado State University (CSU) SHIP Example:

At Colorado State University (CSU), the Student Health Insurance Plan (SHIP) offers a range of benefits and features:

Enrollment: Eligible students taking six or more resident instruction credits should enroll in the Care26 waiver and enrollment system. Graduate students taking five or less credits, undergraduates enrolled in a combination of online and resident instruction credits, and CSU Online students enrolled in six or more credits must complete the online enrollment form to confirm enrollment. If you do not validate your enrollment or waive coverage prior to the Add/Drop date you will be automatically enrolled in SHIP.
Graduate School Contribution: The Graduate School provides a health insurance contribution exclusively to help offset the cost of health insurance through CSU’s Student Health Insurance Plan (SHIP). The Graduate School health insurance contribution is provided to graduate assistants who meet ALL criteria each fall and/or spring semester. Any graduate student receiving the Assistantship Health Insurance Contribution must first positively enroll in the Student Health Insurance Plan (SHIP).
Medical Benefits:
- Copays apply for general office visits ($10), labs ($5 per test), and physical therapy ($15, no limit on visits).
- No copay for preventative services, psychiatry and counseling, medical procedures and supplies, and immunizations as recommended by the CDC or travel vaccines when required to complete a CSU degree.
Prescription Drug Benefit: $5 cost share at the CSU Health Network Pharmacy for non-specialty medications, after the first $500 in prescription refills. Specialty medications are not available at the CSU Health Network Pharmacy.
Dental Benefit: SHIP Dental plan available to use at CSU Health Network and with Anthem Dental Complete community providers (up to $1000 in services annually, paid at 100% for prevention care (2x year), 80% minor restorative, 50% major restorative, some exclusions apply).
Flex Benefits: $150 plan year maximum benefit.
Deductible: $1,000 In-Network / $2,000 Out-of-Network.
Out of Pocket Maximum: $6,850 In-Network / $13,700 Out-of-Network.
Mental Health Care: Greater Access to Mental Health Care (psychiatry, behavioral health, counseling): no co-pay/no co-insurance/no deductible In-Person, Outpatient Care via Anthem In-Network (community) providers.
In-Network Providers: Benefits will be paid at a higher level if students access services from an Anthem PPO in-network provider. Students are strongly encouraged to utilize these providers whenever possible to reduce their out-of-pocket expenses. Students can also obtain a referral to an in-network provider by visiting CSU Health Network. To find an in-network provider, please access the In-Network Provider Directory, contact Anthem Customer Service at 1-844-412-0752, download the Sydney Health App from Google or Apple Play Store, or create an Anthem account here.
Claims: Individuals enrolled in the Student Health Insurance Plan (SHIP), who obtain services from an in-network provider, will usually not be required to submit a claim form; most offices will directly bill your insurance.

University of Iowa (UI) UIGRADCare Example:

The University of Iowa offers UIGRADCare, a comprehensive health care program that covers hospital, medical, surgical, outpatient, and other health care services, including physical therapy. If you have a spouse/partner or child(ren) who will need insurance, you must complete an enrollment form in MyUI to add them to your policy. Your form will be processed in the order it was received. Please be sure that your residing address is up-to-date in MyUI, as this is where your insurance card(s) are sent.

Alternative Health Insurance Options

Besides student health plans, graduate students have other insurance options to consider:

1. Covered California (and other State Exchanges)

Students can opt out of their student health plans and purchase health insurance through Covered California (or their state's health insurance exchange). However, if students accept and enroll in the school’s health insurance plan, they will not be eligible for financial help through Covered California while they are covered by their school’s plan.

Minimum Coverage Plans: If students are under 30, they may be able to buy an additional health insurance plan option called a minimum coverage plan (also known as a catastrophic plan). These minimum coverage plans usually have lower monthly premiums and mostly protect consumers from worst-case scenarios. Catastrophic plans through Covered California cover three doctor visits or urgent care visits, including outpatient mental health and substance use visits, with no out-of-pocket costs, and free preventive care.
Tax Dependents: If students are claimed as a dependent on their parent’s taxes and choose to opt out of their student health insurance, their parent’s Covered California family plan would still be eligible for tax credits. Additionally, if students choose to stay or accept their student health plan, their parents would still be eligible for tax credits through Covered California, if otherwise eligible.
Out-of-State Considerations: If the student is going to school outside the state of California, only emergency services may be covered by a Covered California health insurance plan. Covered California does not offer any health plan products that have a network of doctors, hospitals or other health care providers outside of California at this time. The exception being that all emergency services must be covered at the in-network price, even if the service was received out of state.

2. Parent's Insurance Plan

If you are a tax dependent, you can be covered under your parent’s Covered California health plan, no matter where you live. However, if the school they attend is far away from the parent’s home, the parent’s health insurance may not cover medical services while the student is away at school. Students should speak with their parent’s health insurance plan for more information.

Read also: Graduate Fees at CMU

3. Individual Health Insurance Plans

Students can also purchase individual health insurance plans directly from insurance companies or through brokers. These plans offer a wide range of coverage options and price points.

Resources for Graduate Students

Several offices on campus provide and administer health care and insurance resources for graduate students, including Human Resources and University Health Services. These resources can help you navigate your options and make informed decisions about your healthcare coverage.

The University of Texas (UT) also provides multiple health insurance options available to you at varying costs depending on your status as a student, employee or fellowship holder. During your time as a graduate student, you may experience changes in eligibility for the various types of insurance as your employment or funding status changes.

Obtaining Coverage After Graduation

Whether you have graduated or are moving on from CSU, you may be thinking about what to do for health insurance. It's important to research your options and secure coverage as soon as possible to avoid any gaps in protection.

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