Student Health Insurance Plans

Many colleges and universities in the United States require that their enrolled students have adequate health coverage to participate in on-campus learning and activities.

As a result, many institutions of higher education purchase group health insurance policies to be able to offer their students comprehensive and school-customized medical coverage at prices the students can afford. In the past, these student health insurance policies varied greatly in their coverage levels and out-of-pocket costs for enrollees. Since implementation of regulations from the Affordable Care Act (ACA) 2014, however, student health insurance policies must meet the same minimum standards of coverage as other comprehensive medical insurance policies to be ACA compliant. Another important change that came with the passage of the ACA was the extension of the age limit that children can stay on their parent’s health insurance policy until they are 26 years of age, in most circumstances. Along with student health insurance plans managed by institutions of education and parents’ health insurance policies, students can choose from a few other types of health insurance plans as well.

As ACA-compliant insurance policies, student health insurance providers have extremely open eligibility criteria for applicants. Preventive care services are always covered in student health insurance plans, along with emergency services, ambulatory services, hospitalizations and much more. Like other comprehensive medical insurance policies, student health plans cost enrollees a monthly or annual premium along with a mix of payments from deductibles, copayments and coinsurance fees. Because many schools purchase group insurance policies and even subsidize a part of the total policy cost, student insurance plans can often be one of the more affordable options available to students today. If you are in the market for a new health insurance policy for students, becoming familiar with all of the options and taking into consideration any special medical needs you may have should point you towards the best sort of health plan for your needs. Keep reading to learn more about your choices for student health insurance and how you can choose the best plan to suit your health care needs.

Health Insurance Options for Students

Students have multiple options for health coverage, each with its own eligibility criteria and pros and cons. An insurance policy that is specifically geared towards students is just one of the many possibilities. The most common ways students choose to invest in medical coverage include:

Student Insurance Plans: Student insurance plans are health insurance policies offered by institutions of education to enrolled students. As part of a group insurance policy, these plans are often subsidized by the school and able to offer students comprehensive health care coverage at very affordable rates. Students cannot be denied access to a student health policy due to pre-existing conditions or medical history. Individuals shopping for a new student health insurance policy should watch out for insurance providers offering plans that are not technically an ACA compliant student health insurance policy.

Parents’ Health care Plan: Students with a parent who has a comprehensive health care policy that allows for dependents to be added on to the policy can continue to use their parents’ policy up until their 26th birthday. Students on family policies must have access to coverage that meets the ACA minimum standards limitations for the plan to be considered adequate coverage. Joining or remaining on a parent’s health care policy can allow you to keep seeing the health care providers you prefer and usually keep premium costs relatively low.

Employer Health Insurance Plans: Employed students may be eligible for employer-based health insurance. Employer-based insurance plans are often seen as ideal for workers in terms of coverage and cost because a portion of the overall policy cost is subsidized by the employer. If you have access to an employer-based health insurance plan, seriously consider its benefits before automatically choosing a typical student plan.

Individual Health Insurance Policy through your State Insurance Marketplace: Individuals looking for certain types of coverage may prefer to opt for an individual health insurance policy through the federal or state insurance marketplace. Most of the plans found in the marketplace meet minimum ACA standards of compliance and offer multiple levels of coverage referred to as Bronze, Silver, Gold, Gold and Platinum levels. Several types of individual insurance policies area available on the market, and these plans vary significantly in out-of-pocket costs and freedom to choose your physicians.

Medicaid: Low-income and other students in need may be able to qualify for free or discounted medical coverage through state Medicaid. Publically funded Medicaid health programs can be a great way to get comprehensive health insurance at a rate you can afford. If you think you may make les than 150% of your state’s poverty line, you may qualify for low cost Medicaid coverage. All states have minimum eligibility requirements for Medicaid, but some states may offer expanded coverage to include more of the population in need of affordable health care.

Catastrophic Health Insurance: Students who are younger than 30 years of age and in relatively good health may want to consider purchasing a catastrophic health insurance plan. These insurance policies meet all minimum ACA requirements to be considered adequate coverage, including free preventive care checkups and coverage for maternity medical services, but with extremely high deductible prices. Many catastrophic plans have deductibles that are as high as the total out-of-pocket medical expenses limit for policyholders of typical individual’s health insurance policies. The upside of catastrophic insurance is that the annual premiums are kept quite low compared to other ACA complaint health insurance plans.

Short-Term Health Insurance: Short-term health insurance policies are those that are for periods of less than a year and that are intended to help policyholders bridge gaps between their primary insurance policies. These policies are rarely ACA compliant and do not meet the minimum standards of care required to be seen as adequate health coverage. In lieu of going months without having any health care on school breaks or between jobs, short-term health insurance can be a good idea.

Medical Coverage Provided by Student Health Insurance Plans

Prior to the minimum standards set in place by the ACA, many insurance programs did not provide coverage for substance abuse services while some plans did not include coverage for maternity services. Today, all ACA compliant student health insurance plans must include minimum coverage requirements. Minimum requirements include:

  • Preventive and wellness care such as checkups, counseling, vaccines and other services.
  • Ambulance services.
  • Emergency room visits and services.
  • In-patient hospital treatment.
  • Maternity services and prenatal care.
  • Pediatric health care for kids, including dental and vision services.
  • Mental health services and treatment for substance abuse issues.
  • Prescription drugs.
  • Laboratory and diagnostic tests.
  • Rehabilitative services, helping patients come back from serious illnesses or injuries, and habilitative services, helping individuals with long-term health issues adapt to a new way of living and devices to help you recover if you are injured, or have a disability or chronic condition.

Many schools who purchase group insurance policies for their student body work with the insurance provider to provide customized policies that are particularly well suited to students in that area. In many situations, this means that school-based student health insurance plans often include additional coverage for medical services that may be in particular need by the student population being served, such as extended coverage for mental health and wellness services.

Common Out-of-pocket Costs for Enrollees of Student Health Insurance Plan

Costs for student health insurance plans range widely, much like individual health insurance plans purchased through the state marketplace. While in the past a student health insurance policy could have offered weak coverage with high prices, today’s ACA regulations make it harder for such policies to exist. Out-of-pocket costs for students mirror those seen in other health insurance policies, with the bulk of the policy cost being paid through a combination of different fees, including:

  • Insurance Plan Premiums: The static monthly or yearly amount you pay to participate in the insurance policy
  • Deductibles: The amount you have to pay for your own medical services before insurance coverage begins
  • Copayments: A pre-set amount you have to pay at the time of service for most medical services
  • Coinsurance: The percentage of medical costs that are your responsibility even after your insurance plan kicks in

Many colleges have their own health center that may offer free or reduced-price coverage to enrolled students, making it simple to take advantage of the basic benefits of a student health insurance policy. Many schools integrate the cost of a student health care policy until a student’s semester costs, so enrolled students should check to make sure they are not buying insurance they already have.

It might also interest you: