Student Health Insurance

Getting Coverage in College

When you’re getting ready to head off to college, obtaining health insurance is usually not part of your plans until your school gives notice you must have coverage. Most colleges and universities in the United States require students to be covered by a major medical plan. Do you have the necessary coverage?

In many cases, college students under the age of 26 may be covered by their parents’ health care plan, thanks to the Patient Protection and Affordable Care Act (PPACA). But there is a population of students who are either beyond the dependent age, traveling abroad, or whose current plan (parents’ or individual) does not provide the appropriate geographic or medical coverage.

Insurance Plans

There are a number of different avenues you can explore when shopping around for a student health insurance plan that meets your medical and budgetary needs. Application and enrollment procedures are standardized, but the details of the health insurance requirement you’ll need to fulfill will vary by school.

College Plans

Because most colleges mandate student health insurance, they are also obligated to offer or endorse an on-campus health insurance plan. Your advisor can direct you to the office handling insurance information and enrollment, which is usually your campus health center.

At most colleges, the services you receive through the health center may be automatically covered in whole or part by the campus plan. Examples of services usually covered include treatment for mental health, dental care, and eye care, as well as routine preventive care.

Each school offers slightly different health plans, so make sure you establish at the outset which services are covered. When you inquire about or enroll in any type of health care plan, you must have a clear idea of what financial protection it gives you in all possible situations, including emergencies.

State Plans

If you are attending a state university, there may be a state health plan designed for students that would cover you if you seek initial treatment at the campus health care clinic or at other offices in the network within a certain geographic area. If such a plan meets the standard set forth by your school, that will be a second option for you.

An excellent example of this type of plan is the University of California Student Health Insurance Plan offered to undergraduates and graduate students. The UC SHIP page will give you an idea of what a state plan offers.

Private Student Plans

You can always opt for one of the private health plans, if you can find one to supplant the college plan or the state plan. The major health insurance vendors will either offer health insurance branded for students or individual health insurance plans. Their costs may be a bit higher, but you can shop around for the best plan for the best price if you remain within your school’s guidelines for coverage.

Most health insurance companies now have online enrollment, which means you can get a quick response to your application. They also accept online payments, sometimes offering coverage as soon as the first payment is processed.

Student Criteria

While most schools let any registered, fee-paying student seek care at the campus health clinic, each has its own set of criteria for eligibility in its student health insurance plan. To qualify for some plans, you must be a full-time student, within a certain age range, and/or in good general health. If your school has a contract with a third party insurer to offer a student health plan, then the insurer’s underwriting criteria will apply.

One example of such an arrangement is the University of Virginia’s contract with Aetna, whereby U.Va. endorses Aetna’s student health insurance and Aetna administers a special plan for U.Va. students. Some students at the University of Kentucky, in contrast, are automatically enrolled in the school’s student health plan.

Travel Insurance

Even if you have a comprehensive and appropriate insurance plan or you’re covered by your parents’ plan, you may not be covered if you travel outside the country. While you’re collecting immunizations and passports in preparation for your upcoming international trip, do include a short-term student health plan that extends your medical coverage throughout your journey. You can ask your current insurer how to do that.

Are You a Health Risk?

All health insurance plans want to know what level of risk to assign to your application, and of course that will be based on your health. The insurer will ask you to fill out a lengthy questionnaire that details your health and family history. Pre-existing conditions, those health problems that you have had prior to seeking health care insurance from a company, are no longer a bar to obtaining insurance, again thanks to PPACA.

Full protection against being excluded from insurance due to a pre-existing condition will phase in by 2014, but at the very least you may now check with either your state’s health department or with the U.S. Department of Health and Human Services about obtaining insurance if you have such a condition. You may be eligible for the Pre-Existing Condition Insurance Plan.

Asking the Right Questions and Getting the Best Plan

Chances are that your personal situation may change. You may travel, whether in or out of the country. You may marry or have a child. You may drop out of school. Based on foreseeable changes in your future, evaluate the student health plans offered to you with a view to how well your coverage will adapt to a new set of circumstances.

Where am I covered? Will my plan follow me around the country or during international travel? Some plans specify a certain geographic area, outside of which you will have no health insurance in effect unless you obtain extra coverage.
If there is no international coverage, is there at least emergency coverage or evacuation coverage? Natural disasters have reached a large part of the country in the last few years, so be prepared.
Is coverage comprehensive or does it apply only to traumatic injuries and life-threatening emergencies?
Are dependents and spouses covered? Common-law spouses or domestic partners?
How much is my deductible? This is the amount you must pay before your plan starts to pick up your medical bills.
When is the deductible renewed? Some plans renew the deductible every year. This means that unless you require care above and beyond your deductible, you always pay full cost for your own medical treatment.
Is there a required “pre-authorization?” A pre-authorization means your insurance company wants to decide what care they will pay for ahead of time, and each doctor’s visit must be approved beforehand. This does not include life-threatening emergencies.
Are prescription drugs covered?
Do I have coverage for any specialty care, such as dental, eye care, or treatment for mental health?
Can I get short-term coverage separately?
What is the payment plan?
What forms of payment are accepted? It’s convenient if you can pay online with a credit or debit card, or pay your premium automatically from your bank account.
Is there a Nurse Advice Line? Some health care plans offer this helpful service, usually at no extra charge. The typical Nurse Line is available at any time for patients with questions regarding an illness or injury. Ask the nurse about your medical issues and receive advice as to whether you should see a doctor and, if so, how quickly.
If I leave school or graduate, how long does my student plan continue to cover me?

Read the Fine Print

Health insurance is not a pleasant topic, but it is an unavoidable one, because everyone needs health care at some point. Make sure you have as much coverage as you can afford, and familiarize yourself with how your plan works. You’ll be glad you did.