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Health Insurance Plans For College Students

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Each year, college students face a critical test that they probably don’t hear about in any classroom: having the right health insurance to cover the costs of ailments and emergencies that may arise while they’re in school.

Thanks to the Affordable Care Act, the health reform legislation more often known by the moniker “Obamacare,” students now have at least a half-dozen health care choices.

“Five years ago, a student had very few options,” says Jenny Haubenreiser, immediate past president of the American College Health Association. “Now, they have many options.”

Poor health may be the last thing on the minds of young, vibrant college students. But it pays to think about illness before it happens.

“We cannot overestimate the importance of insuring the young adult population,” says Haubenreiser, who is now the director of health promotion at Montana State University. “There’s this idea they are young and invincible. But they need care just like anyone else.” Following are six ways college students can answer the question: What do I do about health insurance?

Thanks to health care reform, students under the age of 26 can remain on their parents’ health insurance.

College life can add a few wrinkles to this Obamacare provision, however. For example, if a student is going to school in a different state, it’s important to contact the insurance company to make sure there will be in-network providers near campus. Large insurers often do have affiliated networks in other states, but parents need to check with their particular plan, says Cheryl Fish-Parcham, deputy director of health policy for the health care consumer group Families USA.

“Students might also want to schedule routine preventive care visits while they are at home on vacation in order to have access to the network of their parents’ plan,” she says. Plus, parents and students should find out how the insurer will reimburse emergency care claims in the college town.

The possible absence of in-network coverage can create extra expenses for students and force them into making difficult choices, Haubenreiser says. “If something comes up and they have to leave to get care for a longer-term illness, that will essentially take them out of school,” she says.

Many colleges offer their own health plans to students. A college may work with an insurance company, which pays any claims. Or, plans may be self-insured by the school, which makes the payouts directly.

College health plans have a major advantage over other health insurance options because the premium costs are grouped with other higher education expenses, such as tuition and room and board, Haubenreiser says. “So, your student loans can assist with that.” These plans often appeal to older students no longer eligible to remain on their parents’ health insurance, she says.

“These plans will also cover services that are often needed by young women for their reproductive health,” adds Fish-Parcham.

But school plans may not always be the best option for students.

“These plans may have much more limited coverage than other individual insurance,” Fish-Parcham says. For example, they may not pay for injuries to a student who got hurt while intoxicated.

She urges students and parents to examine student health plans carefully because there may be yearly limits on claims or doctor visits.

Things should improve in 2014, when these plans must drop annual coverage dollar limits to comply with Obamacare, Fish-Parcham says.

Americans now have the opportunity to shop for health insurance on Obamacare’s new health insurance exchanges, or online marketplaces.

Buying a policy through your state’s exchange can make sense if your budget is tight, says Jen Mishory, deputy director of Young Invincibles, a nonprofit that specializes in economic issues facing young Americans.

She explains that people using the marketplaces can qualify for tax credits to reduce their monthly insurance premiums. You’re eligible if your household income is up to 400 percent of the federal poverty level and you meet other criteria, such as not being able to get affordable coverage through an employer.

“Depending on your income, it could be an enormous discount,” Mishory says. Exchange shoppers — including college students without other options — can purchase comprehensive health insurance coverage that goes into effect as early as January. Haubenreiser is concerned that students who shop on exchanges may not make the wisest decisions. “The young adult is going to go for price point over quality or the benefits provided,” she says.

In the exchanges, Americans under 30 have the option of purchasing “catastrophic” health plans with lower premiums and high deductibles.

“This will be very attractive to the young population,” Haubenreiser says.

While initial preventive care visits are covered at no charge, these plans come with deductibles of more than $6,000. Haubenreiser worries that one serious accident or unexpected disease diagnosis could lead to a real out-of-pocket hardship for a student. “Six-thousand dollars can derail a student’s career pretty quickly,” she says.

She also fears that students with high deductibles may be reluctant to go to the doctor. “They won’t get the care, and they’ll wait until they are really sick.”

Before springing for catastrophic coverage, Mishory suggests comparing the plans with more comprehensive exchange policies that may offer you a discount.

“You cannot use tax credits to buy catastrophic plans,” she says. “So, if you are low or moderate income, you definitely want to check to see whether you quality for monthly tax credits to reduce your premiums.”

Students from low-income families may be able to apply for coverage through Medicaid, the federal-state program providing health insurance to poor Americans.

In the past, Medicaid coverage was limited to narrow populations, including children and pregnant women. As part of health insurance reform, states now have the option of expanding Medicaid eligibility.

Students under 65 years of age in participating states may enroll if they earn up to 133 percent of the federal poverty level.

“If you are a dependent on your parents’ tax return, your eligibility will depend on your (family’s) household income,” Mishory says.

However, many students do not have Medicaid as an option, says Robin Gelburd, president of FAIR Health, a nonprofit focused on providing information about health insurance and health care costs.

“Only half the states are choosing to expand their Medicaid programs,” Gelburd says. Coverage is available nationwide for students who were on Medicaid while in foster care but are aging out of that system, Fish-Parcham notes.

“New rules permit former foster children to keep Medicaid until age 26,” she says.

The vast majority of Americans will be required by law to carry health insurance beginning in 2014. However, there are exceptions to the rule, including members of Indian tribes and members of some religious groups.

Some college students are likely to fall into another category that has been granted an exemption, Gelburd says.

Health reform rules state that the insurance mandate does not apply to people who do not earn enough money to file income taxes. Right now, that means making under $10,000 for a single person under age 65, Gelburd says.

“Many full-time students will not be earning enough to trigger the (Affordable Care Act’s) requirement to have health insurance,” she says.

Of course, a decision to skip coverage altogether is not to be made lightly.

Read this story on Bankrate.com.

“Students will need to evaluate the benefits of the security that the insurance provides for unanticipated medical expenses against the cost of the coverage,” Gelburd says.

This work is the opinion of the columnist and in no way reflects the opinion of ABC News.

Health insurance plans for college students

Last Updated: December 7th, 2009

Last updated June 25, 2010

By the time your children toss their high school graduation caps into the air, they’ll probably have chosen a college and mapped out their freshman courses. Health insurance is the last thing on their minds.

Young immortals

Young adults, ages 19 to 29, are the largest growing age group in the country at risk of being uninsured, according to the National Conference of State Legislatures (NCSL). They account for about 13 million of the 47 million Americans living without health insurance. While many youths may feel immortal, it’s not a good idea to go without health insurance. If your child is involved in an accident or diagnosed with a serious medical condition, the cost of health care could send you and/or your child into medical debt.If you have an employer-provided medical plan, it will generally cover your children until they’re 19, and may extend coverage to dependents as old as 24, or until they graduate from college. But health plans often require that dependents be full-time college students. It doesn’t matter whether the child lives at home or school.

Some states have enacted laws that allow parents to continue health insurance coverage for their children – even if they are not enrolled in college full-time. In 1994, Utah became the first state to enact legislation allowing coverage for unmarried dependents to continue up to age 26, regardless of school enrollment status, according to the NCSL. A 2006 New Jersey law provides coverage for unmarried dependents up to age 31, as long as they do not have dependents of their own. At least 30 states have enacted similar legislation to extend dependent coverage, regardless of enrollment in school.

If you don’t have health insurance for your child, another option is a college health plan.These plans could save you money, since most plans are subsidized by tuition (though not necessarily subsidized for the student’s spouse or dependents).

College plans are not free, and benefits vary from college to college. But it shouldn’t be difficult to find affordable health insurance. Committees from each college meet with insurance companies and design plans specific to their schools.

Putting a college health plan to the test

Be sure to find out:

  • Is the plan an HMO or can the student use any provider?
  • Does the plan cover emergency room visits?
  • Is there coverage during school vacations?
  • Can the student maintain coverage during the summer break even if they’re not taking classes?
  • Can the plan be used at the best treatment facilities in the college community?
  • What services are offered free or at low cost in the campus health clinic?
  • Are pre-existing conditions excluded from coverage?
  • Does the plan cover sports-related injuries?

College plans sometimes limit preventive care, but students may have the option of going to the college health center for free services. Many times there’s no charge for office visits to the health center, although students may be charged for lab work, physical therapy, X-rays, prescriptions and treatments for a minor injuries. Other covered services may include mental health treatment, well-child care, newborn and infant care, routine pap and pelvic exams, cholesterol screening and routine STD and AIDS testing. Mammograms are usually covered when prescribed by a doctor.

Typically, a school insurance provider will pay 100 percent of the cost for health center services. But a student’s coverage may drop and a deductible may be imposed if the student receives treatment outside the health center or visits and out-of-state doctor.

“If a student needs radiology services across the street, then they might have to pay a co-payment,” says Elaine Whetzel, administrator of the Student Health Center at Georgetown University in Washington, D.C. “Most campus health centers are not equipped with lab facilities, so often those tests have to be sent out.”

Dorothea Lyons, a spokesperson for Quincy, Mass.-based University Health Plans Inc., a nationwide student insurance broker, says, “Each school is different. Some have health centers, some don’t. Some include charges as part of the regular tuition and fees to allow the students to go to the health center and receive treatment at no cost. Some also charge a small fee at the time of service for a check-up or flu shots, though the cost is usually small.”

Lyons adds that often treatment at a college health center is independent of insurance, but anything outside the health center could fall under a health plan.

Student athletes

If your child plays intercollegiate sports, he may not be covered for injuries sustained during practice or a game. The National Collegiate Athletic Association administers insurance certification guidelines to colleges and universities for intercollegiate sports. While the NCAA requires all student athletes to have health insurance before joining a college athletic team, some schools will cover most of the student’s medical expenses if they are injured during a game. In some cases, if the child is covered under his parent’s insurance, there may be exclusions regarding injuries sustained while taking part in intramural sports. Check your health insurance policy to determine if your child is covered in the event of a sports-related injury.

Pre-existing conditions

Coverage for pre-existing conditions isn’t a problem if you are extending coverage for your child through your employer-funded plan. College health plans and individual health insurance are a different story. Under some state laws, college health plans can refuse to pay for treatment of medical conditions that existed before the coverage took effect. Some states waive pre-existing conditions after six months of enrollment and some do not. It is important to read the fine print and understand how pre-existing conditions apply to your insurance plan. So before you sign up for a college health plan, make sure you know how pre-existing conditions are defined.

Parents sometimes choose buy a college’s health insurance even when the student is covered under their plan — if their policy requires doctor referrals for care. Obtaining referrals across states can be problematic. (Many HMOs require referrals for visits to out-of-network providers.) Parents who want their out-of-state college children to get prompt care without calling home for a physician’s referral should consider college health plans.

Individual health insurance programs also commonly have a six-month waiting period before pre-existing conditions are covered. Individual plans designed specifically for college students also often have pre-existing condition exclusions, and parents should carefully evaluate these plans because they “can have exceptionally broad definitions” that could deny coverage, according to Hodgkins Beckley Consulting, a consulting firm in Fort Collins, Colo.

Yahoo!-ABC News Network | © 2018 ABC News Internet Ventures. All rights reserved.

Each year, college students face a critical test that they probably don’t hear about in any classroom: having the right health insurance to cover the costs of ailments and emergencies that may arise while they’re in school.

Thanks to the Affordable Care Act, the health reform legislation more often known by the moniker “Obamacare,” students now have at least a half-dozen health care choices.

“Five years ago, a student had very few options,” says Jenny Haubenreiser, immediate past president of the American College Health Association. “Now, they have many options.”

Poor health may be the last thing on the minds of young, vibrant college students. But it pays to think about illness before it happens.

“We cannot overestimate the importance of insuring the young adult population,” says Haubenreiser, who is now the director of health promotion at Montana State University. “There’s this idea they are young and invincible. But they need care just like anyone else.” Following are six ways college students can answer the question: What do I do about health insurance?

Thanks to health care reform, students under the age of 26 can remain on their parents’ health insurance.

College life can add a few wrinkles to this Obamacare provision, however. For example, if a student is going to school in a different state, it’s important to contact the insurance company to make sure there will be in-network providers near campus. Large insurers often do have affiliated networks in other states, but parents need to check with their particular plan, says Cheryl Fish-Parcham, deputy director of health policy for the health care consumer group Families USA.

“Students might also want to schedule routine preventive care visits while they are at home on vacation in order to have access to the network of their parents’ plan,” she says. Plus, parents and students should find out how the insurer will reimburse emergency care claims in the college town.

The possible absence of in-network coverage can create extra expenses for students and force them into making difficult choices, Haubenreiser says. “If something comes up and they have to leave to get care for a longer-term illness, that will essentially take them out of school,” she says.

Many colleges offer their own health plans to students. A college may work with an insurance company, which pays any claims. Or, plans may be self-insured by the school, which makes the payouts directly.

College health plans have a major advantage over other health insurance options because the premium costs are grouped with other higher education expenses, such as tuition and room and board, Haubenreiser says. “So, your student loans can assist with that.” These plans often appeal to older students no longer eligible to remain on their parents’ health insurance, she says.

“These plans will also cover services that are often needed by young women for their reproductive health,” adds Fish-Parcham.

But school plans may not always be the best option for students.

“These plans may have much more limited coverage than other individual insurance,” Fish-Parcham says. For example, they may not pay for injuries to a student who got hurt while intoxicated.

She urges students and parents to examine student health plans carefully because there may be yearly limits on claims or doctor visits.

Things should improve in 2014, when these plans must drop annual coverage dollar limits to comply with Obamacare, Fish-Parcham says.

Americans now have the opportunity to shop for health insurance on Obamacare’s new health insurance exchanges, or online marketplaces.

Buying a policy through your state’s exchange can make sense if your budget is tight, says Jen Mishory, deputy director of Young Invincibles, a nonprofit that specializes in economic issues facing young Americans.

She explains that people using the marketplaces can qualify for tax credits to reduce their monthly insurance premiums. You’re eligible if your household income is up to 400 percent of the federal poverty level and you meet other criteria, such as not being able to get affordable coverage through an employer.

“Depending on your income, it could be an enormous discount,” Mishory says. Exchange shoppers — including college students without other options — can purchase comprehensive health insurance coverage that goes into effect as early as January. Haubenreiser is concerned that students who shop on exchanges may not make the wisest decisions. “The young adult is going to go for price point over quality or the benefits provided,” she says.

In the exchanges, Americans under 30 have the option of purchasing “catastrophic” health plans with lower premiums and high deductibles.

“This will be very attractive to the young population,” Haubenreiser says.

While initial preventive care visits are covered at no charge, these plans come with deductibles of more than $6,000. Haubenreiser worries that one serious accident or unexpected disease diagnosis could lead to a real out-of-pocket hardship for a student. “Six-thousand dollars can derail a student’s career pretty quickly,” she says.

She also fears that students with high deductibles may be reluctant to go to the doctor. “They won’t get the care, and they’ll wait until they are really sick.”

Before springing for catastrophic coverage, Mishory suggests comparing the plans with more comprehensive exchange policies that may offer you a discount.

“You cannot use tax credits to buy catastrophic plans,” she says. “So, if you are low or moderate income, you definitely want to check to see whether you quality for monthly tax credits to reduce your premiums.”

Students from low-income families may be able to apply for coverage through Medicaid, the federal-state program providing health insurance to poor Americans.

In the past, Medicaid coverage was limited to narrow populations, including children and pregnant women. As part of health insurance reform, states now have the option of expanding Medicaid eligibility.

Students under 65 years of age in participating states may enroll if they earn up to 133 percent of the federal poverty level.

“If you are a dependent on your parents’ tax return, your eligibility will depend on your (family’s) household income,” Mishory says.

However, many students do not have Medicaid as an option, says Robin Gelburd, president of FAIR Health, a nonprofit focused on providing information about health insurance and health care costs.

“Only half the states are choosing to expand their Medicaid programs,” Gelburd says. Coverage is available nationwide for students who were on Medicaid while in foster care but are aging out of that system, Fish-Parcham notes.

“New rules permit former foster children to keep Medicaid until age 26,” she says.

The vast majority of Americans will be required by law to carry health insurance beginning in 2014. However, there are exceptions to the rule, including members of Indian tribes and members of some religious groups.

Some college students are likely to fall into another category that has been granted an exemption, Gelburd says.

Health reform rules state that the insurance mandate does not apply to people who do not earn enough money to file income taxes. Right now, that means making under $10,000 for a single person under age 65, Gelburd says.

“Many full-time students will not be earning enough to trigger the (Affordable Care Act’s) requirement to have health insurance,” she says.

Of course, a decision to skip coverage altogether is not to be made lightly.

Read this story on Bankrate.com.

“Students will need to evaluate the benefits of the security that the insurance provides for unanticipated medical expenses against the cost of the coverage,” Gelburd says.

This work is the opinion of the columnist and in no way reflects the opinion of ABC News.

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