If you, your dependent, or your spouse are going to college, having health insurance coverage is typically a requirement. While some students have access to their own coverage or coverage through a parent’s plan, there will likely also be an option to enroll in a student health insurance plan offered through the institution. It can be confusing to decide which insurance option makes the most sense.
Student health insurance is commonly offered and may be packaged into tuition costs. Institutions typically also offer separate plans for coverage. All student insurance coverage must be compliant with the Affordable Care Act (ACA). Thus, to waive coverage, the coverage under another plan instead of plans offered by the institution must also be ACA-compliant.
To determine your best option, it’s important to understand how your college’s or university’s health insurance is structured and evaluate all your options against your healthcare needs (more on this below). The first step is to compare the annual fixed costs (total monthly premiums) of your current coverage against the plan offered by the institution. Additionally, you can also evaluate options on the Marketplace.
If you decide to keep your current coverage, you are entitled to waive the student plan by submitting the required documents to the institution. Waiver deadlines are often dependent on the academic calendar but the waiver process typically occurs at the beginning of each semester or quarter. For dependents who are covered under a parent’s plan, under the ACA they are able to stay on the plan until they turn 26.
Another option is to go through the Marketplace. Sometimes, these plans may be less expensive than student insurance. Students may also get coverage through Medicaid if they qualify as low-income and meet the state’s eligibility requirements.
Below is a summarized list of the four main options available:
Enrollment Option: | Good for: |
Remain on a family group plan | Students who are under 26, attend an in-state college, and/or would like to continue accessing the same provider network. |
Enroll in student health insurance | Students who are going to an out-of-state school, are over 26 and student insurance is less costly than their current plan, and/or do not have or want to stay on family insurance. |
Enroll in an individual Marketplace plan | Students who are over 26 and qualify for premium tax credits to subsidize their Marketplace plan or students whose colleges do not offer school health insurance. |
Enroll in Medicaid | Students who are over 26 and have no income. Additionally, students who are pregnant and disabled are also eligible. |
Additionally, here are a couple of things to keep in mind that can impact how best to configure your student health insurance:
If you are attending an out-of-state school, consider the provider networks in your health insurance options. For instance, if a plan requires referrals from a Primary Care provider, you may want to look for a new doctor closer to school. It is also important to know which hospitals participate with the plans you are considering for emergency situations. Otherwise, another consideration is to check if your plan offers telehealth visits with your providers near home. State licensing can impact availability. For example, if you are a student planning to go to an out-of-state school and access mental health services with your provider from home, you should check if your provider is licensed in the new state.
If you want to stay on your current plan, consider if you will have the same level of coverage and access to needed services near the school. If you are a dependent covered under your parent’s plan, knowing whether your school is in the coverage area of the plan is important. If your school location is out of your plan’s coverage, you may want to switch to a plan that has access to a larger network of providers to assure coverage at the best cost. If you change your legal residency, this is considered a qualifying life event, which allows you to make plan changes outside of open enrollment or when the semester or quarterly coverage ends.
Some student plans require enrollment in a certain number of units or credit hours to be eligible for coverage. This is something to keep in mind in case you are thinking of going part-time or taking time off from school.
Some colleges offer summer coverage, even if you aren’t enrolled in classes. It is important to pay attention to deadlines to enroll otherwise you may miss the window for coverage. If you lose coverage over the summer, you may qualify for a special enrollment period to enroll in an ACA-compliant plan or look into short-term health plans. However, voluntarily dropping a student plan is not considered a qualifying event.
Learn More:
Student health insurance: required reading | Healthinsurance.org
Student Health Insurance Guide | Best Colleges
Last Revised June 27th, 2022
