Heading to college? Here’s what students and young adults need to know about health insurance

Minneapolis, MN, May 31, 2023 (GLOBE NEWSWIRE) -- For young adults heading to college, the life lessons can start before classes do. Like learning to deal with rent, groceries or car payments. For many, the learning curve also includes finding affordable health insurance for students. It can be new and intimidating territory, which is why healthinsurance.org is providing tips to help students shop for coverage.

“Even if a family already has a health insurance plan, that doesn’t necessarily mean the plan will provide all the coverage the student needs while they’re at college” said Louise Norris, health policy analyst for healthinsurance.org. “You can’t just buy health insurance at any time, or use it anywhere. That’s why it’s important to understand how health insurance works as you prepare for college.”

Location affects coverage

Many health plans provide coverage of non-emergency care only in a specific geographic area. That’s important if college students move far from home, to a place where their doctors may be outside of their existing plan’s provider network. If that’s the case, students may find coverage is limited, and costs for care and medicine are much higher.

“If you’re currently covered by a plan, like your parents’ insurance, start by examining that plan’s limitations,” said Norris.

Timing is critical

“If your existing plan won’t work for you in your new home-away-from-home, start shopping for new coverage – as soon as possible,” Norris said. “Understand there are limited times each year when insurers offer open enrollment. You don’t want to miss out and end up uninsured.”

Normally, you can only sign up for Affordable Care Act (ACA) coverage during the annual open enrollment period each fall. Fortunately, students heading to college qualify for a special enrollment period if they move. But that enrollment opportunity only lasts for 60 days beginning on the date of the move.

“Timing is one of the most important considerations for purchasing health insurance,” Norris said. “Plan ahead so you don’t miss your window of opportunity.”

It’s possible to find some plans offering year-round open enrollment, but they might not include certain benefits or be available to people with existing health conditions, Norris added.

Explore your options: Several choices of health insurance for students

Young adults may have several coverage options, depending on their circumstances. Young adults are allowed to stay on a parent’s health insurance plan until the age of 26. This is the most common coverage option for students. It is a particularly good option if the student’s school is close to home, or if the plan would provide adequate coverage for the young adult at their new location.

Other options include:

Marketplace coverage. These are ACA-compliant plans required to cover essential benefits with no annual or lifetime benefit maximums. Students may qualify for incom e-based subsidies that lower the cost of this coverage, but keep in mind that parents’ income will be counted if the student is still listed as a tax dependent. Marketplace plans can only be purchased during the annual open enrollment period or if the applicant is eligible for a special enrollment period.
College plans. Colleges and universities may offer a student health insurance plan. In many cases, these plans are regulated by the ACA so they provide coverage comparable to a Marketplace plan. Keep in mind that not all plans marketed to students by colleges and universities, or by outside entities, are ACA-compliant.
Employer coverage. Students who work while they are in college may be offered employer-sponsored health care coverage. Even if someone has an offer for employer coverage, they can still stay on a parent’s plan until the age of 26. They also still have the option of purchasing a Marketplace plan, and may still qualify for Marketplace subsidies if the employer plan is considered unaffordable.

These options can afford students and young adults more privacy than remaining on a parent’s plan. For students concerned about the cost of coverage without the assistance of a parent, Medicaid may be an option. Thirty-eight states have expanded Medicaid eligibility to cover adults with incomes of up to 138% of the federal poverty level . (Two additional states, South Dakota and North Carolina, plan to expand Medicaid in the coming months, and the Medicaid expansion income limit extends to 215% of the poverty level in the District of Columbia.)

Consider your individual needs

In addition to location, cost and coverage, individual needs also can influence the choice of health plan. Some things to consider:

Prescription medications. Coverage of prescription medications varies from plan to plan, based on the drugs in a plan’s formulary. Some plans may cover a brand-name medication, while others may cover only the generic version of that drug, or may not cover the drug at all. Particularly for young adults with prescriptions for maintenance drugs, this could be an important consideration when choosing health insurance for students.
Doctors and specialists. Plans also differ in how they allow access to doctors and specialists. Plans categorized as HMO, PPO, EPO and POS have networks of medical providers. People who see providers outside of a plan’s provider network may find they have limited coverage for services and will almost certainly face higher costs.
Birth control and maternity care. Coverage will vary by plan. For example, young adults on a parent’s plan may not have full maternity coverage. And student plans offered by religious schools may limit contraceptive coverage.
Travel. Most health insurance plans don’t cover medical expenses during foreign travel. Students who are planning to travel or study abroad may want to look at additional travel health insurance coverage options.

“When it comes to health insurance for students and young adults, there are a wealth of choices,” Norris said. “Just remember: Don’t assume you’re covered wherever you’re headed, and don’t delay exploring your options. That way, you can make a solid financial decision for your future.”

Healthinsurance.org is a free online source of consumer health resources, including information about individual health insurance, major medical insurance and affordable medical insurance.