Insurance Department Offers Information on Health Insurance Options for College Students

HARRISBURG, Pa., Aug. 22 -- The Pennsylvania Insurance Department issued the following news release:

As part of Governor Wolf's education and outreach initiative to help consumers better understand what is available to them and make the most of their insurance dollar, Acting Insurance Commissioner Jessica Altman today announced a consumer alert on the different health insurance options for college students.

"As the fall semester begins, it's important for college students to make sure they have health care coverage. What is best for each individual student will vary according to that student's circumstances," Acting Commissioner Altman said.

In the consumer alert, Acting Commissioner Altman notes for most students, the options are to remain on their parents' health plan, or to buy coverage on their own.

"One of the benefits of the Affordable Care Act (ACA) is that all insurance plans or insurers that offer dependent coverage must continue covering dependents on the policy until the age of 26," Acting Commissioner Altman said. "Generally, someone can join a parent's plan and stay on until turning 26, even if that person gets married, has a child, starts or leaves school, lives in a parent's home or elsewhere, turns down coverage from an employer, and regardless of whether that person is claimed as a tax dependent."

For students staying on their parents' plan who no longer live in the same area as their parents, it is particularly important to understand the difference between getting coverage through a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). An HMO plan typically only covers care received from a network of providers that have agreed to contract with the insurer. These providers are usually located in the area where the health plan is sold. This means students insured under an HMO may be outside of that HMO's service area of physicians and hospitals while at school.

"What this may mean for students under HMO plans is they may be covered for only emergency care while at school, and may have to travel into the HMO service area for any other treatment," Acting Commissioner Altman said. "The distance a student may have to travel for care, and the ability to make these trips, is an important consideration for students and families with HMO plans."

PPOs also have a contracted network of providers, but these plans typically also offer some coverage for care received from out-of-network providers. A PPO plan may pay benefits at out-of-network levels for care received outside of a PPO network, but it's important to remember the costs to the consumer for out-of-network services may be considerably higher than for in-network services.

"Parents and students should always check with their insurance company or the appropriate person who handles health benefits for employer provided coverage for specifics regarding service areas and the level of benefits when a student is away at school. It's also a good idea to research providers in the insurance network before you leave for school, so you'll know where to go if care is needed," Acting Commissioner Altman said. She also reminded students to make sure to have the appropriate insurance cards before seeking any kind of care.

Because of these network concerns, or if coverage under a parent's plan is not available, another option for students away at college is to purchase their own student health insurance plan. Students can do this either on their own, from healthcare.gov or an exchange run by the state if the state where they attend school runs its own individual health plan exchange rather than using the federal government site, or by purchasing a plan directly from an insurer. Some schools also offer health insurance plans for their students.

"Because college students who buy their own coverage may be doing so for the first time, I urge students to read carefully the policy before buying it. If you have questions ask a parent, other family member, or someone else you trust," Acting Commissioner Altman said. "Students may also visit localhelp.healthcare.gov, to find people in their area who can offer free help understanding the costs and coverages offered by various plans."

Some schools offer on-campus resources for mental health services, such as counseling. However, if a school does not offer these services, or if the school offers a limited number of visits, students may need to seek treatment through an off-campus provider. Various federal and Pennsylvania state laws require mental health services to be covered as an essential health benefit, and offered at what is called "parity", or essentially at the same level, as medical services. More information on how your insurance impacts access to mental health and substance use disorder services is available on the department's website.

Routine dental and eye care are typically not covered in health insurance plans for adults, so students may want to consider a supplemental dental or vision policy.

"College students have many things to think about, include academics, learning to live on their own, and making new friends, but they should make sure they have the appropriate health coverage. Not being able to get the care they need or facing large bills for coverage can negatively impact other aspects of a student's life," Acting Commissioner Altman said.

For more information and resources on health insurance, visit http://www.insurance.pa.gov/Coverage/Pages/Health-Insurance.aspx.