Mandatory College Student Health Insurance Requirements

Enrolling in a college or university can be an exciting time for a young adult or anyone who wants to go back to school to develop more skills. Often there is a concern about tuition costs, but one unseen expense is mandatory college student health insurance.

Is mandatory college student health insurance expensive? Health insurance for students adds thousands of dollars to your overall tuition expenses. But in some cases, the full suite of health benefits colleges and universities offer may surpass other health insurance plans.

Read on to know more about mandatory student health plans. Find out who is eligible, your options if you’re a student, and what you should want from student health insurance.

Why do all colleges require students to have health insurance?

All colleges and universities require students to have health insurance that meets or exceeds national standards. When students have proper health insurance, they are more alert, more productive, and thus more likely to graduate.

Also, the Patient Protection and Health Care Act (PPHCA — otherwise known as the Affordable Care Act or ACA) requires many adults to have adequate health insurance.

If you earn a taxable income during the year, you need to have health insurance to avoid a penalty for that tax year. The good news is that the ACA prohibits health insurance companies from barring customers with pre-existing conditions or a low life expectancy from obtaining health insurance.

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Are you eligible for a student insurance plan offered through your school?

For many colleges, you need to be a full-time student or at least enroll for an entire quarter to be eligible for that school’s health insurance program. You will have access to the school’s on-campus health services regardless of your eligibility for a full-time plan.

When you enroll for a qualifying term, your school will automatically enroll you in their health care program. Many schools have their version of a Student Health Insurance Program (SHIP), and others will work with outside health insurance companies, like Aetna.

If you choose to opt-out of your school’s health care program, you need to fill out a waiver form. To successfully get your waiver, you must prove the following:

• You are enrolled in a qualified health care program. To prove that you have a health care plan, colleges require that you provide proof of coverage.
• Your current health care plan must meet or exceed the minimum standards set forth by the ACA. Alternatively, colleges can set their own standards.
• Your current health care plan is in-network. While some state plans extend out-of-state catastrophic care, they do not provide basic or preventive care.

If your college or university does not approve your waiver request, you will receive a bill around the time your first tuition payment is due.

How many health insurance options do you have as a student?

Your best option might be to enroll in your college’s health insurance program — if you qualify. Here are a few options you have if you don’t qualify or want a waiver:

• Stay on your parents’ health insurance plan. The ACA mandates that adult children can use their parents’ health insurance until age 26.
• Purchase your own domestic insurance plan. If you can afford your own health insurance, find one from a health insurance exchange.
• Use an employer-sponsored plan. If you already have a job, your company may have already enrolled you in their health care plan.
• Take advantage of a state health insurance plan. Besides an exchange, some states offer Medicaid services for students below a certain income level. Also, California has Medi-Cal for low-income residents.
• Purchase a supplemental plan if you plan to travel out of state or out of the country during a school year. Some colleges, like Duke University, might offer extended coverage for students who travel abroad during a school year, but you might need to find your own plan in most cases.

No matter what you do, you must have a health insurance policy with comprehensive coverage.

What should you look for in university health plans for students?

What is “comprehensive coverage” for health insurance policies?

As a page on the Covered California website points out, the essential health benefits are as follows:

• Ambulance services
• Emergency services
• Hospitalization
• Maternity care
• Newborn care
• Mental health services
• Substance abuse services
• Behavioral health treatment
• Prescription drugs
• Rehabilitative services and devices
• Habilitative services and devices
• Lab work
• Preventive and wellness services
• Chronic disease management
• Services for children

While dental and vision care might not be requirements for most adults, these are requirements for child medical care. Colleges must provide all these services, and federal law prohibits them from offering only supplemental student insurance plans. On the flip side, college health plans can be secondary to your primary health insurance plan.

How much does health insurance for college students cost?

Below is a sample of prices from colleges and universities. All rates are for full enrollment (from the fall of 2021 to the Spring of 2022).

Some notes:

• Dependents can be on most plans if the student is also on each plan.
• In most cases, price ranges for children depend on how many dependent children a student has.
• Duke charges $10,380 for students to add their own immediate families.
• Pomona college charges higher rates for new students.
• Syracuse University charges $4,192 for multiple dependents (spouse and child).
• Willamette University students may pay a $50 fee to add dependents to their PacificSource Health Plan.

Universities might have extra charges for prescriptions and other services besides their flat annual rates.

Mandatory Health Insurance For College Students: The Bottom Line

As you get ready to send your kids to college or go back to school, you need to be prepared by having adequate health care coverage. Whether you stay on your parent’s plan, use an employer’s plan, or take advantage of your school’s insurance, find the best option for you.

• Make sure that the plan you choose has comprehensive coverage. Besides emergency care, find plans with prescription and preventive care. A hospital confinement indemnity clause might come in handy, as well.
• Find out more about your chosen school’s health insurance plan. You can find this information on college and university websites and downloadable brochures but make inquiries with your school’s health department.
• Know your rights as a patient. Besides ensuring comprehensive coverage, inquire about the types of services and procedures that your chosen health insurance company will approve ahead of time.

For more information about the Affordable Care Act, the U.S. Department of Health and Human Services has links to the full text of the ACA on the HHS.gov website. And if you want to know more about different types of life insurance plans, you can start with our guide about term life insurance.

References:

1. https://www.coveredca.com/support/before-you-buy/students/
2. http://www.healthcare.gov/law/full/index.html