Your Health Insurance Checkup

Do you have health insurance? We hope so, because going without could leave you with thousands of dollars in medical bills—and it’s illegal. Since the federal Affordable Care Act took effect in 2014, students are required to have health insurance coverage, whether through a college-sponsored plan, parent plan, Medicaid or individual health coverage.

College-Sponsored Plan:

Many colleges and universities offer sponsored health insurance plans, and some will automatically enroll and bill you for this coverage even if you already have insurance. All college-sponsored health plans must provide what the Affordable Care Act defines as “minimum essential coverage,” which includes emergency services, prescription drugs, maternity and newborn care, hospitalization and mental health and substance use disorder services. Specific coverage and costs vary, so check with your school for details. If you don’t want to use a school-sponsored plan, you must provide proof of outside insurance and request a waiver each year for the charge to be dropped from your bill. Pay attention to the deadline for providing this information, which in many cases is in August for the fall semester, for example.

Parent Plan:

Students may remain on their parents’ health insurance policy until age 26, but if you’re attending school in another state, be sure to check if the plan will cover you and if there are “in network” providers near your school.

Medicaid:

Students under the age of 65 in states that participate may enroll in Medicaid if they earn less that 133 percent of the federal poverty level. This may be a good option for students who are financially independent from their parents. (Those listed as a dependent on their parents’ tax return will have their eligibility determined by the family’s household income.)

Individual Health Insurance:

The Affordable Care Act also allows you to purchase your own individual policy through what is known as the health insurance marketplace. Many of these plans offer special student rates, and premiums are reduced based on financial need. Another advantage is that you can’t be denied coverage because of a pre-existing condition. There are limited enrollment periods, however, so visit Healthcare.gov to find out more.

It’s important to do some research and explore all your options before deciding which type of coverage is best for you. To help you get started, here’s some basic terminology you will encounter when reviewing healthcare plans:

  • Premium: The payment (usually monthly) for the insurance policy in effect. A plan with a lower premium usually comes with a higher deductible, and vice versa.
  • Deductible: The portion you pay before insurance coverage kicks in. Your monthly premium and co-payments often don’t count toward your deductible.
  • Co-insurance: The percentage you pay when your health plan doesn’t cover 100 percent of your medical costs.
  • Co-payment (copay): Your financial share of a specific healthcare service. For example, you may have a copay of $20 when you visit a doctor’s office.
  • HMOs: Short for Health Maintenance Organizations. These are organizations that provide or arrange care for insured individuals and groups.
  • PPOs: Short for Preferred Provider Organizations. PPOs are managed care organizations of medical doctors, hospitals, clinics and other healthcare providers that have contracted with insurance providers to provide care at reduced cost.

Figuring out what insurance option is best for you can be confusing, so here are some resources that can help with the process.

healthcare.gov/quick-guide

healthcare.gov/young-adults/college-students

medicalbillingandcodingonline.com/medical-insurance-for-students

 

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