College students have several options when it comes to health insurance coverage. Your options may depend on your age, income, state of residency, school, and immigration status, and you can read more about the options for your situation here. The following FAQ, however, is aimed at full-time college students who are U.S. citizens under the age of 26, as they tend to have more decisions to make about their health care than other types of students.
One such decision that affects many incoming freshmen is whether to stay on their parent’s health insurance plan or participate in the student health insurance plan (group coverage offered by the school in which they will enroll). There is no universal right answer, but the following questions can guide your decision-making if you have to make that choice.
Do I have to have health insurance?
Almost certainly. Under the Affordable Care Act, almost every U.S. citizen is required to have “minimum essential coverage,” but even if you qualify for an exemption, your prospective college will likely require you to have health insurance to enroll.
Are my only options to stay on my parent’s plan or to buy in to student insurance?
No, but they tend to be the most popular options because of cost, convenience, and quality of coverage. Your other options may include:
- Catastrophic insurance
- A marketplace plan
Read more about those options here.
So, I can stay on my parent’s plan?
Yes, in most situations. Under the Affordable Care Act, you may stay on your parent’s private health insurance until you turn 26, even if you are married or have other options for coverage through school or work. Private is the key word here. That means that staying on a parent’s plan is not an option for students whose parent is or will soon be on Medicare, as Medicare only insures people 65 or older.
If your parent is on Medicare, you will generally need to pursue health insurance through your school, the marketplace, a private company, or the Medicaid expansion, if available in your area. If your parent has recently or will soon receive Medicare, and if you previously had insurance through that parent’s employer or former employer, you may be eligible to stay on that plan for three years because of a federal law known as Cobra. To participate in Cobra, however, you will be charged the entire premium and an administrative fee; if this is the case for you, please review your options. Staying on this insurance may not be cheaper or more convenient than another option.
What are the benefits of staying on a parent’s plan?
For many college students, staying on a parent’s plan is a tempting choice because it’s so easy. Not only are they already familiar with their benefits and in-network providers, but they don’t have to take responsibility for finding their own insurance.
For some students, staying on a parent’s plan also means that the parent is still responsible for the health care bill. Obviously, if you are interested in staying on the family plan, you will need to talk to your parents about their expectations. It could be that they will continue to cover your portion of the monthly premiums or that they expect you to contribute a small amount each month. Every family is different, but do remember that if you stay on your parent’s plan, your parent will be the one who receives the bill or has the premium taken out of his or her paycheck. If your family is asking you to pay your portion of the premium, you will most likely need to pay your parent back rather than paying the insurer directly.
What are the downsides of staying on a parent’s plan?
When students start college, many move away to a campus in a different city, state, or region. They’re far from home, and the providers they’ve had for years aren’t nearby. Some take chances, thinking they won’t get sick and that they’ll just have their checkups when they head home for summer or winter vacation. Others find new doctors, but those doctors aren’t always in-network. Remember, visiting an out-of-network provider or hospital is not always cheap.
If you’re moving to a new city for college, find out whether there will be local, in-network providers before you sign up to stay on your parent’s plan. This is especially important if you are managing a chronic illness, are a collegiate athlete, or are otherwise at-risk for injuries and illnesses while you’re at school. Taking a gamble with your health care is never a wise idea. You can generally find information about in-network providers by calling the member services number on your insurance card or visiting your insurer’s website.
Tell me about the student health insurance plan.
Most schools give students the option to participate in group coverage, which is only available to enrolled students, faculty, staff, and their dependents. As with any insurance, the benefits depend on the plan in which your school participates. So do the premiums and deductibles. You can generally find information about the student health insurance plan offered to you by checking your prospective school’s website or your acceptance package.
What are the benefits of student health insurance?
The student health insurance option will be accepted by a network of providers in your college town (this isn’t a guarantee if you stay on your parent’s plan). One of those in-network providers is very likely the student health center on campus, which means that you have access to convenient, on-campus care.
The premiums associated with student health insurance depend on the school, but it’s worth noting that these costs are usually included in your bills for tuition and fees. That means that instead of writing one check for tuition and another for health insurance, you pay both with one check. This simplifies payment for students, particularly those on financial aid whose award packages may be applied to the total cost of attendance (health insurance included).
Another benefit is that some schools may provide specific health grants to cover the costs of student insurance for students with very high financial need. If your school does this, you should note that these grants are generally not available for students who decide to stay on family insurance, so check with your school.
What are the downsides of student health insurance?
While most student health insurance plans comply with the new regulations set forth by the Affordable Care Act, you may find that your student health insurance does not provide coverage as thorough as your parent’s plan does. Of course, this is not always the case, so it makes sense to look into what the plan does and doesn’t cover before making this assumption.
With student health insurance, it’s also possible that there are very few in-network providers serving your hometown. Before making your choice, you may want to consider whether you anticipate receiving more care in your college town or in your hometown.
Any advice for choosing between student health insurance and a parent’s plan?
Some students might feel like their choice is made for them based on the accessibility of in-network providers or the cost of one plan over the other. The best option for you really depends on what your options look like, how much health care you expect to need, and what the costs associated with each plan look like. While it may be easiest to write off the student health plan and stay on a parent’s, do some research before you make your decision; compare both plans.
|Parent’s Health Insurance||Student Health Insurance|
|Are in-network providers available in my college town?|
|Is the student health center, or another close-by clinic, in network?|
|Do I expect to need care in my college town?|
|Are in-network providers available in my hometown?|
|Do I expect to need care in my hometown?|
|Are there penalties for visiting out-of-network providers? Potential reimbursements available?|
(Note that student health insurance plans often require you to pay for one semester’s worth of premiums [six months] at once.)
|Copay for primary care visit|
|Copay for specialist|
|Copay for emergency room|
|Copay for urgent care|
|Copay for different tiers of prescription drugs|
|Dental coverage included?|
|Vision coverage included?|
The above table is just a starting point, but those basic questions are important to answer about each plan. (In fact, if you are also considering a third or fourth option, such as a marketplace plan or Medicaid, add another column to your table!)
If some of those terms look like Greek to you, have no fear! If you’re new to health care, this introduction can help. You’ll find even more detail here, or you might ask your parents or a trusted adult to answer your insurance-related questions.
Do I need to notify the insurance companies of my choice?
Yes! If you are already on a parent’s plan, that insurer will keep you on the plan
until your parent removes you. Similarly, most schools assume you will participate in the student health insurance unless you decline the policy and provide proof of adequate coverage from another source. Notify the insurance company that you don’t intend to use.
If you want to remove yourself from your parent’s plan: Usually, the insurance holder (i.e. your parent or guardian) can only add and remove family members during an open enrollment period, so ask your parent to check with human resources. (If your parent receives coverage through the federal or state marketplace, your move to college may count as a “qualifying life event,” which means that you might not need to wait for open enrollment to be removed from the plan.) Regardless, if you decide to participate in student health insurance, let your current insurance know as soon as possible and be sure to provide it with the date that your new insurance kicks in. You often don’t need to tell your school that you intend to participate in its insurance; most schools assume you will participate unless you notify them otherwise.
If you want to opt out of student health insurance: Most schools assume every student will participate in the student health insurance, and they will add the costs of six premiums (one semester’s worth of health insurance) to your bill for tuition and fees. To opt out, you must notify your school early to avoid being charged those fees. In addition to giving notice, you must also submit proof that you have minimum essential coverage, or comparable insurance, from another source. Some schools may also require students to fill out a waiver form before a certain deadline. Call your school to find out more. Please note that if you are already enrolled in your parent’s insurance plan, you don’t need to notify your current insurer; it will assume you are staying on the plan.
May I enroll in my parents’ insurance and school-sponsored insurance?
You may, but be aware that you may be paying two premiums for similar or overlapping coverage. If you decide on double health insurance coverage, one of your plans will be your primary plan and the other will be your secondary plan. This means that your claims will be first sent to your primary insurer and only forwarded to your secondary insurer if your primary plan doesn’t cover those costs. This process is known as coordination of benefits, and you can learn more about it here. For most people, having double coverage doesn’t make sense, especially when it means paying two monthly premiums, but your feelings on this may depend on your individual circumstances.