Student Health Insurance Guide

Being a student is not getting any cheaper. Students have to pay for tuition, housing, food, and a myriad of other things that they never worried about before they left home.

Along with utilities and phone bill, don’t forget about health insurance. While most college students don’t necessarily have huge medical issues come up, it is fairly likely that they will need a doctor at some point while in school. Some examples of healthcare that a student might need are flu shots, antibiotics for strep throat, or advice about a sprained ankle they got from playing football.

Students that feel healthy may consider skipping costs by simply not worrying about health insurance. Sadly, because of fees imposed on the uninsured and because one simply can’t know what, when, or where something will happen, all students need to be prepared. Insurance is something students do need, and because of the Affordable Care Act, if they don’t have insurance, they will have to pay a substantial fee.

 

The ACA and Its Effects

The Affordable Care Act was signed into law in 2010 with the intention of decreasing the number of people who lack health insurance and to help lower the cost of healthcare in general. This means very specific things for you as a student.

  1. The ACA allows students to stay on their parents’ health insurance if they are under the age of 26. This is a fantastic option if their parents already have health insurance. According to HealthCare.gov, students are still eligible to stay on their parents’ plan even if they:
  • Get married
  • Have or adopt a child
  • Start or leave school
  • Live in or out of a parent’s home
  • Aren’t claimed as a tax dependent
  • Turn down an offer of job-based coverage
  1. By choosing a student insurance plan or buying your own insurance plan, you will be able to find an affordable option that meets the specific criteria of the ACA.
  1. ACA has changed the minimum requirements for Medicaid. Depending on state and income level, students could qualify for a Medicaid program as a college student.
  1. Anyone who does not have a plan that qualifies under the requirements of the Affordable Care Act will be subject to a fee, which is 2.5 percent of the year’s income or $695 per month in 2016 depending on which fee is higher.

 

Part of the ACA’s main focus was to decrease the number of people between the ages of 18 and 29 who are uninsured. So far, the program has been extremely successful and around 2.3 million more young people were insured by 2012 than in previous years.

 

Key Terms

When looking for insurance, students should be aware of several different terms. The following list includes a few of the most common terms when talking about health insurance.

  • Premium: An insurance premium is how much you pay to an insurance provider regardless of whether or not you have used the benefits of your plan. Basically, this is the bill paid each month for insurance.
  • Deductible: A deductible is usually a set amount you have to pay for your own health care before an insurance provider will pay either part or all of your health care financial financial burden. The deductible is highly variable depending on the type of plan purchased.
  • Co-pay: Much like a deductible, a co-pay is also a set amount of money paid before a provider will step in to assist your health care needs. Often, you pay a co-pay in lieu of a deductible or coinsurance. This is usually a set fee for a medical visit. Note that co-pays for seeing a general practitioner are usually much lower than visiting a specialist or a trip to the emergency room.
  • Coinsurance: This is the set percentage an insurance provider will pay after a deductible is met. In other words, if coinsurance is set at 90 percent, you will pay 10 percent of your bill and the insurance provider will cover the rest.
  • Pre-existing conditions: These are health conditions that an insurance provider considers a health problem that developed before your contract with them was made. They will generally not cover medical costs resulting from this condition. With the adoption of the ACA, pre-existing conditions have mostly been eliminated from insurance plans.
  • Dependent: This is someone who can use your insurance plan, like a spouse or child.
  • Preventative care: This is health care performed in order to prevent medical problems down the road. The term preventative care casts a wide net and includes multiple types of medical care.

If there are other unfamiliar terms, use this resource from healthcare.gov.

 

What Are the Options?

There are several different options available in insurance plans depending on a student’s circumstance and expectations. Study each type of plan to make sure you know what you want.

  • Parent health care plans: Because of the changes made to healthcare by the ACA, students can now stay on their parents’ healthcare plan until they reach the age of 26.
  • Student health plans: Student health care plans vary between schools. But no matter which school a student attends, all plans will meet the minimum health care standards laid out by the ACA. Most college plans will now be more comprehensive than they have been in the past.
  • Personal health care plans: Students are still free to choose to not use their parents’ health care plan or the offered plans at their college or university. The ACA has provided many new and more affordable options for young people. A good place to look for a suitable plan is on the ACA’s marketplace website because there are a range of different price points and coverage options. Choose a plan that best meets your budget and needs.

 

When selecting a plan, students should be careful to balance the price versus the benefits. It may be tempting to choose the absolute cheapest plan available; however, this decision may leave students in a hard situation in the future. The cheapest plan possible usually has a high deductible that is sometimes upwards of $6,500.

  • Medicaid: Many states have lowered the requirements for medicaid by request of the federal government. Since 2014, a single person can now qualify for medicaid if their income is below 133 percent of the Federal Poverty Level (FPL). This means if a student’s income is lower than $14,500 (in 2011), he or she may be eligible for medicaid.

 

Questions to consider

Here are some other questions or concerns that students should consider while choosing their healthcare plan.

  • Do you have a monthly prescription like birth control?
  • Does your plan cover some or all of the cost of that prescription?
  • How does your plan handle mental health concerns?
  • Can you choose your own doctor or therapist?
  • What amount of coinsurance are you expected to pay? Remember that there is a big difference between paying for 10 instead 30 percent of an emergency room visit bill.

 

Balancing Out-of-Pocket Expenses

Once students choose a plan, it’s time to get down to the details. Students should figure out their budget and how much they can spend on healthcare and study each plan carefully. But make sure to balance out-of-pocket expenses. This can be done in two parts.

  1. Choose a plan that fits your budget. There are a range of different options available to students. Find a plan that will allow give you enough coverage without leaving you in financial straits should a health-related emergency occur.
  1. Know your plan. Find out the details of your plan. Go through the plan and make sure you take advantage of any incentives that may have been included. Some plans provide an incentive for healthy behavior, such as yearly doctor check-ups and general healthy living. Some are as simple as getting a flu shot or participating in a fitness group.

 

Another method of keeping costs down is taking advantage of preventive care. Most health care plans will outright pay for certain preventive care methods. Preventative care can include many different things. Some of the more important things to make sure to look into include:

  • Immunizations: Immunizations will prevent a health issue before it becomes a problem. Most people have been immunized by the time they reach college, but it’s good to make sure you are up to date.
  • Flu vaccine: To promote your health, get a flu shot. This is a simple method of preventing a very common virus. It must be updated on a yearly basis to ensure that you are immunized from the most common strains.
  • Yearly check-ups: Getting a yearly check-up can help students track their personal health and allow them to plan on how to better take care of themselves in the future. Going to get regular check ups is often rewarded by insurance companies, but it also allows you to catch major problems before they really become an issue. Which, in the long term, will help keep the cost of care down. This only requires a little time and sometimes a small investment.
  • Screening for sexually transmitted diseases: If you are sexually active this is an important step in maintaining your health. These screenings can catch diseases which can be more expensive to treat the longer they are allowed to affect the body. While STDs may be a taboo topic  to bring up with a doctor, please remember that doctors regularly test for these issues and it is nothing to be embarrassed about.

 

Another way to curb costs is by maintaining a healthy lifestyle. Here are some suggestions on how to stay healthy in college.

  • Eat healthily: Healthy eating can be simple way to make sure you don’t put on extra pounds. By making sure you are always a healthy weight for your body type, you can avoid a host of medical difficulties.
  • Drink enough water: Staying hydrated allows the body to function at peak efficiency. It is recommended that you drink at least eight 8 ounce glasses (or two liters) of water in a day.
  • Exercise regularly: Along with healthy eating, exercise is important in helping students keep off the “freshman 15” and maintain a healthy weight. It is recommended that everyone exercise for at least 150 minutes per week in a moderate aerobic activity, or exercise for 75 minutes per week in vigorous aerobic activity.
  • Sleep regularly: Lack of sleep can impair students’ ability to think quickly, lower energy levels, and cause them to be more susceptible to mistakes. Making sure you are getting enough sleep will allow you to avoid these problems. Studies have shown that sleep can help with stress hormones, the immune system, appetite, breathing, blood pressure, and cardiovascular health.

 

 

 

More Information

Here is a great list of other resources that students can use when looking for health care options and further information on what they can do. Remember that the more research you do in the beginning, the more you can reduce your costs later.

  • Healthcare.gov: This is a great site where students can get good information on how the ACA specifically affects them. This site is also where they can find the healthcare marketplace to help find a good plan for their situation.
  • Medicaid.gov: This is a fantastic site to find more information for students who are looking into Medicaid. See if it will work for your healthcare needs.
  • After Graduation Information: For students who have graduated college and don’t know what to do, check out this site for more specific information on what to do next.
  • Obamacarefacts.com – This is an independent site that has good detailed information on what the ACA does and how it affects college age young people.