University Students: Health Insurance Options For Older Learners

Health insurance is a crucial consideration for older university students, as the cost of medical care in the United States is extremely high, and many doctors will not see patients who are uninsured. While health insurance is often mandatory for college students, the options available depend on various factors such as age, income, and location. This article will explore the different avenues older university students can take to ensure they have adequate health insurance coverage.

Staying on a parent's plan

Staying on a Parent's Health Insurance Plan

If you are a university student, you may be able to stay on your parent's health insurance plan. This is a great option for students who are under 26 years old and do not want to worry about the additional costs of insurance.

Who Qualifies for Dependent Coverage?

According to the Affordable Care Act (ACA), young adults can remain on their parent's health insurance plan until they turn 26 years old. This applies regardless of their student status, tax-dependent status, marital status, or whether they have access to other coverage.

If you are under 26, you can stay on your parent's plan even if you live in a different state. However, you should carefully review the plan's coverage documents and provider network to understand what is covered in the state where you attend school.

If your parent's coverage is through their employer, you may be removed from their plan when you turn 26, or at the end of the month or year you turn 26.

If your parent's coverage is through the ACA marketplace, you can remain on their plan until December 31 of the year you turn 26.

Some states, like New York and Florida, allow young adults to stay on a parent's health insurance plan until age 30 or 31. Additionally, several states allow disabled dependents to remain on their parent's plan indefinitely.

If you get married or have a child while on your parent's plan, your coverage will continue, but it will not extend to your spouse or child. You will need to secure separate health insurance coverage for them.

If the plan has network restrictions that limit your access to healthcare where you live or attend school, you may want to consider getting your own plan or enrolling in your university's student health insurance plan.

If the cost of adding you to your parent's plan is a financial burden, you may want to opt for your university's student health insurance plan or look for an affordable plan on the ACA Marketplace.

You can have dual coverage and be on both your parent's plan and your own plan. In this case, one plan will be designated as the primary plan, and the other will be the secondary plan.

You can switch from your parent's plan to your own health insurance plan at any time, but you may need to wait for the next open enrollment period or a special enrollment period if you are outside the open enrollment window.

Key Takeaways:

• You can stay on your parent's health insurance plan until you turn 26, and in some states, even longer.
• Your coverage is not affected by your student status, marital status, tax-dependent status, or access to other coverage.
• Carefully review the plan's coverage and network to understand what is covered, especially if you live or attend school in a different state.
• Understand the potential costs and benefits of staying on your parent's plan versus enrolling in your university's student health insurance plan or getting your own plan.
• You can have dual coverage and be on both your parent's plan and your own plan if needed.

Applying for private health insurance

Step 1: Determine Your Eligibility

Before applying for private health insurance, it is important to understand the eligibility criteria. The requirements may vary depending on your age, dependency status, and other factors. In general, you can apply for Marketplace coverage if you meet the following criteria:

• You are under 26 years old and listed as a dependent on your parent's taxes.
• You are 26 years old or older but still listed as a dependent on someone else's taxes.
• No one claims you as a dependent on their taxes, regardless of your age.

Step 2: Gather Necessary Information

When applying for private health insurance, you will need to provide certain information. This typically includes personal details such as your full name, date of birth, and contact information. Additionally, you may need to provide information about your parents or guardians, especially if you are listed as their dependent. The required information may include:

• Your parent's or guardian's name, address, and contact information.
• Your parent's or guardian's income and tax filing status.
• Information about your current health insurance coverage, if any.

Step 3: Compare Your Options

Before submitting your application, it is essential to compare the different private health insurance plans available to you. The Marketplace offers a range of plans with varying premiums, deductibles, and coverage levels. Consider the following factors when comparing plans:

• Premium: This is the monthly or annual payment you make to maintain your health insurance coverage. Premiums can vary significantly between plans, so choose one that fits your budget.
• Deductible: The deductible is the amount you need to pay out-of-pocket before your insurance company starts covering the cost of your medical expenses. Plans with lower deductibles usually have higher premiums and vice versa.
• Coverage: Review the coverage details of each plan to ensure it meets your specific needs. Consider factors such as the included benefits, provider network, and any exclusions or limitations.
• Reviews and Ratings: Look for reviews and ratings from current or previous customers to get an idea of their satisfaction with the plan. This can give you insights into the quality of coverage, customer service, and ease of claims processing.

Step 4: Complete and Submit Your Application

Once you have determined your eligibility, gathered the necessary information, and compared your options, it's time to complete and submit your application. You can apply for Marketplace coverage online, over the phone, or by mail. Here are the steps for each method:

• Online Application: Visit the official Marketplace website, such as HealthCare.gov, and create an account if you don't already have one. Log in and fill out the application form, providing all the required information. Submit the application and wait for a response, which may include eligibility results and plan recommendations.
• Phone Application: Call the Marketplace hotline and speak to a representative who can help you fill out the application and review your options. They will guide you through the process and answer any questions you may have.
• Mail Application: Download and print the paper application form from the Marketplace website. Fill it out completely and accurately, then mail it to the provided address. You will typically receive a response by mail within a couple of weeks.

Step 5: Enroll in Your Chosen Plan

After submitting your application, you will receive information about the private health insurance plans available to you, along with their costs and coverage details. Carefully review the options and choose the plan that best suits your needs and budget. Once you have made your selection, follow the instructions provided by the Marketplace to enroll in your chosen plan. This may involve providing additional information or making your first premium payment.

Applying for short-term health insurance

Short-term health insurance is a temporary solution for those who are in between permanent insurance plans. It is important to note that short-term health insurance is not an ACA health plan and does not provide the same benefits as ACA plans.

Who is eligible for short-term health insurance?

Short-term health insurance is designed for people who are in between permanent insurance plans. You may be eligible for short-term health insurance if you are:

• Waiting for open enrollment to apply for an Affordable Care Act (ACA) plan
• Not experiencing a situation that’s a qualifying life event and you don’t qualify for a Special Enrollment Period (SEP) to apply for an ACA plan
• Waiting for ACA coverage to start
• Looking for coverage to bridge you to Medicare
• Turning 26 and are coming off your parent's insurance
• Between jobs or waiting for benefits to begin at your new job
• A student attending college out-of-state
• Healthy and under 65

How to apply for short-term health insurance:

To apply for short-term health insurance, you will need to contact an insurance provider that offers short-term plans. You can find short-term insurance providers by searching online or through an insurance agent. Be sure to compare plans from multiple providers to find the one that best suits your needs.

When applying for short-term health insurance, you will likely need to fill out a health questionnaire and disclose any pre-existing conditions. It is important to note that short-term health insurance plans may not cover pre-existing conditions, so be sure to read the plan details carefully.

What to consider when choosing a short-term health insurance plan:

When choosing a short-term health insurance plan, there are several factors to consider:

• Cost: Short-term health insurance plans typically have lower premiums than major medical plans, but be sure to consider the deductible and out-of-pocket costs as well.
• Coverage: Short-term health insurance plans may not cover all the same benefits as major medical plans. Be sure to read the plan details carefully to understand what is and is not covered.
• Duration: Short-term health insurance plans are typically available for up to 12 months, but you may be able to renew the plan if needed.
• Provider network: Be sure to check the provider network to ensure that you will have access to the doctors and hospitals you need.

Signing up for a school-sponsored plan

Signing up for a school-sponsored health plan

If you are considering signing up for a school-sponsored health plan, there are a few things you should know. Firstly, the cost of school-sponsored health insurance plans varies at every university. The average annual cost of a public university student health insurance plan is $2,924, while a private school health plan averaged $3,874 annually for undergraduates in the 2023-24 plan year. These costs are typically added to your tuition fees.

It is also important to note that school-sponsored health plans may have additional charges for care at student health clinics. These plans also vary by institution, including costs, benefits offered, coverage areas, and how they work. Therefore, it is essential to carefully review the details of the plan to understand what is and is not covered.

School-sponsored health plans often use a health insurance company's existing network, such as Cigna or Blue Cross Blue Shield. These plans may come with extra benefits, such as virtual or app-based mental health sessions. Additionally, financial aid awards can sometimes include premiums for school-sponsored health plans to reduce monthly costs. Furthermore, these plans often offer coverage for spouses and children for an extra premium.

When deciding whether to sign up for a school-sponsored health plan, consider the following:

• Medication: Can you receive your prescription by mail order, or is there a local pharmacy you can access?
• Primary care: Can you find a primary care physician who is covered and easily accessible near your school?
• In-network care: Are there options for specialist providers, urgent care centres, and hospitals near your school?
• On-campus coverage: Does the school-sponsored health plan cover the on-campus health centre and mental health services?
• Portability: Does the plan cover you when you travel, work, or study abroad, and when you return home?

By considering these factors, you can make an informed decision about whether a school-sponsored health plan is the best option for your needs.

Applying for Medicaid

Medicaid provides free or low-cost health care to eligible individuals based on their income and family size. The eligibility rules differ among states, but generally, it is available for adults with low incomes, people who are pregnant, people aged 65 or over, and people with disabilities. Some states have expanded their Medicaid programs to cover adults with incomes up to 138% of the poverty level, or $20,782 in annual income for a single individual in 2024.

You can apply for Medicaid at any time in one of two ways: directly with your state or through the Health Insurance Marketplace.

Applying Directly with Your State

First, find and check with your state's Medicaid agency to apply. You must be a resident of the state where you are applying for benefits. Each state has its own requirements, so it is important to check with your specific state's agency. You can usually find contact information for your state's Medicaid agency on its official website.

When applying, you may need to provide certain information or documentation. The specific requirements depend on your state, but you may be asked for the following:

• Your name and date of birth
• Your Social Security number
• Your monthly payment amounts for rent, mortgage, or utilities
• Proof of citizenship or immigration status
• Proof of income, such as pay stubs or W-2 forms
• Information about any other government benefits you receive
• Details about any insurance plans offered by your employer or any current insurance plans you have

Applying Through the Health Insurance Marketplace

To apply through the Health Insurance Marketplace, visit HealthCare.gov to create a Marketplace account and complete an application. During the application process, reply "yes" when asked if you would like to see if you can get help paying for coverage. If your application indicates that someone in your household might qualify for Medicaid, the Marketplace will forward your application to your state for a final eligibility decision.

You can also call the Marketplace Call Center at 1-800-318-2596 to apply. TTY users can call 1-855-889-4325.

Frequently asked questions