College can be an exciting (and emotional!) time for the whole family. There are courses to select, dorm decorations to buy and meal plans to choose from. It also marks a big step toward greater independence. So how do you make sure your new college student is taken care of when you can’t be there?
To start, you’ll want to make sure that health insurance is in place before you pack up the car and drop your son or daughter off at campus. Getting sick or injured away from home can be unpleasant enough without the stress of figuring out where to get treated and wondering what will be covered. You’ll need to review your options together and come up with a plan that works for the whole family. There are two primary insurance options for students during their college years: your family health plan or a health plan provided through the college.
Your family health plan.
The Patient Protection and Affordable Care Act of 2010 requires all individual and group health plans to provide dependent coverage for children up to age 26, whether or not the child is a student. If you have a plan such as a preferred provider organization (PPO) that provides coverage for both in-network and out-of-network physicians, then your covered student should be able to see most any doctor on or near campus. Your insurer should then cover a certain percentage of the expenses as described in your plan.
The situation becomes more complicated if you have a health maintenance organization (HMO) plan, which may only cover visits to an assigned Primary Care Physician (PCP), or require referrals to specialists. If there aren’t any in-network providers near the college, your son or daughter may need to schedule appointments with his or her primary care doctor during school breaks or other visits home. But this may be difficult or impossible in an urgent situation.
If your student can’t be covered by your family health plan because they no longer fit the definition of a dependent child, they may be eligible for coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). This is an individual plan that’s based on the benefits in your group plan. Under COBRA, your child may be eligible for coverage for up to 36 months.
The college health plan.
Another option is to purchase health insurance coverage through the college. Many colleges offer low-cost health plans for students. These plans may not be as comprehensive as some policies, but are usually enough to get by on, even if the student becomes seriously ill or has a major accident. College health plans are generally less expensive than family health plans because they have a cap on total benefits paid (for example, some may not pay out more than $250,000). Make sure that you know what the maximum benefit is and that you’re comfortable only having coverage up to that limit.
Plans are usually individually designed for a specific college. The cost and level of coverage provided by college health plans can vary greatly from one school to the next. The health services available both on campus and in the community often determine what coverage the college can offer. State laws may also play a significant role in the cost and level of coverage.
Questions to ask about college health plans.
Because college health plans can vary widely, you’ll want to consider the following questions before you sign your student up:Is the plan an HMO, or can students use any health provider?
- Is the plan an HMO, or can students use any health provider?
- What services are offered for free (or at a low cost) in the campus health center?
- Is the campus health center open 24 hours? How is it staffed?
- Are emergency-room visits covered in all situations or only in specific situations?
- Are hospitals accessible in the college area?
- Does the plan cover students while they’re on vacation (for example, spring break)?
- Does the plan provide coverage during the summer?
- Are mental health treatments included?
- What pre-existing conditions are excluded?
- Are there deductibles and/or coinsurance to be paid?
- What is the maximum benefit amount?
Which plan is best for my student?
Now that you understand your options, you’ll need to make your choice based on your individual circumstances. You should consider your financial resources, how much coverage you’re comfortable with, the location of your student’s college and the services nearby, as well as what services are covered under each plan.
If you have a student in college, or are about to send one off, don’t let planning for health insurance get lost in the shuffle. Understand your coverage options, and weigh the importance of convenience versus expense. Once you’ve made your choice, make sure that your student is clear on how it all works, too. Doing your homework now can help make sure medical issues are a temporary inconvenience, and not a full-blown emergency — so your student can focus on the things that matter.