COLLEGE HEALTH INSURANCE NEEDS:
Planning for College Should Include Health Insurance Considerations

Along with finding a place to live and where their classes are, college students need a quick lesson in how to use their health insurance while away at school. Parents, there are also a few things you need to check before they leave home. Here are a few tips on places to start your student's health check-up from the National Association of Insurance Commissioners (NAIC):

Coverage Through a Parent’s Health Insurance Policy

Any insurance plan or issurer that offers dependent coverage must make that available until the dependent reaches age 26, according to the Patient Protection and Affordable Care Act. Both married and unmarried dependents qualify for this coverage. Until 2014, if the parent's coverage is through an employer, and the dependent is eligible for coverage through his or her own job, the parent's plan is not required to provide coverage.

Some states may have laws that require longer extensions of dependent coverage in certain situations, Call your state insurance department to verify the age limit and any qualifications (such as full-time student, military veteran or marital status).

It is also important to know the difference between how a college student not living at home can obtain coverage through a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). For example, a student insured through an HMO may be outside the HMO service area of physicians and hospitals while away at school. If this occurs, the student likely will have coverage for emergency care, but may have to travel to a physician or hospital within the HMO service area for other care. Similarly, an insurer may pay benefits at out-of-network levels for students who are outside a PPO network. Check your plan provisions, or speak with your insurer or benefits administrator to find out the level of benefits provided when a student is away at school and outside the service area.

Be sure the college student has a copy of the relevant insurance cards and knows how to obtain any required approvals before seeking treatment.

Student Health Insurance Plans

Students who do not have health insurance through a parent’s policy, or who have limited coverage due to network service areas, may opt to purchase a student health insurance plan. Additionally, some schools may require a student health plan as part of registration. Student plans are sold by an insurer that has contracted with a college to offer coverage to its students. In general, these plans have more limited benefits and more exclusions than traditional health insurance plans. For example, most student plans have limited catastrophic coverage of $50,000 per accident or illness. Many policies also will exclude routine examinations and injuries sustained while under the influence of alcohol or drugs.

Dental and Eye Care

Routine dental care and eye care generally are not included as part of a health insurance plan, although many will cover non-cosmetic dental work that is medically necessary due to an accident. Some plans may include limited coverage for dental procedures, such as the removal of wisdom teeth, if performed in a hospital. Finally, most health insurance plans do not cover expenses related to periodic eye examinations, glasses or contact lenses. However, most health insurance plans do cover medical care as a result of an eye disease or injury.

More Information

The NAIC InsureU education program can help you get smart about health insurance options for your children as they get ready to move away to school. If you still have questions, call your state insurance department and talk with a consumer specialist.

UPDATED May 2012

About the NAIC

The National Association of Insurance Commissioners (NAIC) is the U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S. For consumer information, visit insureUonline.org.


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