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College Students and ObamaCare


Sunday, August 17th, 2014

College students are one of several groups that now have new options when it comes to health care. While all Americans who enroll in Health Insurance Marketplace coverage are entitled to a set of essential health care benefits required of all Affordable Care Act (ACA)-approved plans, college students may have questions as to their coverage options.

What Coverage Options Are Available to College Students Under ObamaCare?

One provision of the ACA allows students to be covered under their parents’ health care insurance up to age 26, if that student’s parent has health insurance that covers dependents. If students have been dropped from a parent’s insurance coverage, they can be added again during a new open-enrollment period. However, once college students reach age 26, they will be automatically dropped from their parent’s policy and will qualify for a special enrollment period to obtain their own coverage.

Student Health Insurance and ObamaCare: Who and What Is Covered?

Since not every student has a parent with health coverage that accepts dependents, some students may choose to enroll in a school health plan sponsored by their college or university. Previously, these school-sponsored plans had more limited coverage than traditional insurance, such as annual limits on claims or doctor visits.However, in 2014, the ACA called for these school plans to meet particular requirements, such as eliminating yearly and lifetime claim limits, extending coverage to students with pre-existing conditions, and providing preventive care with no additional cost-sharing.

Although students have a number of health care coverage options to choose from, those who consider a university-sponsored student health plan may have questions as to what is covered under these plans — and who is covered. Here are a few additional areas of consideration that young Americans may want to keep in mind when choosing student health insurance.

  • Self-funded student health plans are primarily regulated by the states, not the federal government and are not subject to the ACA, sothese plans may follow different rules than federally regulated plans.
  • If you’re not a student or have left college,your university is not required to make coverage available to you. However, graduating students may be able to temporarily continue coverage for 90 days to obtain their own health care coverage via the state or federal Marketplace.
  • As of July 1, 2012, student health plans cannot place lifetime limits on essential health benefits and the preventive services offered as part of those defined benefits. Annual limits were eliminated as of January 1, 2014.
  • Generally, a student health insurance provider cannot cancel a student’s coverage. There are some exceptions where coverage can be cancelled if a student deliberately omits information or commits fraud on an application. In such cases, a student health plan must give students 30days prior notice that their coverage will be cancelled.
  • All student health plans must offer preventive services (such as vaccines) without any cost-sharing.
  • All student health plans must cover FDA-approved contraceptives. Despite this, eligible organizations that have religious objections to offering access to contraceptives may be exempt from providing these services if they meet defined criteria.
  • As of January 1, 2014, student health insurance plans cannot deny coverage to students with pre-existing conditions, regardless of age.
  • Student health plans cannot require students to provide prior authorization for emergency services, whether the student received emergency care in-network or out-of-network. Those students, however,may still be responsible for cost-sharing on out-of-network emergency services.
  • Self-funded student health plans may qualify as”minimum essential coverage.” If they do, students covered by these plans satisfy the individual mandate and will not have to worry about paying a penalty tax that is typically levied against Americans (with a few exceptions) without coverage.

College students have several options available for health care plans while they are pursuing higher education. It’s important for these young Americans to understand each of these options and which suits their needs best.

Sources

health care reform simplified

Health Care Reform

Health care reform. What are the facts? How does it affect you? Learn about ObamaCare, patient protection and the Affordable Care Act. Visit Health Care Reform Simplified to find out more. Read More