Do College Students Need Health Insurance?

Many college students will take a sigh of relief after getting through the stress of leaving home and moving into their new dorms. However, amid shopping for textbooks and room décor, it is easy to overlook having a plan for health insurance.

Until recently, a major reason for students to have health insurance was the individual mandate instituted by the Affordable Care Act (ACA), which required Americans to have at least a nominal level of health insurance. Under this law enacted in 2014, anyone who could afford coverage but did not purchase a policy would have to pay a fine when they filed their taxes. However, as of 2019, this financial penalty no longer applies.

While the government no longer holds a requirement to have health insurance, some colleges and universities – including those in California – require students to have health coverage. To determine if this is the case at a college your child is attending, be sure to check with the admissions office.

It is important to consider that mandatory requirements are not the only reason to obtain health insurance for students. For instance, during an unexpected illness or injury, health insurance spares families a sudden financial burden. Even young and healthy people could face common or rare medical issues. In addition, having health insurance encourages students to get regular check-ups and visit a doctor when necessary.

Under the ACA, children can obtain coverage through their parents’ employer-sponsored or privately-purchased insurance plan through age 26. This applies even if they’re married, living away from home or are eligible for employer-sponsored coverage. However, college students need to know what their current insurance pays for and whether they need to buy extra coverage.

For example, families who are members of an HMO typically have coverage only within the state where the parents reside. It’s important to check with the insurer on whether there are in-network providers near campus. An absence of coverage can result in substantial expenses for students requiring emergency medical care or frequent doctor visits.

While PPO coverage may extend out-of-state, it’s still necessary to find in-network doctors and hospitals near campus. In general, only the largest insurers such as Anthem Blue Cross have affiliated networks in other states.

As an alternative, most colleges offer health plans to students. These plans often have an advantage over other health insurance options because they’re convenient, comprehensive and competitively priced. Because they’re grouped with other higher education expenses such as tuition and books, student loans can help with the expense.

However, be aware that it is common for the college to automatically enroll students in its sponsored health plan. If you have comparable insurance and don’t want to keep dual coverage, the student is required to submit a signed waiver of enrollment form by the specified deadline or you will be charged the premium.

College students can also shop for health insurance on government-sponsored or private health insurance exchanges, but this can be complicated. If they are attending school in another state, they will likely want to purchase a policy through that state’s marketplace. If they are attending school in California, they may purchase a policy through the California Marketplace, known as Covered California.

Finally, students who are concerned about paying for health insurance may be able to obtain a plan through Medicaid, a federal and state government program aimed at assisting people with limited financial resources obtain health insurance. This program has expanded since the ACA was passed, and many states now offer Medicaid to individuals who wouldn’t have previously qualified.

There are many healthcare options to consider for college students. As your children prepare for this new chapter in life, remember to help them make the right and responsible choice about health care.

Pacific Federal is a subsidiary of Zenith American Solutions.