Back to College Health Insurance Needs
August is the time of year when many students are going to
college. Whether it be their first year or not, Commissioner Miller wants to
remind students of the importance of understanding how to
use their health insurance while away at school. If you’re going into
college, you have two main options when considering health insurance: You are
either able to stay covered through your parent’s health insurance policy as a
dependent or you may choose to get your own student health insurance policy.
Under the Affordable Care Act, all insurance plans or
insurers that offer dependent coverage must cover those dependents on the
policy until the age of 26. Generally, you can join your parent’s plan and stay
on until turning 26 even if you get married, have a child, start or leave
school, live in or out of your parent’s home, aren’t claimed as a tax
dependent, or turn down coverage from an employer.
When you are no longer living at home, it is important to
understand the difference between receiving coverage through a Health
Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). An
HMO plan typically only covers care received from a network of providers that
have agreed to contract with the insurer, providers which are generally located
in the area where the health plan is sold. A PPO also has a contracted network
of providers, but typically also offers some coverage for care received from
out-of-network providers. If you are insured under an HMO, you may be outside
of the HMO service area of physicians and hospitals while away at school. This
means that you may be covered for only emergency care, and you may have to
travel into the HMO service area for any other treatment. In contrast, a PPO
plan may pay benefits at out-of-network levels for care received outside of a
PPO network. Always check with your insurance company or someone who handles
health benefits for the employer providing the coverage when it comes to
specifics regarding service areas and levels of benefits when you are away at
school, and it may be helpful to research providers in your network ahead of
time for when care is needed. Also, make sure you have the appropriate
insurance cards with you before seeking any type of care.
Insurance Plans and Other Coverage Options
Another option for students away at college is to purchase
your own student health insurance plan, either on your own or through your
school. Sometimes doing this is more beneficial for you if service areas are
too far from home or you cannot receive coverage from your parent’s policy.
Also, some schools may require students to have health insurance coverage, so
if you do not have insurance or do not feel that your parent’s plan is the best
option for you, the school’s student health insurance plan may be a good
option. As with any insurance policy, be sure to read the policy so you
understand your coverage before you make a decision. If you are not sure that
the plan is a good option for you, you may also want to visit Healthcare.gov to
see if you are eligible to purchase a plan from the federal marketplace.
Your school may have on-campus resources for mental health
services like counseling, but if they do not, or if they only allow a limited
number of visits, you may need to seek treatment through an off-campus
provider. Various laws, including the Affordable Care Act, the Mental Health
Parity and Addiction Equity Act, and PA Act 106, require mental health services
to be covered as an essential health benefit and in parity with medical
services. More information on how your insurance impacts access to mental
health and substance use disorder services can be found here.
Dental and Eye Care
Typically, routine dental care and eye care are not covered
for adults in health insurance plans. For routine dental and vision care, you
may want to consider a supplemental dental or vision policy.