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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.

Parent’s 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.

Student Health 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.  

Mental Health Services

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.