Even though college students tend to be young and healthy, they still need health insurance to protect against crushing costs if they get sick or have an accident and need expensive medical care. And many colleges require that students prove they have health insurance when they enroll. 

One easy way to get coverage is through a parent’s health plan, but that coverage may not be effective if the child moves away to college. 

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Here’s what you need to know about health insurance for college students. 

What are health insurance options for college students?

College students may have several health insurance options: 

  • Stay on a parent’s health insurance until age 26
  • Buy the college’s student health insurance 
  • Get an individual policy or catastrophic health plan through the state's health insurance marketplace 
  • The college student may qualify for Medicaid depending on income and state

For many college students, the best option is to stay on a parent’s plan. The Affordable Care Act requires health plans that cover dependents must offer coverage to adult children until they turn 26. 

Most college students qualify -- they don't have to be a full-time student or live with their parents or be a dependent for tax purposes.

Adding a child to a health plan may increase costs. However, if you already have a family plan, adding another dependent likely won’t affect insurance premiums. 

Some policies are priced as employee + 1 and employee +2, but others have either self-only vs. dependent coverage or employee plus children. 

"If the premiums are employee plus children, then it's the same premiums for two or three children," says Wayne Sakamoto, an independent health insurance broker in Naples, FL. 

Even if you aren't covering other children, adding your college student under your policy may still be your most affordable option, especially if you get insurance through your employer. Employers usually subsidize the premiums both for employees and their dependents. If both you and your spouse have employer-sponsored health insurance, compare the cost of adding your college student to either parent's policy. Also, check out the plan’s provider networks to see your child’s options when in school, especially if the college is out of state. 

Find out more about the differences between employer-sponsored health insurance and individual health insurance

Here are questions to answer when deciding on a plan for a college student:

  • Does your health insurance have in-network doctors and hospitals near their college? If not, some policies (such as PPOs) may let you use out-of-network providers but charge higher deductibles and copayments. Other plans, such as HMOs, don't cover out-of-network providers, except for emergencies. 
  • What type of medical care will your child need while away at school? Will they get basic care at the college's health clinic? 
  • Are there specialists they may need to see while they're away at school? How would those visits be covered? Or do they live close enough that they would go to doctor's visits while home from college and need the coverage at school primarily for emergencies?

Think about how the plan covers care where your child lives, especially if they're in a different state and can't make it home quickly if they need to go to the doctor.

"Say the family lives in Texas and they have an HMO plan and the child is living in Florida, it does make sense for the child to get their own coverage for that reason," says Sakamoto.

What academic health plans are available?

Many colleges offer specialized health plans for students and make it easy to sign up. These student health plans are usually inexpensive and are created specifically for the school schedule. 

They may cover the college's student health center as an in-network provider and may also cover local doctors and hospitals.

In addition to the premiums, find out about the policy's details: 

  • What are the deductibles and out-of-pocket costs? 
  • What local doctors and hospitals accept the plan? 
  • What is the coverage like for prescription drugs and other expenses? 
  • What happens if the child gets sick or injured when they're home for breaks? 
  • Are there any coverage limits or exclusions?

Health insurance for college students with no income

Students can also buy their own health insurance from their state insurance marketplace, which usually provide multiple coverage options from several insurers. 

All policies sold on the marketplaces must meet Affordable Care Act standards, such as provide 10 essential health benefits, cover pre-existing conditions and cap out-of-pocket costs for covered expenses. For 2021, the out-of-pocket maximum is $8,550 for an individual, including deductibles and copayments but not premiums.

Depending on income and tax status, they may qualify for a subsidy to help pay the premiums. If their parents claim them as a dependent on their income tax return, the students can't get a subsidy based on their own income. 

But suppose they file their own income tax return. In that case, they may be able to get a premium subsidy if their modified adjusted gross income is between 100% and 400% of the federal poverty level (which is from $12,760 to $51,040 for an individual for 2021 plans). The subsidy can reduce the premiums significantly.

Policies on the state marketplaces and Healthcare.gov come in four basic levels: 

  • Bronze plans have the lowest premiums but the highest deductibles and cost-sharing.
  • Silver plans have moderate premiums and coverage.
  • Gold and Platinum policies have the highest premiums but the lowest deductibles and copayments. 

When shopping for a policy:

  • Review after-subsidy premiums (if eligible) as well as deductibles and copayments.
  • Coverage and costs for your prescription drugs.
  • Find out if the doctors and hospitals you use are considered in-network providers.

Suppose the student is not a dependent on their parents' income-tax return and their income is below 250% of the federal poverty level (which is $31,900 for an individual). In that case, they could also qualify for a cost-sharing subsidy, which helps reduce their deductibles and copayments. But they can only receive this subsidy if they buy a Silver policy.

Another option that may be available on the marketplace for people under age 30 is catastrophic health insurance. These policies have very high deductibles but lower premiums. 

You can sign up for coverage on the state marketplaces and Healthcare.gov during open enrollment period each year (from Nov. 1 to Dec. 15 in most states for coverage starting Jan. 1). Some states that run their own marketplaces have slightly longer open-enrollment periods. 

You may also qualify for a special enrollment period to sign up at other times of the year in certain circumstances, such as if you move or you lose family health insurance coverage (if you turn 26 or your parent loses his or her job with coverage). 

Students who aren’t dependents on their parents' income tax return may qualify for Medicaid coverage in some states if they have very low income -- less than 138% of the federal poverty level. That level is $17,609 for an individual in 2021. Eligibility is based on monthly income less than $1,467. If you qualify, you usually pay no premiums and little or no cost-sharing for coverage. 

But the rules and eligibility requirements vary a lot by state. Some haven’t expanded Medicaid coverage to childless adults. See Medicaid.gov for more information or you can go to your state marketplace or use the Medicaid quick screening tool at Healthcare.gov to see if you are eligible.

What is Student Medicover?

Another option for international students attending college in the U.S. Student Medicover is a specialized health plan for international students studying in the United States. 

They’re usually required to have health insurance, like other students, but they aren’t eligible for some of the options that are available to Americans and their family's coverage at home may not extend to the U.S.

Student Medicover may cover care at your college's student health center as well as doctors and hospitals in the UnitedHealthcare Options PPO system. For more information, pricing and several coverage choices, see https://www.smcovered.com/.