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Last updated June 25, 2010

By the time your children toss their high school graduation caps into the air, they'll probably have chosen a college and mapped out their freshman courses. Health insurance is the last thing on their minds.

Young immortals

college health plansYoung adults, ages 19 to 29, are the largest growing age group in the country at risk of being uninsured, according to the National Conference of State Legislatures (NCSL). They account for about 13 million of the 47 million Americans living without health insurance. While many youths may feel immortal, it’s not a good idea to go without health insurance. If your child is involved in an accident or diagnosed with a serious medical condition, the cost of health care could send you and/or your child into medical debt.If you have an employer-provided medical plan, it will generally cover your children until they're 19, and may extend coverage to dependents as old as 24, or until they graduate from college. But health plans often require that dependents be full-time college students. It doesn't matter whether the child lives at home or school.

Some states have enacted laws that allow parents to continue health insurance coverage for their children – even if they are not enrolled in college full-time. In 1994, Utah became the first state to enact legislation allowing coverage for unmarried dependents to continue up to age 26, regardless of school enrollment status, according to the NCSL. A 2006 New Jersey law provides coverage for unmarried dependents up to age 31, as long as they do not have dependents of their own. At least 30 states have enacted similar legislation to extend dependent coverage, regardless of enrollment in school.

If you don't have health insurance for your child, another option is a college health plan.These plans could save you money, since most plans are subsidized by tuition (though not necessarily subsidized for the student's spouse or dependents).

College plans are not free, and benefits vary from college to college. But it shouldn’t be difficult to find affordable health insurance. Committees from each college meet with insurance companies and design plans specific to their schools.

Putting a college health plan to the test

Be sure to find out:

  • Is the plan an HMO or can the student use any provider?
  • Does the plan cover emergency room visits?
  • Is there coverage during school vacations?
  • Can the student maintain coverage during the summer break even if they're not taking classes?
  • Can the plan be used at the best treatment facilities in the college community?
  • What services are offered free or at low cost in the campus health clinic?
  • Are pre-existing conditions excluded from coverage?
  • Does the plan cover sports-related injuries?

College plans sometimes limit preventive care, but students may have the option of going to the college health center for free services. Many times there's no charge for office visits to the health center, although students may be charged for lab work, physical therapy, X-rays, prescriptions and treatments for a minor injuries. Other covered services may include mental health treatment, well-child care, newborn and infant care, routine pap and pelvic exams, cholesterol screening and routine STD and AIDS testing. Mammograms are usually covered when prescribed by a doctor.

Typically, a school insurance provider will pay 100 percent of the cost for health center services. But a student’s coverage may drop and a deductible may be imposed if the student receives treatment outside the health center or visits and out-of-state doctor.

"If a student needs radiology services across the street, then they might have to pay a co-payment," says Elaine Whetzel, administrator of the Student Health Center at Georgetown University in Washington, D.C. "Most campus health centers are not equipped with lab facilities, so often those tests have to be sent out."

Dorothea Lyons, a spokesperson for Quincy, Mass.-based University Health Plans Inc., a nationwide student insurance broker, says, “Each school is different. Some have health centers, some don’t. Some include charges as part of the regular tuition and fees to allow the students to go to the health center and receive treatment at no cost. Some also charge a small fee at the time of service for a check-up or flu shots, though the cost is usually small."

Lyons adds that often treatment at a college health center is independent of insurance, but anything outside the health center could fall under a health plan.

Student athletes

If your child plays intercollegiate sports, he may not be covered for injuries sustained during practice or a game. The National Collegiate Athletic Association administers insurance certification guidelines to colleges and universities for intercollegiate sports. While the NCAA requires all student athletes to have health insurance before joining a college athletic team, some schools will cover most of the student's medical expenses if they are injured during a game. In some cases, if the child is covered under his parent's insurance, there may be exclusions regarding injuries sustained while taking part in intramural sports. Check your health insurance policy to determine if your child is covered in the event of a sports-related injury.

Pre-existing conditions

Coverage for pre-existing conditions isn’t a problem if you are extending coverage for your child through your employer-funded plan. College health plans and individual health insurance are a different story. Under some state laws, college health plans can refuse to pay for treatment of medical conditions that existed before the coverage took effect. Some states waive pre-existing conditions after six months of enrollment and some do not. It is important to read the fine print and understand how pre-existing conditions apply to your insurance plan. So before you sign up for a college health plan, make sure you know how pre-existing conditions are defined.

Parents sometimes choose buy a college's health insurance even when the student is covered under their plan -- if their policy requires doctor referrals for care. Obtaining referrals across states can be problematic. (Many HMOs require referrals for visits to out-of-network providers.) Parents who want their out-of-state college children to get prompt care without calling home for a physician's referral should consider college health plans.

Individual health insurance programs also commonly have a six-month waiting period before pre-existing conditions are covered. Individual plans designed specifically for college students also often have pre-existing condition exclusions, and parents should carefully evaluate these plans because they “can have exceptionally broad definitions” that could deny coverage, according to Hodgkins Beckley Consulting, a consulting firm in Fort Collins, Colo.