Understanding Health Insurance as a Student: A Comprehensive Guide
Glossary of Terms
- Advance Premium Tax Credit (APTC): A discount you can apply in advance of your insurance premium; when you apply for coverage on the marketplace, you estimate your income for the coming year, and if it’s low enough, you qualify for the credit. If, at the end of the year, your income was more than your estimate, you pay back part of your APTC.
- Children’s Health Insurance Program (CHIP): If you’re 19 or younger, you may qualify for CHIP, meaning your parents can pay a minimal price for your health insurance and can enroll you anytime. To qualify for CHIP, your parents must earn too much to qualify for Medicaid but not enough to pay for private health insurance.
- Coinsurance: After you meet your deductible for healthcare services that are covered by your insurance, coinsurance is an additional percentage you might have to pay, depending on your plan.
- Copay: After you meet your deductible for healthcare services that are covered by your insurance, copay is a fixed amount you might have to pay, depending on your plan. Most plans will have either a copay or coinsurance, not both. Typically, the lower your premium, the higher your copay, and vice versa.
- Cost Sharing Reduction Subsidy: “Cost sharing” is a blanket term that includes copayments, coinsurance, and deductibles — in other words, after you’ve met your premium each month, and you go to the doctor (or receive other healthcare services), you share additional costs for your care with your insurance company. If your income is low enough, you may qualify for the cost sharing reduction subsidy, which lowers the amount you pay.
- Deductible: Your out-of-pocket expense for services that are covered by your insurance.
- Dependent: If you’re a parent, you claim your kids as dependents on your taxes, which, depending on your income level, may qualify you for a credit to lower the cost of your kids’ health insurance. If you’re under 26, you can remain on your parents’ health plan as a dependent.
- Group Plan: A healthcare plan provided by schools, employers, and other organizations. Under the ACA, employers with 50 or more full-time employees must offer health insurance to 95 percent of their full-time employees.
- Health Savings Account (HSA): Some high deductible health plans on the marketplace offer an HSA, which allows you to put earnings into an account expressly for the purpose of paying for certain medical expenses. The IRS doesn’t tax money you put into an HSA. Some employers offer an HSA (meaning they match the amount you put into it each month), and some financial institutions do as well.
- In-Network: Your insurance company partners with certain providers, facilities, and suppliers who form a network.
- Marketplace: The federal government’s online service where you can shop for health insurance and enroll in various plans. Phone and in-person assistance is also available, and you can find out whether you qualify for Medicaid or CHIP, as well as other subsidies. Some states have their own marketplaces as well.
- Medicaid: A federal program offering free or cheap healthcare for individuals and families who qualify due to low income, disabilities, pregnancy, or old age. You may not be able to receive Medicaid if your state hasn’t expanded coverage.
- Out of Network: Providers, facilities, and suppliers that are not partnering with your insurer. You pay more for healthcare from out-of-network providers than for in-network providers.
- Premium: The amount you pay for health insurance each month.
- Preventive Care: Healthcare services — such as check-ups, screenings, and counseling — you receive to help prevent future problems. The majority of health insurance plans, including those on the marketplace, cover preventive care at no cost to you.
- Student Health Insurance Plan: A healthcare plan for full-time university students. At most public universities, full-time students are required to have health insurance and will automatically be enrolled in student health insurance unless they waive it and do one of the following:
- Enroll in a plan via federal or state marketplace
- Qualify for Medicaid or CHIP
- Remain on their parents’ health plan
Affordable Care Act (ACA)
- It allows you to be on your parents’ health insurance plan until you’re 26: According to Healthcare.gov, all your parents have to do is add you to their plan during open enrollment. If you lost your health insurance at some point, your parents can add you to their plan during a special enrollment period.
- It provides subsidies: According to the Obamacare Facts website, 60 percent of young adults have qualified for subsidies that lower the cost of insurance to $100 or less per month. Subsidies include the Advance Premium Tax Credit and income-based breaks. To see which subsidies you qualify for, apply for individual insurance during open enrollment at the Health Insurance Marketplace site.
- It endorses Student Health Insurance Plans (SHIP): Many SHIP meet federal guidelines for Minimum Essential Coverage, and become accessible once you are accepted and enroll at a university offering insurance to students.
- It includes Medicaid and CHIP: If you qualify for Medicaid or CHIP (Children’s Health Insurance Program), these programs also meet the Minimum Essential Coverage guidelines.
Student Health Insurance Myths
Questions to Ask
Insurance for Study Abroad Students
- If you’re on your parents’ plan, contact the insurance company. Give them the details of your trip and find out what they can do to accommodate your travel insurance needs.
- If you’re on a student health insurance plan, talk to your adviser. They’ll help you determine whether the university is providing international health insurance, and if not, whether there are any travel insurance companies partnering with the college to offer discounts on travel insurance. The study abroad program may also include insurance.
- If you’re on a marketplace or private plan, contact the insurer and find out about its travel insurance options. If it doesn’t have any, look at travel insurance plans from major insurers and compare rates.
Minimizing Healthcare Costs by Maintaining Student Health
- Exercise: Do your best to get about 150 minutes of moderate exercise per week, or 75 minutes of vigorous activity.
- Eat right: Plan your meals each week and set aside time to prep meals ahead of the week with fresh ingredients from the grocery store. Avoid fast food and processed foods. If you have the money and no time, consider ordering meals from companies that deliver fresh, healthy prepared meals to your door.
- Sleep: Over 30 percent of adults don’t get the sleep they need, yet sleep keeps you healthy and helps you get better grades. Set aside time for at least seven hours of sleep per night and shut down screen time at least an hour before bed.
- Care for your mental health: As mentioned, many health insurance plans offer free mental health counseling, which is a preventive service. But don’t wait until the burden of stress or other mental issues causes you to need counseling.
- Interact with other people: Online classes can leave you isolated. Meet with your professors via Skype, make time for your friends, attend a study group, study in a coffee shop where you can occasionally talk to other people, and try social sites like Meetup.com for social opportunities.
- Relieve stress: Consider mindfulness meditation, which is proven to lower stress. Don’t hold yourself to unrealistic standards and expectations, set your phone to “do not disturb” when you’re studying, take breaks, exercise, and use time management techniques.