California health insurance - Understand Health Coverage - College Health Plans
When Does A College Plan Make Sense?
When a child goes off to college, there's a laundry list of items to address and health insurance definitely fits somewhere between living arrangements and major selection.
Many times, the main consideration is whether the child (young adult??) should remain on the family California health insurance plan either individual or through an employer sponsored plan, or look at the health plan offered to students by the college.
There are a few items to consider when making this decision so let's take a look at the general landscape of college provided health insurance plans
You can always run your alternative to college plan health quote here:
Health insurance requirement by college
Most colleges require that the enrolling student have health insurance and they provide a college sponsored plan as an option.
How do you compare the college sponsored plan versus your own coverage?
Comparing College Health Plans and Other Options
First, look at the benefits and make sure it does not have limits or restrictions of coverage that your own plan does not have.
The two real issues with colleges plans are caps on benefits and out-of-network coverage.
Caps refer to limitations in benefits.
For example, if the plan covers up to a certain daily amount for hospital stays, that can be a real issue.
Hospital care is extremely expensive these days and a daily cap can result in 10's of thousands of dollars out of your pocket.
Outside of a lifetime benefit maximum (ideally in the millions), avoid plans that have daily or other caps on coverage.
Out of network can also be an issue.
How will the college plan handle a student's coverage when he/she is visiting home or traveling (even abroad)?
Some colleges have medical schools and even hospitals as part of their campus (UCLA or Stanford for example) and the care can be very good while on or around campus.
Just make sure there will be coverage outside of that facility.
Also, how does the plan handle the summer time or a quarter when the student is not actively enrolled.
Each college plan will be different but you typically need to be a full-time enrolled student to remain on the plan.
The Blue Card program with Blue Cross of California or Blue Shield of California (Employer Plans Only) works well for PPO subscribers in that it allows them to extend their benefits to BCBS providers in other States.
This does not apply to HMO plans.
Health Considerations and College Plans
Important Update - Health qualification generally does not apply since 2014!
What does apply is the potential to get a tax credit based on income.
We can help with that since it's a little more involved for college students.
- If the college student files their own taxes, we would look at their income to establish tax credit eligibility.
- If the parents claim the child for current tax year, we would look at household income.
Keep that in mind when quoting the Covered Ca health plans.
We're happy to help with this process at 800-320-6269 or by email.
If a student has existing health issues when considering accepting a college plan, he/she needs to be careful.
Involuntary loss of coverage can be a Special Enrollment trigger so check with us if your losing college coverage.
To be safe, it might make sense to keep the individual coverage or group plan in this situation.
With individual California health insurance, an individual can remain on as long as he/she pays the premium.
The student can usually be separated from a family plan onto his own coverage (same plan) regardless of health status.
As for coverage under a group plan (through parent's employer plan as dependent), he/she will likely have a Cobra option when no longer eligible to remain on as a dependent.
A child can typically remain as a dependent if a full-time student and financially dependent on their parents until age 26.
If a student enrolls on a college plan and has health issues, outside of getting coverage through a new employer, it may be difficult to qualify for individual coverage once ineligible for the college plan.
College plans typically do not have an extension option such as Cobra.
This is another issue to address when looking at the college plan detail.
Keep in mind that after Jan 1st, 2014, health qualification are no longer be an issue as most plans will be guaranteed issue due to Health Reform changes.
You can access the online application here:
Cost considerations and college plans
If the college health plan is robust (without the limitations listed above) and continuation of coverage (such as Cobra or individual if the student has health issues), are not a concern, look at the cost of the plan.
College plans are usually priced pretty well but you want to make sure to compare apples and apples...i.e. there are no limitations.
In the end, I would personally feel more secure keep individual or group dependent coverage for a student when compared to a college sponsored plan only because they have the ability to continue coverage (not tied to student status).
Each situation (and college health care option) is different so it's important to look at the specifics of your situation.
The new Health Subsidies will greatly affect this decision as well.
Call us at 800-320-6269 with any questions. Our services are free to you as licensed health agents.