When it comes time to waive or enroll in the student health insurance plan (SHIP) offered by your student's college every year, most parents assume their family health plan is always the better choice and quickly check, "Waive."
"That may have been true in the past," says Jenny Haubenreiser, executive director of Student Health Services at Oregon State University. "But, college student health insurance plans must comply with the rules of the Affordable Care Act (ACA), also known as Obamacare. This has increased benefits and eliminated pitfalls of past college student health plans making them an affordable, comprehensive solution for your student's health needs."
Here are seven ways Obamacare has improved college student health insurance plans.
1. Deductibles are very low, comparatively.
The low deductibles offered by many college plans are worth comparing to your existing family health insurance plan or any plan offered on your state health marketplace or the federal exchange at HealthCare.gov.
"The ACA allows colleges to structure plans based only on healthier college students who have fewer medical needs than other adult groups, which allows for the lower deductibles," says Teresa Koster, division president at Gallagher Student Health & Special Risk.
Student deductibles drop as low as $100 to $300 for the many colleges which operate an on-campus health clinic and which require all students to provide proof of insurance. Otherwise, student deductibles may be in the $500 to $1,000 range.
2. College plans include nationwide and often international coverage.
College students need health coverage wherever they attend school, when traveling around the U.S. with friends, visiting home and even while studying abroad.
According to the Department of Education's most recent statistics, 18 percent of U.S. college students attended college out of their home state in fall 2012 and 36 percent of college Juniors studied abroad in 2010-2011 for the summer or a semester.
Check whether your existing plan network is nationwide or even offers coverage for out-of-network use, before waiving the college plan, especially if you have an out-of-state student or one with plans to study or travel abroad during the year, Koster says.
"Many college SHIPs solve this problem by offering complete coverage for both U.S. and international students nationwide and even internationally when they study abroad," she says.
This way, your student might not need additional insurance for travelling abroad and families don't suffer higher charges for a simple out-of-network doctor's visit.
Only emergency room visits are allowed anywhere without out-of-network charges, thanks to Obamacare.
3. There's no maximum cap on benefits.
The 2014-15 school year is the first year there’s no maximum cap on benefits for SHIPs, due to Obamacare.
"Maximum caps limited the amount a health plan would pay in the event of a lengthy hospital stay for an accident or a diagnosis for an illness that requires constant treatment. That left students medically unprotected and families financially unprotected in the past," Haubenreiser says.
By getting rid of the caps, students are now covered for any health issue. And, since Obamacare set new limits on out-of-pocket expenses for all health plans including SHIPs, families are better financially protected, too.
4. Students with pre-existing conditions are fully covered.
Obamacare eliminated preexisting condition clauses for all health plans in America, including SHIPs, so students entering college with a chronic disease or other condition requiring treatment will be covered.
"These students need their college student health insurance to provide for continuous care and treatment for ongoing health issues immediately upon entering college, and now it does," Haubenreiser says.
If your student has a preexisting condition, Haubenreiser says to compare the college SHIP deductibles, premiums, copayments, network and out-of-pocket expense limits to your current family plan or other plan choices to see which will be more cost-effective for your family.
5. SHIPs must have 10 essential health benefits.
The ACA ensures that all health plans offer the same 10 "essential health benefits," or specific categories of health care coverage such as chronic-disease management and prescription drugs. SHIPs that didn't offer these 10 essential benefits in the past must offer them now, Haubenreiser says.
"Most importantly, mental health, substance use disorders and behavioral health treatments are universally included," Haubenreiser says. "This allows for interventions for students suffering from depression, loneliness, drug use, eating disorders or social problems at a very early stage of a problem, where help will more likely be successful."
6. Preventive wellness visits and screenings are now free of charge.
Obamacare requires all health plans to cover a specific list of preventive screenings and wellness services at an in-network provider without charging for copayments or coinsurance, even if you don’t meet your plan’s yearly deductible.
These visits include a yearly check-up, depression screening, diet counseling, sexually-transmitted disease prevention counseling and specific preventative services for women such as a well-woman exam and contraceptions.
Haubenreiser explains this benefit removes the financial barrier to wellness care faced by most college students.
"If it costs money to go to the doctor, (students often) won't go. Offering the free preventive services and screenings can make that difference," she says.
7. A 12-month plan is now mandatory
A major pitfall of many past SHIPs is colleges could choose to offer the health insurance plan for only 10 months of the year, depending on state regulations. This left students who used SHIPs in the past unprotected during summer months, Haubenreiser says.
However, the ACA mandates all adults must be covered by a qualified health insurance plan for the whole year. SHIPs in 2014 must be ACA-compliant and offer a 12-month plan, so your student is now covered without gaps, Koster says.