The cost for Stanford University’s student insurance policy rose this year to $5,592. (Image by Victor Gane licensed under Creative Commons.)
Student health insurance costs anywhere from $0 to north of $5,000 a year. Which end of the range you get has a lot to do with what your kid’s school requires for coverage.
Some families discover that they don’t need student health insurance at all, because their kids are covered on the family’s policy, while some get a surprise bill — on top of their spending on tuition, books, furnishing their student’s dorm room, and maybe a little spending money.
Every family is likely to consider some of the same factors. Here’s how some parents have solved this equation to get the best deal for their families.
First — waiver or no waiver?
Most schools require proof of insurance that covers providers in the school’s area, either via an existing family policy or via purchase of the school’s policy. Before doing anything else, find the college’s policies and deadline for providing proof of insurance.
If you decide to use your existing insurance and thus ask the school for a waiver, before filing that waiver, make sure your plan has in-network providers near your kid’s school. Your out-of-network benefits may cover little besides emergency care.
Even if your policy covers out-of-state care, make sure to check with your kid’s college. “Boston University makes you get insurance even if you have your own [policy] in New York that covers out of state,” wrote one frustrated New York State mother.
If your child is studying, working or interning in a different state, you could consider a health plan that covers you at home and also has networks around the country. Many plans have a Preferred Provider Organization, or PPO, which don’t require referrals to see a specialist, and some (but not all) insurance policies have networks nationwide.
Some schools, like Penn State, do not require proof of coverage or enrollment in a school plan. Penn State students without adequate coverage are “strongly encouraged to enroll in the Penn State Student Health Insurance Plan (SHIP),” according to a university news release.
At other colleges and universities, if you miss the cutoff to provide proof and thus receive an insurance waiver, “then the college will automatically enroll the student for their student insurance policy,” said a former employee of a college in the Midwest.
In her job helping student-athletes show proof of coverage, the former college employee had to give bad news to out-of-state parents.
Both Medicaid and some forms of private coverage “didn’t travel out of network in a meaningful fashion,” she said.”[It] was always a struggle as I informed parents that their insurance didn’t do squat should their child get injured.”
How many people use student health plans?
As the main source of health insurance, student health plans are not especially common. Between 10% and 20% of students relied on their school’s health plan over each of the last several years, according to survey data from the American College Health Association, or ACHA.
Over the same period, two-thirds of students used their parents’ plans as their primary coverage, with the rest covered by a different plan. (In the most recent survey, 3.3% of students said they had no health coverage at all; 1.3% said they were unsure whether they did.). But sometimes those plans don’t meet a school’s standards for adequate coverage. When that happens, parents often must pay for the college’s plan or one that covers as much.
Students with university health plans can stay on their parents’ plans, and some do. It may cost parents nothing to keep them on the plan and will make it easier for students to get care back home.
Prices vary among schools
Several parents with more than one child in college wrote in with their experiences. Their stories show how different the cost can be depending on the school their kid attends.
Because her health plan has in-network providers near her son’s college in Evanston, Illinois, one mother was able to waive coverage with a $4,000 premium. She wasn’t so lucky with her daughter, who attends college in Montreal. With no coverage in Canada, they had to payout $1,500 for her school’s health plan.
At Stanford University, the cost for Cardinal Care, its student insurance policy, was $5,208 for 2018-2019 school year, and rose to $5,592 for 2019-2020. Coverage runs from Sept. 1 to Aug. 31 and covers students on campus, nationwide and overseas.
Student health plans may be run by one of the big national insurers – for example, Aetna Student Health or UnitedHealthcare’s UHC Student Resources. Another carrier is University Health Plans, a division of Risk Strategies, a national insurance brokerage and consulting firm.
When the college says your health plan isn’t good enough
Colleges can require more extensive coverage than what is required under the Affordable Care Act, or ACA. They may reject an insurance waiver if it judges that a parent’s plan covers too little.
That’s what happened when one mother’s son attended the University of Illinois, which “would not accept our plan,” she said. Fortunately, the premiums were affordable for them — about $1,000 a year — and her son never got sick enough to test whether the plan was okay or not. “Mostly,” she said, “he used the student health service.”
(Update: A Tulane student’s mom wrote, “Tulane requires us to submit our family insurance plan information. They then decide whether it meets or exceeds the plan they offer to the kids ($5,800/year). If they don’t like it, you’re stuck paying for the student plan! “)
Students going out of state can also choose to enroll in the school plan or apply for an ACA plan, which offers coverage via healthcare.gov or their state insurance exchange. If the student is a dependent under 26, the ACA application uses the family’s income, not the student’s, to figure if tax credits are available. Read more here.
The school plan could be a better deal… or not
It’s worth checking if the university plan is cheaper, as it was in the case of a dad who wrote in. His daughter attends George Washington University, where her annual premium of $2,690 is almost $100 cheaper per month than her old Kaiser Permanente plan.
Sometimes the college’s plan has better coverage, too. “Our current ‘insurance’ only works in NYC,” wrote another dad. Now his kids are covered on student plans at the University of Colorado, Boulder, and Cornell University, for “less than $200 or $300 a month.”
“Compared to tuition and lodging and books it’s an incredible bargain,” he said.
Of course, what’s a good deal for one person is exorbitant for another. A mom recalled her shock on learning the $1,643-per-semester premium to cover her son at the University of California, Berkeley. She is looking for alternative plans through Kaiser Permanente and Covered California, that state’s ACA exchange. What she chooses will be especially important this spring, when he turns 26 and can no longer stay on her plan.
“My son plays rugby and the possibility of injury is real,” said the mom of a student at the University of Delaware. “I want him to have the ability to see any doctor he may need without worrying about coverage.”
The family health plan, MVP Health Care of New York, was no help in Delaware. Outside the state it only covers emergencies, she said. “They won’t even cover urgent care visits.”
For about $2,000, they signed him up for the school’s plan, which had a lower deductible and covered doctors in New York.
Her son is still on the family’s MVP plan, she said. Removing him doesn’t save any money.
Another mom, who also has a student on the family’s MVP health plan, said that under her plan, care they get outside of New York, where MVP is located, is covered by Cigna. (Pro tip: Ask your insurance company if they have out-of-state coverage options. This may never have been an issue for you before, but it could be a big help now.)
It’s worth noting that colleges and universities might have different rules for star athletes. The University of Central Florida, for example, flew its quarterback and two doctors who had been treating his knee injury to Mayo Clinic in Rochester, Minn., according to this article by Beth Kassab for The Orlando Sentinel, describing the special arrangements allowed by the NCAA.
You are not alone in your frustration
Are the plans effective? That depends on who you ask.
Andrew Cuomo, then New York State Attorney General, issued results of an investigation of student health plans in 2010 saying that “College-sponsored health plans often pay out far less in benefits than they collect in premiums, skirting state regulations and shortchanging students,” Danny Hakim wrote in The New York Times:
“Many plans also do not cover common situations that affect students, including injuries sustained in suicide attempts or while drunk. And some colleges force students to buy college-sponsored coverage even if they are enrolled in a parent’s plan or covered by Medicaid. While some colleges negotiate broad coverage from insurers, others receive what seem like low-cost plans, but they provide so few benefits that they are among the most lucrative for the insurance industry.”
Dozens of readers wrote in with comments about student health insurance experiences.
If the emails received at ClearHealthCosts are any indication, the problems are just as real nearly a decade later. “It feels so wrong to see how the insurance industry is using colleges to increase their revenues by making it mandatory,” wrote one mom.
Another mom described juggling three insurance policies for her family of four. Her older kid’s school said his insurance was not adequate, forcing the family to buy a policy that is about $2,000 yearly. Soon her younger child will age out of the Child Health Plus program, which has no copays or deductible. She and her husband are on a separate plan.
“I am still trying to figure out what is the best way to deal with this,” she wrote. “I will keep you posted with any good findings.”