TCHS_CollegeStuHealthOptAdEngR7 (002)

As another school year gets under way, college students around the country are grappling with exciting questions: What classes am I going to take this year? What should I major in?
There is another important question that may not be at the top of that list: What kind of health care coverage should I get?

For many young adults, especially those out on their own for the first time, the question of health care coverage is far from the top of the list. Every young adult should explore the range of new health coverage opportunities – and obligations – under the Affordable Care Act (ACA), and make informed decisions about their health coverage. 

Broadly speaking, college students have 6 options for complying with the individual mandate of the ACA: 

  1. Staying on their parent’s plan until age 26 years
  2. Medicaid coverage, depending on income level and state;
  3. Former foster youth can access Medicaid coverage until age 26 regardless of income. (This is new under the ACA)
  4. Job-based insurance
  5. Purchase a private plan:  Students can purchase an individual plan either through the Exchange or Individual market- subject to the open enrollment period
  6. Student health insurance

Listen to segments from our radio show about college student health here:

College Student Health  Mental Health Options

Staying on their parent’s plan until age 26

Children and young adults up to age 26 can stay on their parent's employer health plan even if they have another offer of coverage through an employer or their college. 

Students can join or stay on their parent’s insurance until age 26 even if they are married, not living in the same state, and/or not financially dependent on their parents.  Whether or not the parents claim the adult child as a dependent has no bearing on the ability to join their health plan.

There are two major exceptions:

  • The parent’s plan must already offer coverage for dependent children.
  • Adult children may not join if the parent has a “retiree-only” plan.

Medicaid coverage, depending on income level and state

Many states extended Medicaid coverage to all individuals making less than between $12,060 and $16,642 per year. (Students in non-expansion states will often not qualify because they are not eligible as non-disabled adults.)

There is no open enrollment period for Medicaid, which means that you can enroll at any time throughout the year. Please refer to our Medicaid guide to see how your state deploys Medicaid guidelines.

Former foster youth can access Medicaid coverage until age 26 regardless of income (this is new under the ACA).

Effective January 1, 2014, all states were required to extend Medicaid coverage to age 26 for all youth who are enrolled in Medicaid and in foster care on their 18th birthday, or enrolled in Medicaid when they aged out of foster care if over age 18. This provision is intended to parallel a provision in law that is currently available to non- foster care youth to remain on a parent or guardian’s health plan until.

Student Health Insurance Plan (SHIP)

Most universities require that students have health coverage. More than half of colleges offer a Student Health Insurance Plan (SHIP). With four-year schools more likely to offer SHIPs than two-year schools.  Most schools enroll students into their SHIP and require that they opt-out  in order to to get coverage elsewhere with proof of coverage.

ACA provisions that do apply for college plans:

  1. Free preventive care
  2. Free access to all FDA-approved contraceptive methods
  3. No Recession
  4. Student health insurance plans may not establish lifetime limits on the dollar value of "essential health benefits" for any enrollee
  5. The medical loss ratio rule (80/20)

Purchase a private plan

Students can purchase an individual health plan either through their State Exchange or individual market- subject to the open enrollment period each fall. Catastrophic plans (which feature low premiums and cover only serious illnesses or accidents) are also available and  meet the individual mandate requirement of the ACA, but may not qualify as insurance under their school’s coverage requirement. Only Exchange health plans may qualify for discounts based on income levels. However, if an adult child is offered dependent coverage through their parent’s employer-based insurance, they are ineligible for Exchange subsidies.

Click here to learn more about purchasing a private plan through your state's Exchange website.