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Affordable Care Act – Health Options For College Students

Regardless of whether you are a recent graduate from high school or an older adult headed back to college for a new degree, the possible ramifications of being blindsided with a serious and unexpected medical condition while in college are significant. The ramifications would of course be amplified without health insurance—the financial costs alone can be staggering. Some simple research, planning, and minor investment in a health insurance plan during your college years can mean the difference between a small deductible and thousands of dollars of medical debt on top of your student loans. Understanding your options is the first step in developing a health insurance strategy for your college years.

In 2010, the United States congress signed into law the Affordable Care Act (ACA). While the ACA was principally focused on health insurance for all US citizens, it also included provisions specific to college students. In March of 2012, the Department of Health and Human Services released final regulations for Student Health Insurance Coverage under the ACA, which clarified and expanded some of the ACA’s provisions as it relates to student coverage. Following is a discussion of the changes resulting from the ACA, the HHS rules and other student health insurance options.

Your Parents’ Health Insurance

The first question you need to address is whether or not you are able to be covered by your parents’ insurance plan.  If you are, this should carry over through your college years, thanks to the health insurance provisions of the ACA.  Prior to the signing of the ACA, health insurance policies often limited coverage of dependents to those of minor age, and required all dependents covered by the policy to be living in the same residence of the primary policy holder. Under the ACA, however, these restrictions were relaxed to allow non-resident coverage, and extended the maximum coverable age to 26.

Be aware though that being covered by your parent’s insurance policy doesn’t always solve all of the health insurance problems. Most insurance plans require the provider to be a member of their network. This may pose a problem to students who are attending college far from their parents’ residence. While the provisions of the ACA do address this issue in regard to Emergency Room visits, they do not eliminate the risk that you may pay a premium for out-of-network service providers.

School-Sponsored Insurance Plans

If you are not eligible to be insured under your parent’s policy you still have several options. First and foremost among these is to seek coverage under your college or university’s health insurance plan, if it has one.  According to the U.S. government’s General Accounting Office, more than half of all colleges and universities sponsor their own medical insurance plans for students. The GAO reported annual premiums for the policies ranging from as little as $30 per year to as much as $2,400, with an average of $850 per year. The best way to check if this is an option for you is to consult with your Office of Student Services to see if the college offers health insurance coverage. In addition, health care clinics and services are often available to students on campus and can supplement the provisions of your college’s insurance plan.

The HHS regulations redefine the way the plans are classified, and therefore changes the way that coverage is made available.  The new rule defines ACA student plans as “individual health care coverage” and offers new protections.  Some of these include the removal of lifetime limits on coverage, restrictions on insurance companies being able to drop coverage in the midst of sickness, and a lifting of pre-existing condition restrictions for students under the age of 19.  The purpose of the new rule is to keep students covered in most circumstances until the new health care regulations of 2014 take place.

Annual Limits

The new HHS rule dictates that annual limits must be a minimum of $100,000 for policies from July to September of 2012, and a minimum of $500,000 from September of 2012 to January of 2014.  After January of 2014, no limits may be imposed. This could result in higher premiums for coverage.

Medical Loss Ratio

Starting in 2013, calculations of medical loss ratio will have to take in a wider variety of plans, making sure that students are not excluded because of the plan they have chosen.  This also, includes a move from State by State aggregation to national aggregation.

Notice Requirement

Health insurance issuers will be required to disclose to the student when the policy being issued does not meet the minimum annual limits requirements.  Students must also be notified when they become eligible for health coverage as a dependent under their parents’ employer plan The rule also states that students must be notified in terms that they can easily understand so as to avoid confusion, and that such notices must be posted in easy to spot places so that everyone is aware of what they are purchasing.

What These Changes Mean

Students will now have more control over their health care options.  The new rule helps to ensure that students have access to healthcare that they need, and that they are given viable, affordable options.  The rule also is designed to help students be more aware of what rules, restrictions, and provisions their health care plans include so that they are not caught off guard by unseen changes.

Uncertainty Around The ACA Persists

The ACA has met with significant debate by citizens and legislators, and the fact that full enactment of its provisions doesn’t happen until 2014, mean that there is still uncertainty as to how long these rules will remain in place. Congress is scheduled to consider the ACA again during the summer of 2012 and it’s likely that the debate (and possible changes to the law) will continue during the roll-out period. However, as already discussed, there are aspects of the law pertaining to health insurance coverage that are already implemented, including options for acquiring both private and government-provided coverage. One of the best ways to figure out these options is to check out the presentation of current and future provisions of the Affordable Care Act at Healthcare.gov.

Other Alternatives to Healthcare for Students

Preventative Care

A provision of the ACA designed to facilitate preventative care and which was put into effect immediately upon enactment of the law is its coverage of certain preventative care screenings—these procedures have been made available to all health insurance policy holders without charge, and without payment of normal co-pay fees or charges.

Online Prescriptions

Many students now order their prescriptions online, which provides them with a continuous supply of the medications that they need, while saving them money in the process. If you find that the prescriptions that you need are breaking the bank every month, you can definitely take advantage of some online offers that are sure to save you money. Online pharmacies are also much more convenient than traditional versions, since you do not have to wait for your prescription to be filled or visit a store during regular business hours. 

Free or Low-Cost Community Clinics

If your campus does not have a major medical clinic it is a good idea to check on the availability of free or reduced-fee health care services provided the local county or city health clinics. Many of these clinics provide an impressive array of services that many are not aware of, and provide these services at incredibly affordable prices. Nearly every county in the country that is large enough to host a college or university campus will have a public health facility of some kind.  It is also important to know that in the case of an actual medical emergency, even if you do not have medical insurance, there is the hospital Emergency Room. In accordance with the Emergency Medical Treatment and Active Labor Act (EMTALA), Hospital Emergency Medical Departments cannot turn away patients who demonstrate an immediate health conditions which is recognized as an “emergency health situation” under the guidelines of the EMTALA.

The ACA has done much to improve the availability and affordability of healthcare for college students. Understanding the recent changes, as well as your other options, will help you identify a health insurance plan and strategy that is right for you.

Today’s guest article is provided by Ryan Devereux. Mr. Devereux is a financial blogger who has followed the healthcare debate in the United States. He wrote this article on behalf of the team atwww.OTSchools.com, who work to find the appropriate occupational therapy academic program for prospective therapists.

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