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Planning for College
Should Include Health Insurance Considerations
As the fall semester
approaches, college students and their parents
should think carefully about the students'
ongoing health insurance needs. A serious
illness or injury could lead to catastrophic
consequences for a college student without
health insurance.
Coverage Through a Parent's Health Insurance
Policy
The good news is that most health insurance
policies cover dependents until the age of 25.
Insurance policies differ, so check with your
health insurer about how the policy defines a
full-time student and the maximum age of
coverage. Most policies consider a student
taking at least 12 credit hours per semester (6
or 9 in the summer) to be a full-time student.
It is also important to know the difference
between how a college student not living at home
can obtain coverage through a Health Maintenance
Organization (HMO) or a Preferred Provider
Organization (PPO). For example, a student
insured through an HMO may be outside the HMO
service area of physicians and hospitals while
away at school. If this occurs, the student will
have coverage for emergency care, but may have
to travel to a physician and hospital within the
HMO service area for other care. Similarly, an
insurer may pay benefits at out-of-network
levels for students who are outside a PPO
network. Check your plan provisions or speak
with your insurer to know the level of benefits
provided when a student is away at school and
outside the service area.
Be sure the college student has a copy of the
relevant insurance cards and knows how to obtain
any required approvals before seeking treatment.
Student Health Insurance Plans
Students who don't have health insurance through
a parent's health insurance policy, or who have
limited coverage due to network service areas,
may buy a student health insurance plan. Student
plans are sold by an insurer that has contracted
with a college to offer coverage to its
students. In general, these plans have more
limited benefits and more exclusions than
traditional health insurance plans. For example,
most student plans have limited catastrophic
coverage of $50,000 per accident or illness.
Many policies also will exclude routine
examinations and injuries sustained while under
the influence of alcohol or drugs.
For more information about obtaining health
insurance, go to www.texashealthoptions.com, a
website maintained by the Texas Department of
Insurance. There is specific information to
assist college students at
www.texashealthoptions.com/cp/students.html.
For more information contact: PIO@tdi.state.tx.us
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