Montpelier, VT—College-bound students in Vermont should think carefully right now about how best to continue or obtain health insurance coverage through their college years. If you are young, healthy and active, the idea of an injury or serious medical condition may seem remote. But can you afford to be wrong? Accidents or unforeseen illness can strike at any age and treatments for life’s bumps, breaks and illnesses can cost tens of thousands of dollars. Having health insurance shrinks the risk of incurring medical bills that could adversely impact your financial future, and it provides the peace of mind that comes from knowing you have coverage if you need it.
Some of the health insurance options available for college bound students are:
The good news is that many health insurance policies cover dependents who are full-time students until the age of 23. Individual policies differ, so check with your health insurer about how the policy defines a full-time student and what the maximum age of coverage is. 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. However, college students who marry will lose their status as a dependent under their parents' policy regardless of their age or status as a full-time student.
If a parent is insured by a health maintenance organization (HMO) or preferred provider network (PPO), there may be provider network restrictions that you should be aware of. These restrictions are discussed in more detail below.
Coverage Through 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.
Students are faced with mountains of confusing forms at registration time. If you are a parent of a college student, and your policy provides the same or better coverage than the school offers, make sure your student doesn’t elect an unnecessary college health insurance plan.
Coverage Through Green Mountain Care
Some students may be eligible for health insurance coverage under Green Mountain Care while they are attending college. Green Mountain Care is a family of comprehensive low-cost and free health coverage programs offered by the state of Vermont and its partners. Programs include Catamount Health, VHAP, prescription assistance and more. Generally, Vermont residents must be uninsured for at least 12 months to qualify for Green Mountain Care. However, there are some exceptions to this rule for college students who lost coverage under their parent’s policy. In addition, students who graduate, take a leave of absence, reduce their credit hours or stop attending college may qualify.
To learn more or to enroll call Green Mountain Care at 1 (800) 250-8427, TDD: 1 (888) 834-7898 or visit www.GreenMountainCare.org.
Students should have a copy of all relevant insurance cards and know about obtaining referrals and approvals (if necessary) before seeking treatment. If you have any questions about health insurance coverage, check with your insurer first. Below are just a few important issues students should research before leaving for school:
If a college student living away at school obtains coverage through an HMO or PPO, there are important restrictions to consider. 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 likely 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.
Routine dental care and eye care generally aren't included as part of a health insurance plan, although many will cover non-cosmetic dental work that is medically necessary due to an accident. In addition, some plans may include limited coverage for dental procedures, such as the removal of wisdom teeth, if performed in a hospital. Most health insurance plans do not cover expenses related to periodic eye examinations, glasses or contact lenses. But, most health insurance plans do cover medical care as a result of an eye disease or injury.
To learn more about the different kinds of health insurance, call Health Insurance Consumer Services at 800-631-7788 or visit our website (Go to www.dfr.vermont.gov, click on Health Care Administration, and then access the Consumer Help and Consumer Publications sections).