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Medical consultation and coverage for college and university health services

Health Insurance for Students

Most students, unless they qualify for an exemption, will have to purchase health insurance or they will be subject to a tax penalty.

A student may be eligible for an exemption, for example, if a student is not lawfully present in the United States or if they do not file taxes because they are below the tax filing threshold.

Student Health Plans and the Affordable Care Act

A "student health plan" refers to a special policy of health coverage that colleges and universities make available to their enrolled students. Typically, the student health plan is different from the employer-sponsored group coverage that colleges and universities offer their faculty and staff.

Student health plans count as health insurance coverage (e.g. "minimum essential coverage") under the Affordable Care Act. Therefore, for the months consumers are enrolled in student health coverage, they will not have to pay a penalty.

If students have a "fully insured" student health plan, that plan does have to cover all 10 of the essential health benefits," including ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services including oral and vision care. Generally, fully insured plans must also offer contraceptives without cost-sharing (meaning no co-pays, etc.). A fully insured plan is one that your college or university purchases from a health insurance company.

However, if the student health plan is "self-insured," it might not be required to cover essential health benefits. Consumers should check with their college to find out what type of student health plan it offers.