As colleges and universities decide whether to reopen their campuses this fall, much of the discussion has focused on the ethics behind the decision and the associated health risks of in-person instruction.
But I see two important gaps in this discussion: Who should pay the cost of treating the inevitable COVID-19 cases that will occur; and what do college students need to know about their coverage?
Here are four things every college student – and those who care about them – should know about health insurance coverage when it comes to COVID-19:
Weigh coverage options. If the student is covered under a student health insurance plan through the school, it may be worth considering whether that is still the best option. The Affordable Care Act allows dependents to stay on their parents’ plan until age 26. Many students already take advantage of this, but for those who don’t, it may be worth a second look, particularly if the parents are insured. The catch is that the parents’ premiums might increase if they are switching from single or spousal coverage to family coverage.
Students can also qualify for a special enrollment period on HealthCare.gov – or their state-specific health insurance marketplace – if their county or state of residence is changing. This is likely a good option only if students earn some income. That’s because the financial subsidies for marketplace coverage kick in only if you are making at least 100% of the federal poverty level, which is $12,760 a year for a single person.
If you don’t earn any income or work only part-time, health insurance coverage through Medicaid may be an option. If the student lives in a state that expanded Medicaid under the Affordable Care Act, or attends a college or university in a state that did, the student has a better chance of being eligible.
Ask how COVID-19 is covered. All universities planning to reopen their residential campus are developing detailed plans with protocols that include measures such as social distancing, daily symptom reporting and regular testing. In these plans, a positive test will likely result in isolation, retesting, contact tracing and other measures to protect the student and their campus. However, treating complications of COVID-19 is a different story. Students will certainly be connected with treatment, but these plans don’t often address who pays for it.
Several major health insurance companies have committed to waiving out-of-pocket costs for COVID-19 treatment, but some already have plans to end this benefit.
Given that COVID-19 treatment can cost into the tens of thousands of dollars or more for cases requiring hospitalization, a student could be responsible for their full annual out-of-pocket maximum of either $3,000 or $5,500 when those bills come due.
Use telehealth. Students may have other health care needs to be addressed during this pandemic but may not be able to or feel comfortable going to their student health or neighborhood clinic in person.
Many insurers and student health plans have waived copayments for telehealth visits. But some are already looking to scale back this benefit as states continue to reopen. Things don’t always work as planned. Patients still get billed sometimes for “free” telehealth, so double-check before you pay any bills.
Out-of-network care. For students who decide to stay home this fall, or have to because their college or university is offering courses online only, an important consideration is whether and how generously their student health insurance plan covers out-of-network care. A student may be in a different city, state or even country from their school, which means that the network associated with the student plan might not be accessible.
Out-of-network coverage generally comes with a higher deductible and greater financial responsibility for the patient.
Paul Shafer is an assistant professor of health law, policy and management at Boston University. Distributed by The Associated Press.
