Health Insurance for Students in California: Unless they qualify for an exemption, most students will have to purchase health insurance or be subject to a tax penalty.
A student may qualify for an exemption if they are not legally present in the United States or if they do not file taxes because their income is very low, for example.
Health Insurance for Students and the Affordable Care Act
A “student health plan” refers to a special policy that colleges and universities offer their students. In general, the student health plan is different from the employer-sponsored group coverage that these colleges and universities offer to their staff members.
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Health plans for students are classified as health insurance coverage (minimum essential coverage) under the Affordable Care Act. Therefore, consumers will not have to pay a penalty during the months they are enrolled in a student health plan.
If students have a health plan for “full insurance” students, that plan does not have to cover each of the 10 essential health benefits, including outpatient services for patients, hospitalization, maternity and newborn care, mental health and services for substance abuse disorders, behavioral health treatment, prescription drugs, habilitation and rehabilitation services, laboratory services, prevention and welfare services and chronic disease management, and pediatric services, including oral and vision care.
In general, full insurance plans must also offer contraceptives without cost sharing (without copayments, etc.). A complete insurance plan is one that your college or university buys from a health insurance company.
However, if the student’s health insurance plan is “self-insured,” you may not be required to cover essential health benefits. Consumers should inquire about the type of health plan for students offered by their school.
Covered Health Insurance for Students in California
Students may choose not to participate in health plans for students and purchase coverage through Covered California. Depending on your income, students can receive tax credits to help pay for a private health plan through Covered California or receive free or low-cost coverage through Medi-Cal.
However, if students accept and enroll in the school health insurance plan, they will not be eligible for tax credits through Covered California while they belong to their school’s plan. Before deciding to enroll in your school’s health insurance plan or a Covered California health plan, you should consider the location of the clinics and doctors, and the cost of accessing these services.
Minimum coverage plans
Students under the age of 30 could purchase an additional health plan option called a minimum coverage plan. These minimum coverage plans tend to have lower premiums and protect consumers more in case the worst happens.
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Catastrophic plans through Covered California cover three doctor visits or urgent care visits, including outpatient mental health/substance abuse visits, no out-of-pocket costs, and free preventive benefits. All other services will be charged at the regular price negotiated by the network until the person pays a total of $ 6,350. After paying this amount, all services within the network will be covered 100%.
Health plans for students and health plans for parents
For a Covered California health plan, as long as the students are tax dependent of their father and/or mother, or under 25, their eligibility for student health coverage does not disqualify them from being covered under the plan. family health of his father and/or mother.
Before making this decision, students should consider insurance coverage from their parent’s network. If students attend a school away from their parents ‘home, their parents’ health insurance may not cover medical services they receive while at school.
Students should speak directly with their parents’ health insurance plan for more information. If the student is in a school outside of the state of California, the Covered California health plan will only cover costs for emergency services. Services obtained outside the state of California that are not emergency services will not be covered by the plan.
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If students are claimed as dependents on their parents’ tax returns and choose not to participate in student health coverage, their family’s Covered California family health plan still qualifies for tax credits. In addition, if students choose to stay or accept the student health plan, their parents still qualify for tax credits through Covered California, if they meet the other requirements.
However, parents must state correctly on their application that even if their child, or the student, is a tax dependent, he or she does not seek health coverage through Covered California’s health plan.
However, a student who does not plan to participate in the student health plan and join the Covered California family plan must consider network coverage. If students attend a school away from their parents ‘home, their parents’ health insurance may not cover medical services they receive while at school. Students should speak directly with their parents’ health insurance plan for more information.
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If students are tax dependent, they may be covered by their parents’ Covered California health plan, no matter where they live. However, Covered California does not offer any health plan products that have a network of doctors, hospitals or other health care providers outside of California, at this time.
That is why, if the school the student attends is in another state, the health insurance of the parents will not cover most of the medical services while the student is in school.
The only exception is that all emergency services will be covered at the network price, even if the service is received in another State. Students considering this option should speak directly with their parents’ health insurance plan for more information.