What You Need to Know
You can get medical insurance through your parents’ plan or one of your own.
Different kinds of insurance have different costs and benefits.
Student health plans and those that meet Affordable Care Act requirements have specific enrollment periods, while others can be available at any time.
As you head to your college or university, are you thinking about healthcare? Like most college students, you may feel you don’t need health insurance because you don’t see doctors that often. Young adults are the age group with the highest uninsured rate.1 But if you want to be covered or if your school requires medical insurance, you have several choices in Delaware.
What Are Health Insurance Options for Delaware Students?
Here are some types of student health insurance policies available in Delaware:
- Through your college or university: Your school may offer a cost-effective student plan, either its own or from an insurance provider.
- Your parents’ insurance plan: By law, you can stay on their plan until you’re 26.
- Health Insurance Marketplace plans: You can buy plans that comply with the Affordable Care Act (ACA) through the federal Marketplace.
- Medicaid or the Children’s Health Insurance Program (CHIP): No- or low-cost health insurance may be available through Assist, based on your age and income.
- Catastrophic health plans: If you’re under 30, you can buy a lower-premium plan with a high deductible that covers serious accidents or sickness.
- Short-term health plans: You can get short-term plans that cover up to three months, nonrenewable.
- Job-based health plans: If you’re working, your job may offer medical coverage.
Why Do Delaware Students Need Health Insurance?
Your school may require you to buy its student health plan or show proof of similar coverage. Or, like one-sixth of young adults, you may have a chronic medical condition that needs managing.2
Without insurance, the cost of an unexpected illness or accident could put you in debt before you even finish school. For example, the government estimates3 that it costs up to $7,500 to fix a broken leg or $30,000 for a three-day hospital stay.
What to Consider When Searching for Student Health Coverage in Delaware?
Here are some questions to think about as you look at insurance options:
Will You Attend School In-State or Out-of-State?
If your parents’ job-based plan or Marketplace plan covers dependents, it can cover you no matter where you go to school. Be sure their plan has network providers close to your school so that you can pay in-network rates for services.
Can Someone Claim You as a Dependent?
Your parents can claim you as a dependent. If they do, you can’t get premium subsidies if you buy your own Marketplace plan.
Will You Stay on Your Parents’ Plan or Enroll in Your Own Plan?
Legally, you can stay on your parents’ Marketplace or employment plan until age 26.4 On your own plan, your lower income could qualify you for lower premiums through subsidies.
What Plans Are Cheaper?
Your (or your family’s) income can determine if you’re eligible for Medicaid’s free or low-cost health coverage or subsidies on Marketplace plans. While catastrophic plans have low premiums, they don’t qualify for subsidies.5
What Plans Offer Better Coverage?
Health policies that follow ACA requirements typically offer the best coverage. They’re required by law to cover preexisting conditions and “10 essential health benefits,” including hospital care, emergency services, prescription drugs and mental health services.
What If You Skip Health Insurance?
Delaware doesn’t mandate health insurance, so you won’t pay a fine for not having any. If your school doesn’t require health insurance, you could save the cost of premiums but risk large out-of-pocket bills if you need medical care.
What Are Health Insurance Rules in Delaware?
In 2020, Delaware launched a reinsurance program to partially reimburse providers for high-cost claims. The goal is to reduce premiums for those buying individual Marketplace plans.6 Delaware also in 2019 added the core protections of the ACA to state law, making sure the protections stay in place if the ACA is ever changed or repealed.7
How Do You Get Covered Under Your Parents’ Plan in Delaware?
Your parents can add you to their Marketplace insurance plan during the annual Open Enrollment Period (or during a Special Enrollment Period if you’re eligible).8 A plan with dependent child coverage has to cover you to age 26 by law. You qualify even if you don’t live with your parents or if you graduate, get married or have a child.9
How Do You Get Covered Under Your School Plan in Delaware?
Many schools offer student health insurance plans to their full-time undergraduates with a minimum number of credit hours. Costs and coverage will vary by school. Some schools add insurance costs to other school fees so that you can pay for them with your financial aid. Your school’s admissions office will have the details.10
The University of Delaware will bill students $352 for spring/summer and $77 for winter as a Wellbeing Fee covering most charges at its Student Health Services ambulatory care center. Student Health is in-network with Blue Cross, Aetna and Cigna, and will bill insurance companies as needed. All students must also have health insurance coverage. Through Aetna and University Health Plans (UHP), the university sponsors a Student Health Insurance Plan (UD Plan) that offers benefits for covered medical expenses at a relatively low cost. Without an online waiver form by the deadline, undergraduate students with 12+ credit hours will be billed $1,232 for winter and $1,412 for spring.11
Delaware State University, through its Student Health Services, provides treatment for sickness and injury and some on-site diagnostic testing. It refers students elsewhere for specialty care. The school requires health insurance. If you have none, it offers a cost-effective Student Health Insurance Plan (SHIP) through UnitedHealthcare. If you carry 12+ credit hours and don’t opt out with a waiver, $390 will be billed to your Student Account each semester.12
Wesley College’s Wellness Center offers a full-time nurse for ambulatory care, minor procedures, and pharmacy supplies free of charge. The school requires health insurance but doesn’t provide a plan. Instead, it recommends contacting Humana One, Cigna, or Assurant Health for available plans. 13 Wesley College will become part of Delaware State University in July 2021, and this may affect healthcare offerings.14
Wilmington University doesn’t provide medical services at any of its locations. Its Student Life Department offers health and wellness programs through its “Live Well to Learn Well” program. You have to get your own health insurance coverage.
Some colleges and universities offer student healthcare plans of their own or coordinate with private insurance companies.
How Do You Get Covered Through the Affordable Care Act in Delaware?
Your parents can add you to their carrier’s plan during the Open Enrollment Period, from November 1 to January 15 each year. If you miss that period, you can still be added if you qualify for a Special Enrollment Period in situations like losing other health coverage.
You can buy an ACA-compliant individual plan through Choose Health Delaware, which connects to the federal Health Insurance Marketplace website. Plans are also available off-exchange from insurers, certified agents and brokers.
The Marketplace plans run month-to-month, so you can get less than a full policy year’s coverage.
If you qualify, you could lower your out-of-pocket costs with subsidies such as an advanced premium tax credit (APTC) or cost-sharing reductions (CSR) available with specific Marketplace plans.15 About 86% of Delaware residents who apply qualify for APTCs.16 You can’t get subsidies if you buy ACA plans outside of the Marketplace.
If your parents’ healthcare plan insures you, check that it has network providers near your school, especially if your school is out-of-state.
How Do You Get Covered Through Medicaid or CHIP in Delaware?
Medicaid provides coverage to Delaware residents with low income or disability through Delaware Health and Social Services.
In 2014, Delaware expanded Medicaid under the ACA to cover nearly all childless nonelderly adults who earn under 138% of the federal poverty level.17 You can apply through HealthCare.gov to see if you’re eligible. You can also call Medicaid Customer Relations at (800) 372-2022.
If you’re under 19 and you or your family earn too much for Medicaid, you may qualify for the state Children’s Health Insurance Program (CHIP), called the Delaware Healthy Children Program (DHCP). Apply through ASSIST or call (800) 996-9969.
What Are Other Options for Coverage in Delaware?
If you’re under 30, a catastrophic health plan may be a good choice. These lower-premium plans are available through the Marketplace.18 Because of the high deductible, you may have to pay for most services out-of-pocket before your coverage begins. Your plan does cover preventive care and three primary care office visits per year before the deductible is met.
Short-term, or temporary, health plans in Delaware can’t last longer than three months and can’t be renewed. Each insurer must use the same underwriting standards for everyone who applies.19
Temporary plans aren’t required to offer ACA-level benefits, including coverage for preexisting conditions. You’re not guaranteed to be approved and can be rejected for any reason.20
You can buy short-term health insurance from an insurer or through a licensed insurance agent. Premiums are generally low, but be sure the amount of coverage offered meets your needs.
What Are Resources for Delaware Students?
Your school’s admissions office will be able to help you. You can get information on nonschool plans through ASSIST or Choose Health Delaware.
If you decide to get health insurance, look at the various healthcare options available in Delaware, so you can choose the best plan for you before you head off to school.