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What You Need to Know
You can get medical insurance through your parents’ plan or one of your own.
Costs and benefits vary among different kinds of insurance.
Student health plans and those that meet Affordable Care Act requirements have specific enrollment periods. Others can be available year-round.
As you head off 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 need 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 health insurance coverage, Idaho offers you several choices.
What Are Health Insurance Options for Idaho Students?
Here are some types of student health insurance policies available in Idaho:
- Through your college or university: Your school may offer an affordable student plan, either its own or through an insurance provider.
- Your parents’ insurance plan: Legally, 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): State-based no- or low-cost health insurance may be available through Your Health Idaho, depending on your age and income.
- Catastrophic health plans: If you’re under 30, you can buy a lower-premium plan with a high deductible covering serious accidents or sickness.
- Short-term health plans: You can get short-term plans that cover different amounts of time depending on the type you buy.
- Job-based health plans: If you’re working, your job may provide medical coverage.
Why Do Idaho Students Need Health Insurance?
Your school may require you to buy its student health plan or show proof of comparable coverage. Or, like one-sixth of young adults, you may have a chronic medical condition you need to manage.2
Without insurance, you could be in debt before you even finish school. How? Because of the cost of an unexpected illness or accident. For example, government estimates3 say 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 Idaho?
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. But check your network. See if in-network doctors and providers have offices near your school. That way you can pay in-network rates for services without having to travel.
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 if the plan covers dependents.4 On your own plan, with your lower income, you could qualify for lower premiums through subsidies.
What Plans Are Cheaper?
Your eligibility for Medicaid’s free or low-cost health coverage depends on your (or your family’s) income. The same applies to subsidies on Marketplace plans. Note: Catastrophic plans have low premiums, but 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.” These benefits include hospital care, emergency services, prescription drugs and mental health services.
What If You Skip Health Insurance?
Idaho 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 by doing so, you risk paying large out-of-pocket bills if you need medical care.
What Are Health Insurance Rules in Idaho?
Certain American Indians, Alaska Natives and members of federally recognized tribes can buy health insurance through Your Health Idaho. They can enroll any month of the year and may have no healthcare expenses, depending on income. This coverage will be coordinated with Purchased and Referred Care (PRC), a tribal program or an urban Indian health program.6
How Do You Get Covered Under Your Parents’ Plan in Idaho?
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).7 Legally, a plan with dependent child coverage has to cover you to age 26. You qualify even if you no longer live with your parents or if you graduate, get married or have a baby.8
In-Network Providers
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 Under Your School Plan in Idaho?
Many schools offer student health insurance plans to full-time undergraduates who carry a minimum number of credit hours. Costs and coverage will vary by school. Some schools add insurance costs to your student account so that you can pay for them with your financial aid. Your school’s admissions office can provide the details.9
The University of Idaho’s Vandal Health Clinic provides primary and preventive care to students on the Moscow campus. All full-time students (12+ credits) must submit proof of valid health insurance as a condition of enrollment. Uninsured or underinsured students will be automatically enrolled in its Student Health Insurance Program (SHIP) and charged $951 per semester for fall and spring and $483 for the summer semester. These fees can be covered by financial aid. UnitedHealthcare Insurance Company underwrites SHIP, and SHIP benefits outside of Vandal Health Clinic are administered by UnitedHealthcare StudentResources (UHCSR) through its network of providers.
At Northwest Nazarene University, NNU Health Services provides a school doctor on a walk-in, first-come, first-served basis during clinic hours. All undergraduate students must have health insurance. The school provides insurance for those without proof of other acceptable health coverage through a Student Health Insurance Plan (SHIP) administered by the Wellfleet Group that costs $2,042 per year ($855 for fall and $1,187 for spring/summer).
Boise State University’s students are eligible to receive services at the student Health Center from board-certified medical professionals, licensed counseling staff and wellness experts. It’s in-network with several insurers and will bill most insurance carriers. Uncovered charges will be billed to your student account. The school sponsors a voluntary Student Health Insurance Plan (SHIP) through PacificSource Health Plans for students with six or more credits, although it doesn’t require proof of insurance for registration. The cost is $405 per month, and care at the Health Center has no deductible or coinsurance.
School Plans
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 Idaho?
Your parents can add you to their ACA 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.
Idaho set up its own state-run health insurance exchange in 2014. You can buy an ACA-compliant individual plan through Your Health Idaho, which connects to the federal Health Insurance Marketplace website. You can also buy ACA plans off-exchange from insurers, certified agents, brokers and enrollment counselors.
Since Marketplace plans run month-to-month, you can get less than a full policy year’s coverage.
You can lower your out-of-pocket costs by qualifying for subsidies such as an advanced premium tax credit (APTC) or cost-sharing reductions (CSR) available with specific Marketplace plans.10 About 86% of Idaho residents who apply qualify for APTCs.11 You can’t get subsidies if you buy ACA plans outside of the Marketplace.
How Do You Get Covered Through Medicaid or CHIP in Idaho?
Medicaid provides coverage to Idaho residents with low income or disability through the Idaho Department of Health & Welfare.
Effective in 2020, Idaho expanded Medicaid under the ACA. It now covers nearly all childless nonelderly adults who earn under 138% of the federal poverty level, or $1,482 per month for an individual in 2021.12 Idaho’s Children’s Health Insurance Program (CHIP) offers low-cost health coverage for those under 19 whose family income is too high for Medicaid.
You can apply for either program through HealthCare.gov to see if you’re eligible. You can also call the Department of Health and Welfare at (877) 456-1233 about Medicaid programs.
What Are Other Options for Coverage in Idaho?
If you’re under 30, you may want to consider catastrophic coverage. Although these lower-premium plans are available through the Marketplace,13 they don’t have to cover all ACA-required benefits.14 You may have to pay for most services out-of-pocket before your coverage begins because of the high deductible. 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 Idaho are offered in two versions: traditional and enhanced. Traditional short-term plans15 aren’t required to offer ACA-level benefits or cover preexisting conditions. In Idaho, these policies can’t go past 364 days, and a carrier can’t reissue within 60 days of the end of a short-term policy.16 Policies can be purchased year-round, but you have no guarantee of being approved.
The enhanced short-term plans introduced in 2020 offer more benefits, including coverage of preexisting conditions in some circumstances. Insurers can’t refuse you for health reasons and must guarantee renewal within the maximum period (with renewals) of 36 months. Policies can be converted to ACA plans, which the insurer must offer.17 These plans are designed for Idahoans who can’t afford ACA plans or qualify for subsidies.
You can buy traditional short-term health insurance from insurers or through licensed insurance agents. Insurers must obtain specific state government approval to offer enhanced short-term plans. While premiums for both versions are lower than for ACA policies, be sure the amount of coverage offered meets your needs.
What Are Resources for Idaho Students?
Your school’s admissions office will be able to help you. You can get information on nonschool plans through Your Health Idaho.
Next Steps
If you decide to get health insurance, look at the various healthcare options available in Idaho, so you can choose the best plan for you before you head off to school.
