What You Need to Know
You can get medical coverage through your parents’ plan or your own plan.
Costs and coverage can vary among different kinds of plans.
Enrollment periods can be limited for student health plans and those that meet Affordable Care Act requirements, while others can be available year-round.
Are you planning for healthcare as you head off to school? You may not think you need health insurance because you rarely get sick. Young adults make up the age group with the highest uninsured rate.1 But if your college or university requires medical insurance or if you want coverage, you have several choices in Ohio.
What Are Health Insurance Options for Ohio Students?
Here are some types of student health insurance in Ohio:
- Through your university or college: Many schools offer affordable plans to their students, either their own or through insurance companies.
- Your parents’ insurance plan: By law, you can stay on your parents’ plan until you’re 26.
- Health Insurance Marketplace plans: Plans that comply with the Affordable Care Act (ACA) can be purchased through the federal Marketplace.
- Through Medicaid or the Children’s Health Insurance Program (CHIP): No- or low-cost health coverage is available through the Ohio Department of Medicaid, depending on your age and income.
- Catastrophic health plans: You can buy a lower-premium, high-deductible plan to cover serious accidents or illnesses if you’re under 30.
- Short-term health plans: You can get one 364-day, nonrenewable plan that doesn’t meet ACA requirements.
- Job-based health plans: If you have a job, your employer may offer health insurance.
Many universities and colleges have student healthcare plans, either their own or through insurance companies.
Why Do Ohio Students Need Health Insurance?
Many colleges and universities in Ohio require insurance for admission. You may have a chronic medical condition that needs managing. One-sixth of young adults have a chronic illness or health condition.2
Having an insurance policy also protects you if you’re admitted to a hospital emergency room because of an accident or sickness or if you develop a chronic condition. You’ll avoid big bills that could leave you with extra debts after graduation. The government’s estimate3 for fixing a broken leg is up to $7,500 and $30,000 to spend three days in a hospital.
What to Consider When Searching for Student Health Coverage in Ohio?
Here are some questions to answer as you look at options in Ohio:
Will You Attend School In-State or Out-of-State?
Your parents’ Marketplace plan or job-based plan can cover you (if it covers dependents) no matter where you go to school. Be sure their plan has network providers near your school so your services will be covered.
Can Someone Claim You as a Dependent?
Your parents can claim you as a dependent, but if they do, you won’t be able to claim premium subsidies if you want your own Marketplace plan.
Will You Stay on Your Parents’ Plan or Enroll in Your Own Plan?
You may be able to 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 income (or that of your family) can determine if you qualify for subsidies on Marketplace plans or Medicaid’s no- or low-cost health coverage. Premiums for catastrophic insurance policies are low, but they don’t qualify for subsidies.5
What Plans Offer Better Coverage?
Plans that follow ACA rules typically offer the most comprehensive coverage. They have to cover preexisting conditions and “essential health benefits,” including hospital care, emergency services, prescription drug coverage and mental health services.
What If You Skip Health Insurance?
Ohio doesn’t mandate health insurance, so you won’t pay a penalty for not having it. But you might not have a choice if your school requires healthcare coverage for admission. If it doesn’t, you might save some money on premiums, but you risk larger out-of-pocket bills if you need medical treatment.
What Are Health Insurance Rules in Ohio?
Ohio’s rules for short-term health insurance plans are much more restricted than the federal rules. Short-term plans can’t last longer than 364 days and they can’t be renewed.6
If your parents’ plan insures you, check that it has network providers near your school, especially if you’re an out-of-state student.
How Do You Get Covered Under Your Parents’ Plan in Ohio?
You can be added to your parents’ plan during the annual Open Enrollment Period (or during a Special Enrollment Period if you qualify).7 By law, insurers that offer dependent child coverage have to extend that coverage to age 26. You qualify even if you don’t live with your parents or if you graduate, get married or have a baby.8
How Do You Get Covered Under Your School Plan in Ohio?
Many schools offer student health insurance plans to undergraduate students enrolled for a minimum number of credit hours. Plans may be funded directly by the school or through a contract with an insurance company. Costs and coverage will vary by school. Sometimes costs are added to other school fees so you can use your financial aid to pay them. Your school’s admissions office will have more details.9
Case Western Reserve University requires health insurance of students registered for one credit hour or more. Its University Health Service (UHS) provides primary care on campus. Case Western has contracted with Aetna Student Health to supplement UHS services for $2,734 per year. The premium will be billed each semester automatically unless you meet the school’s waiver requirement.10
Kenyon College’s Health Service provides its students with primary care services at no charge. As a supplement, full-time students are automatically enrolled in its Student Health Benefits Plan unless they provide acceptable proof of insurance. The plan is ACA-compliant and facilitated by Wellfleet. The annual premium is $2,800.11
Ohio State University requires all students enrolled at least half-time (6 credit hours) to have health insurance. Unless a waiver is presented, students are automatically enrolled in its SHI Benefits Plan, which UnitedHealthcare Student Resources and other partners underwrite. The premium is $3,366 per policy year, billed per semester.12 Ohio State also offers an optional prepaid medical and drug package for $225 per year through Student Health Services at its Wilce Student Health Center.
How Do You Get Covered Through the Affordable Care Act in Ohio?
Ohio doesn’t have its own Health Insurance Marketplace, so you can buy an ACA-compliant individual plan through the federal Marketplace or off-exchange from insurers, agents, brokers or navigators. Plans must be purchased through the Marketplace to qualify for subsidies. Without subsidies, average annual premiums for 2021 are projected as $5,670.13
If you’re not already on it, you can be added to your parents’ plan during the annual Open Enrollment Period (OEP), which runs November 1 to January 15. If you miss that period, you can still be added if you qualify for a Special Enrollment Period, which applies in situations like losing other health insurance.
Since Marketplace plans run month-to-month, your coverage period can be less than a full year.
If you buy specific Marketplace plans, you may be able to lower your out-of-pocket costs with subsidies such as an advanced premium tax credit (APTC) or cost-sharing reductions (CSR).14
How Do You Get Covered Through Medicaid or CHIP in Ohio?
In Ohio, Medicaid services are provided through managed care plans run by health insurance companies. Either you select one or one will be selected for you. These plans cover the federal essential health benefits, plus other services, at an affordable price. You can contact the plan directly or use the Find a Provider tool.
Ohio expanded its Medicaid coverage under the ACA, so low-income adults without dependent children are eligible for Medicaid if they meet financial guidelines. The coverage is similar to the traditional Medicaid state plan.15 You can earn as much as 133% of the federal poverty level, or $1,428 per month.16
If you’re under 19, you might qualify under the Children’s Health Insurance Program (CHIP). CHIP is a federal program created to help states provide coverage for children in working families who earn too much to qualify for Medicaid.17 Ohio runs CHIP as part of its Medicaid program.
You can check your eligibility at any time of year through the Ohio Benefits website or the federal Marketplace website, or by calling the Ohio Medicaid Consumer Hotline at (800) 324-8680.
What Are Other Options for Coverage in Ohio?
A catastrophic health plan may be an option for you if you’re under 30. These lower-premium Qualified Health Plans are available through the Marketplace.18 Because of their high deductibles, you might have high out-of-pocket expenses before your coverage begins. The plans cover three annual primary care office visits and preventive services before the deductible is met.19
Ohio offers short-term plans as a temporary option. These plans can’t last longer than 364 days. They offer low premiums, but they aren’t required to follow ACA rules. That means they choose what to cover, and they can reject you or charge you more for preexisting conditions.
You can buy a short-term health insurance plan from the insurer or through a licensed insurance agent. Be sure you know what your plan covers.
What Are Resources for Ohio Students?
You can visit the Health Insurance Marketplace or call (800) 318-2596 to see if you qualify for subsidies on ACA plans or free or low-cost coverage. Check the state’s Medicaid eligibility website to see if you qualify, or call the Medicaid Hotline at (844) 640-6446.
If you decide to get health insurance, look at the many healthcare options available in Ohio, so you can pick the plan that fits you best before you head off to school.