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What You Need to Know:
Most Pennsylvania colleges and universities require students to have health insurance.
Most schools offer their own student health plan as a coverage option.
Pennsylvania expanded Medicaid coverage under the Affordable Care Act
Are you heading to Pennsylvania for college? Do you have your health insurance plan? If not, you need to give it some thought because most Pennsylvania schools require it.
Although the Affordable Care Act (ACA) mandates that you can stay on your parent’s plan until you reach age 26, that plan may not offer the coverage you need. The good news is that you have options.
Why Pennsylvania Students Need Health Insurance
Most college students are young and healthy, but illness and accidents can happen to anyone. If they do, these unexpected medical expenses could be very costly. That’s why most Pennsylvania colleges and universities require every student to have health insurance.
More Than the Monthly Cost
If you’re shopping for a health plan, there’s more to consider than the cost of the monthly premium.
Will You Attend School In-State or Out-of-State?
If you’re a Pennsylvania resident attending a Pennsylvania school, your current health insurance may provide the same health coverage while you’re in school.
If you’re a resident of another state who’s coming to Pennsylvania to study, your current insurance plan may not cover the physicians, hospitals, or other providers near your school.
Can Someone Claim You as a Dependent?
If someone else claims you as a dependent on their income taxes, that impacts how you answer questions about household income and household size if you’re applying for an ACA plan or a low-cost or free government plan.
Will You Stay on Your Parent’s Health Insurance Plan or Enroll in Your Own Plan?
There are a few factors to consider when making this decision. It may cost you little or nothing to remain on your parent’s plan. However, if you’re attending school in a different city or as an out-of-state student, check with the insurance company to make sure there are in-network providers near your school. Most schools require your plan to have local providers so if your current plan does not, you’ll need to shop for one that does.
What Plans Are Cheaper?
When evaluating a plan, be sure to look closely at all the costs, which include:
- Premiums: the annual cost to have insurance, paid monthly
- Deductible: the amount you must spend before your plan starts to contribute toward your healthcare expenses
- Copayments: for doctor’s office visits and/or prescription drugs
- Coinsurance: your share of a payment against a claim, which kicks in after you’ve met your deductible
What Plans Offer Better Coverage?
To determine if a plan has the coverage you really need, start by answering these questions:
- Are there in-network providers within easy access of campus?
- Is there prescription drug coverage?
- Are mental health services and preventive care covered?
- Do you have a preexisting medical condition that requires frequent treatment and/or medication?
What If You Skip Health Insurance Coverage?
Health insurance is mandatory at most Pennsylvania colleges and universities, so opting out of coverage won’t be an option.
How to Get Covered Under Your Parent’s Plan in Pennsylvania?
The ACA requires insurance plans to offer dependent coverage for children up to age 26. If you go to college in Pennsylvania and your parents live in a different state, make sure there are in-network providers near your campus.
Sticking with Your Parents
You can stay on your parent’s health plan until you’re 26, but it may not provide the coverage you need.
How to Get Covered Under Your School Plan in Pennsylvania?
Check your school’s website for information about campus health services and health insurance requirements, coverage options and plans.
Among the universities requiring health insurance coverage are Penn State, Temple University, and University of Pittsburgh. Because it is mandatory, full-time undergraduate students, international students and graduate students must provide proof of comprehensive health insurance that includes providers in Pennsylvania.
These schools all offer reasonably priced student health insurance plans for uninsured students and those who do not meet the coverage requirements under an existing plan.1
How to Get Covered through the Affordable Care Act in Pennsylvania?
As of 2021, you can enroll in an ACA plan on the state-run exchange known as Pennie. The 2021 monthly premiums for Pennsylvania plans ranged from $306 to $427, depending on plan level.2 Use this subsidy calculator to check if you qualify for federal help paying for an ACA plan. Students may be added to their parent’s Obamacare plan during the annual Open Enrollment Period, or apply on their own for coverage in Pennsylvania. Moving to Pennsylvania to go to college may also qualify you to enroll during a Special Enrollment Period if you miss the Open Enrollment deadline.
Depending on your age and dependency status, you will apply with your parents or on your own.
- Apply with parents:
If you are under age 26 you can be included on your parent’s application if they’re also applying for coverage under a Pennsylvania Marketplace plan.
- Apply on your own:
If you are over age 26 or are moving to Pennsylvania for school, you will apply for your own plan.
If you’re under 26 and your parents claim you as a dependent on their tax return, you are part of their household even if you’re not living at home. When the application asks for household income, include yours plus your parent’s. If you’re not claimed as a dependent on anyone’s tax return, you should include only your income. That makes it more likely that you’ll qualify for a subsidy.
How to Get Covered through Medicaid or CHIP in Pennsylvania?
Pennsylvania expanded its Medicaid program, Medical Assistance, under the ACA. You may qualify for Medicaid if your income is below a certain threshold and your parents don’t claim you on their tax return. The current income threshold is less than $17,131 for a household of one person.3
Children’s Health Insurance Plan (CHIP) coverage is available for children under age 19 who are not eligible for Medical Assistance.
Applications for Medical Assistance and CHIP are handled via online application on the state’s COMPASS website.
What Are Other Options for Coverage in Pennsylvania?
Catastrophic health insurance plans have low premiums but high deductibles. People under the age of 30 are eligible to apply for a catastrophic plan. These plans have lower premiums, in exchange for high deductibles and out-of-pocket costs.
Short-term health insurance plans are temporary plans that bridge coverage gaps between major medical coverage. They are not required to cover preexisting conditions or essential health benefits like ACA plans do. These plans are limited to 364 days of initial coverage and renewals are limited to 36 months.
Resources for Pennsylvania Students
Healthcare.gov – provides information about ACA plans, coverage, eligibility requirements, and enrollment applications.
Penn State – provides information about student health insurance requirements, waivers, and the university’s School Health Insurance Plan (SHIP)
Temple University – provides information about student health insurance requirements
University of Pittsburgh – provides information about enrollment for the university’s health plan and waiver requirements
Next Steps
Most Pennsylvania colleges and universities require students to have health insurance coverage to remove a potential impediment from earning a degree. If you are required to have insurance, it might as well be the best possible coverage for you. Do your homework and go to school knowing you have healthcare covered.
