As you’re getting your son or daughter ready to head off to college in Texas, there’s one thing that may not be on your to-do list: finding out if he or she needs to have health insurance.
Some Texas colleges and universities require students to have a comprehensive health insurance plan, but most do not. Most schools in the state offer what’s called a Student Health Insurance Plan (SHIP). These academic health plans usually provide broad coverage at a lower cost than many private insurance plans, mostly because they insure a relatively healthy group of people.
What You Need to Know:
Most Texas colleges and universities don’t require students to have health insurance, but all strongly recommend it.
Many schools in the state offer their own affordably priced Student Health Insurance Plans (SHIPs) that usually cover all basic student health clinic fees and include discounts on other services.
If you want to keep your existing plan, you may need to get a waiver from your college saying your plan provides adequate coverage according to the school’s requirements.
Texas schools that do require health insurance coverage won’t always accept a student’s existing health insurance coverage (typically under their parent’s plan), either. You may need to follow the school’s process to verify that your child’s current coverage is sufficient to obtain a waiver.
It’s wise to know what to expect and what your options are for health insurance; doing a little homework ahead of time might avoid some unpleasant surprises later.
Why Texas Students Need Health Insurance
Many college students are young and healthy, but illness and accidents can happen to anyone. If they do, these unexpected medical expenses could even prevent a student from completing their degree. That’s why some Texas colleges and universities require — and all recommend — that every student has a policy that includes coverage for emergency services, hospitalization, outpatient care, prescription medications, preventive care and mental health services.
Not only will this comprehensive coverage ensure a student will be treated for more serious health issues that can’t be handled at the campus health center, but it also helps to avoid crushing medical debt.
Nearly all Texas schools provide campus-based services for minor health issues like flu, sprains and infections. Most don’t charge a fee for basic services as long as the student has the school’s SHIP or pays a health-services fee. This fee is often included as part of the bill for tuition, room and board and other fees for the semester or school year, so you might not even notice it unless you take a close look at your bill.
Coming From Out of State?
Are you coming to school in Texas from another state? Be sure your current plan will cover you and that you can access any medical providers you might need.
What to Consider When Searching for Student Health Coverage in Texas
Here are some questions to consider when looking for coverage:
Are You a Texas Resident Attending a Texas School?
Not only does every state have its own set of health insurance regulations, each school determines what coverage, if any, is sufficient for its students.
If you’re a Texas resident who’s attending a Texas school, it’s likely that whatever coverage you currently have — whether that’s your parent’s health insurance plan, Medicaid coverage, or a federal or state Health Insurance Marketplace plan under the Affordable Care Act (ACA) — will provide the same coverage while you’re in school. It may not, however, cover you for campus student health services, although it should provide coverage for off-campus providers that are in your plan’s network.
If you’re a resident of another state who’s coming to Texas to study, though, your current insurance plan may not cover you and any providers you’d need to see would likely be out of your network.
Can Someone Claim You as a Dependent?
If your parent(s), a guardian or someone else can claim you as a dependent on their income tax return, it’s likely you can remain on that person’s health insurance plan, if they have one, until you’re 26. If your parents are applying for an ACA Marketplace plan (also known as Obamacare) during the Open Enrollment Period, they can include you, too.
If you’re leaving your home state to attend college in Texas, you can apply for an ACA health insurance plan in Texas on your own and still remain a dependent for tax purposes, although your parent’s income will be considered on the Marketplace application if you are a dependent.
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. Cost and coverage (meaning what benefits are included) are key considerations, of course, especially if you have a preexisting condition or are at risk for illness. It may cost you little or nothing to remain on your parent’s plan, and that policy might provide better benefits, especially if you continue to see a specialist or other providers back home.
Another consideration is privacy. Although access to your medical records is protected by signing a HIPAA (Health Insurance Portability and Accountability Act) form if you’re 18 or older, if you remain on your parent’s plan they will have access to statements and explanation of benefits information from the insurance company.
Sticking With Your Parents’ Plan
For many students (but not all) staying on their parent’s plan while they’re away at college is the most economical option.
Which Offers the Best Value?
Many colleges offer their own affordably-priced SHIP through an academic insurance carrier; your school’s website should provide a list of plan benefits. Be sure to look closely at all the costs, which include:
- Premiums: the annual cost to have insurance, paid monthly
- Deductible: the amount you have to spend before your plan starts to contribute toward your healthcare expenses
- Copays for doctor’s office visits and/or medication
- Coinsurance: your share of a payment against a claim, which kicks in after you’ve met your deductible
Together, these costs could be more than what you’d pay under your parent’s plan. Remember, too, that the deductible for a family plan is usually met much more quickly than a plan covering only one person.
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 where you’ll be going to school?
- Does your college’s student health plan only include providers from its own healthcare system?
- Is there prescription drug coverage?
- Are mental health and preventive care covered?
- Do you have a preexisting medical condition that requires frequent treatment and/or medication? If so, are there in-network providers on your parent’s plan or qualified local providers if you switch plans?
- If you study abroad, will your plan cover you while you’re there?
What If You Skip Health Insurance Coverage?
Even though most colleges in Texas don’t require students to have a comprehensive health plan when they enroll, as mentioned above, students risk incurring medical debt should they get sick or injured and the student health center can’t handle it.
Students can usually access basic primary and preventive care services at the student health center for nothing or a small fee. Most campuses accept some in-network health plans in addition to their own SHIP. You can usually find a list of in-network plans on the school’s website. You will be responsible for paying all costs that aren’t covered by your health fee, SHIP or your insurance plan.
What Are the Health Insurance Rules for Students in Texas?
Texas law states that public higher education institutions with medical, dental, nursing and public health schools may require students to be covered by health plans. This primarily affects graduate students, although some undergraduate programs, such as those at Texas A&M’s School of Nursing, require student health insurance.
The requirement is based on these students’ exposure to health risks while delivering patient care during their clinical experiences. Other Texas A&M undergraduates aren’t required to be insured but the school does offer its own SHIP and will submit student health center charges to private insurance. It won’t, however, submit charges to Medicaid or a Children’s Health Insurance Plan (CHIP).
How to Get Covered Under Your Parent’s Plan in Texas
The ACA requires insurance plans to offer dependent coverage for children up to age 26. And if your parents claim you as a dependent and you live and attend college in Texas, they can obtain coverage for you on their private health insurance plan if it offers dependent coverage.
If you go to college in Texas and your parents live in a different state, your coverage on their plan should apply to Texas providers as long as the policy is network-based and there are Texas providers in the plan’s network.
How to Get Covered Under Your School Plan in Texas
The best place to get information about student health insurance requirements and opportunities for coverage is on your school’s website. Health insurance is required at Rice University, Southern Methodist University, Texas Christian University and Texas Tech, among others, for any student taking nine credit hours or more. These schools all offer a SHIP plan and have a process for obtaining a waiver if you want to use your or your parent’s current health plan.
The Student Health Center at the University of Houston accepts no insurance other than its own SHIP. Students without its plan can pay a discounted rate at the time services are rendered. You will be given a statement you can send to your own insurance plan to seek repayment.
The University of Texas at Austin’s SHIP provides 100% coverage of all student health services, plus in- and out-of-network benefits for off-campus providers. Deductibles, copays and coinsurance may apply for off-campus services.
At Texas A&M University, health insurance isn’t required to receive on-campus student health services and the school will submit charges to its SHIP or to a student’s own health insurance plan if you have either. Anything not paid will be added to your account with the school’s business office.
Baylor University encourages students to have health insurance coverage, either through its SHIP or their own insurer. Access to campus student health services is open to everyone regardless of coverage but unpaid charges are placed on the student’s account.
Some school-provided plans may allow you to use your financial aid package to pay your monthly premiums.
How to Get Covered through the Affordable Care Act in Texas
Texas does not have its own state ACA Health Insurance Marketplace where you can buy a health plan. Instead, it participates in the federally facilitated Marketplace, operated through healthcare.gov.
Students may be added to their parent’s Obamacare plan during the annual Open Enrollment Period, or apply on their own for coverage in Texas. Moving to Texas to go to college may also qualify you to enroll during a Special Enrollment Period.
Applying on your own might also qualify you for premium subsidies offered under Obamacare, which helps you pay premiums if your income qualifies you. That’s because by applying on your own, only your income will be taken into account, not your family’s household income.
If your only coverage will be through the school’s plan, make sure it’s considered qualified health coverage as defined by the ACA.
How to Get Covered through Medicaid or Children’s Health Insurance Plan (CHIP) in Texas
The Texas Medicaid program is open only to low-income pregnant women, children and parent and caretaker relatives, Supplemental Security Income (SSI) recipients, people who are disabled, those age 65 and older, and former foster care youth.
CHIP coverage is only available for children through the age of 18 whose family income exceeds Medicaid limits but who can’t afford insurance.
Application for Texas Medicaid or CHIP coverage is handled through the Texas Health and Human Services website.
What Are Other Options for Coverage in Texas?
Catastrophic health insurance plans have low premiums but high deductibles. People under the age of 30 are eligible to apply for a catastrophic plan, which meets the Affordable Care Act’s qualifying health coverage standard. These plans provide the same essential health benefits and some preventive services as regular Marketplace plans. Check with your college to find out if it will accept a catastrophic plan as coverage if health insurance is required.
Short-term health insurance plans are affordable and it’s typically easy to enroll, but they don’t cover all essential health benefits as defined by the Affordable Care Act and therefore don’t count as qualifying health coverage under Obamacare.
In Texas, short-term plans may provide coverage for up to 364 days and you have the option of renewing for up to a total of 36 months. A short-term plan might be a good choice if you’re waiting for permanent coverage to kick in. Again, if your school requires health insurance, check to see if a short-term plan provides sufficient coverage to obtain a waiver.
There are a variety of travel health insurance plans that may provide coverage for students while studying abroad, either fully or as gap coverage for benefits not covered by your existing health insurance plan. Most SHIP plans do offer limited coverage for students studying abroad.
Resources for Texas Students
ACA Subsidy Calculator – provides a tool to calculate what type of subsidy you might be eligible for if you choose an ACA plan
Aging Out at 26 – provides information about insurance options when you age out of remaining on your parent’s plan
Healthcare.gov – provides information about ACA plans, coverage, eligibility and enrollment applications. See also information specific to college student coverage.
Short-Term Health Insurance Explained – provides general information about short-term health insurance coverage
Short-Term Health Insurance in Texas – provides specific information about coverage in Texas
Student Health Insurance/Benefits Plans Coalition – provides recommendations and standards for college SHIPs nationwide
Texas Health Insurance – provides information about general health insurance options in Texas
Texas Medicaid Program – includes eligibility requirements and applications
Though most Texas colleges and universities don’t require students to have health insurance, it’s a wise decision to have coverage. Finding which plan provides the best benefits for you at the best price requires a little homework, though the right option may be to remain on your parent’s plan, if possible.
If you aren’t a Texas resident, make sure you talk to your existing plan provider, if you have one, about any coverage limitations while you’re going to school.
And unless you’re buying the college’s plan, learn about the process for getting a waiver stating that your current plan is sufficient. That way, you can focus on school, knowing you’re covered for any health issues, should they arise.