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Concerned about healthcare as you head off to your college or university? Like most students, you may figure you don’t need health insurance because you’re healthy and hardly ever see a doctor. Young adults make up the age group with the highest uninsured rate.1 But if you want insurance, or if your school requires it, you have several coverage choices in West Virginia.
What You Need to Know
You can get insured through your parents’ plan or buy a plan for yourself.
Costs, benefits and restrictions vary significantly between available plans.
Some plans (student health plans and plans that meet Affordable Care Act requirements) have specific enrollment periods, while other types can be purchased year-round.
What Are the Health Insurance Options for West Virginia Students?
You have several options for student health insurance in West Virginia. Here are some details:
- Through your school: Many colleges offer affordable plans for students, either their own or through insurance companies.
- Through your parents’ health plan: If you’re under 26, you can stay on your parents’ plan.
- Health Insurance Marketplace plans: You can apply for a plan that meets the Affordable Care Act (ACA) requirements through your state’s Marketplace.
- Medicaid or the Children’s Health Insurance Program (CHIP): Based on your age and income, you may be eligible for no- or low-cost health coverage through Medicaid or WVCHIP (West Virginia’s CHIP).2
- Catastrophic health plans: If you’re under 30, you can access a high-deductible plan to cover you for severe injuries and illnesses.
- Short-term health plans: You can get plans that cover you for up to 36 months but are not ACA-compliant.
- Job-based health plan: If you have a job, you may get insurance through your employer.
On Your Parents’ Plan?
If you’re on your parents’ plan, make sure the plan has providers near your school, whether you’re an in-state or out-of-state student.
Why Do West Virginia Students Need Health Insurance?
Your school may require you to be insured for admission. You may also have a chronic medical condition that needs managing. One-sixth of young adults have a chronic health condition or illness.3
Having insurance also protects you against possible catastrophic losses, leading to extra debts after graduation because of a severe accident or sickness. U.S. government statistics4 say it can cost up to $7,500 to fix a broken leg and $30,000 to spend three days in a hospital.
College Health Plans
Many colleges and universities offer healthcare plans designed for students.
What to Consider When Searching for Student Health Coverage in West Virginia?
Here are some questions to think about.
Will You Attend School In-State or Out-of-State?
Whichever you choose, your parents can cover you through their Marketplace plan or job-based plan (if it covers dependents). In either case, make sure their plan has contracted with network providers near your school.
Can Someone Claim You as a Dependent?
If your parents claim you as a dependent, you won’t qualify for premium subsidies should you decide to buy 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’ insurance until age 26, whether their plan is through an employer or the Marketplace.5 Unless your parents have declared you as a dependent, you could get lower premiums by buying your own plan. Your lower income may qualify you for subsidies where theirs may not.
What Plans Are Cheaper?
Your (or your family’s) income will determine the cost of some plans, depending on the available assistance. You might be eligible for no- or low-cost Medicaid health coverage or subsidies on Marketplace plans. Catastrophic insurance policies also have low premiums, but they don’t qualify for subsidies.6
What Plans Offer Better Coverage?
ACA-compliant plans generally offer the most comprehensive coverage. By law, they must cover preexisting conditions and “essential health benefits.” These include hospital care, prescription drug coverage, maternity services and mental health services.
What If You Skip Health Insurance?
West Virginia doesn’t mandate health insurance, so you won’t pay a penalty for being uninsured. If you’re uninsured, you save on monthly expenses but risk larger out-of-pocket bills for any medical care. Remember, your school might require insurance for admission.
What Are Health Insurance Rules in West Virginia?
West Virginia runs its Marketplace as a partnership with the federal government. You can use the federal healthcare.gov website to shop and sign up for plans that the state manages.
Its expansion of Medicaid to non-parents or related caregivers means you can earn up to 138% of the federal poverty level as a single person ($17,609 in 2021) and still get Medicaid health coverage.7
How Do You Get Covered Under Your Parents’ Plan in West Virginia?
You can stay on or be added to your parents’ application during the Open Enrollment Period (or during a Special Enrollment Period if you qualify).8 As long as you’re under age 26, it doesn’t matter if you graduate, get married, have a child or no longer live in your parents’ home.9
How Do You Get Covered Under Your School Plan in West Virginia?
Many colleges offer student health plans, usually depending on your number of credit hours. These may be funded directly by the school or through a private insurance company, with costs and benefits varying by school. Costs for some plans may be charged with the school’s other fees, which lets you apply loans to your healthcare coverage. Your school’s admissions office will have more details.10
West Virginia University students are required to carry health insurance. Students who don’t present a health insurance waiver will be automatically enrolled in Aetna’s student health plan.11 The premium ($1,086 per term in 2021) will be billed to the student’s account.12
At Marshall University, Marshall Health provides student healthcare, linked to the Marshall University School of Medicine. Aetna Student Health offers the school’s student health insurance plan to uninsured students at an annual premium of $1,720.13
At Shepherd University, while individual insurance isn’t required, it’s strongly recommended. Its Health Center suggests students stay on their parents’ health insurance plan, enroll in Medicaid, enroll in a student health plan or buy a plan through the Health Insurance Marketplace.14
How Do You Get Covered Through the Affordable Care Act in West Virginia?
You can buy an ACA-compliant Qualified Health Plan through the West Virginia Marketplace (at the healthcare.gov website) or off-exchange (through certified insurance agents or insurance providers). Only plans purchased through the Marketplace may be eligible for subsidies.15
If you aren’t already on your parents’ plan and you’re eligible, they can add you during the plan’s yearly Open Enrollment Period (OEP), between November 1 and January 15 each year. You can be added outside of the OEP if you’re eligible for a Special Enrollment Period after a life event, such as losing other health coverage.
Since Marketplace plans are purchased on a month-to-month basis, you can buy one for less than a full year.
Subsidies on specific Marketplace plans can lower your out-of-pocket expenses if you’re eligible. You can estimate your ACA subsidies as an advanced premium tax credit (APTC) or cost-sharing reductions (CSR).
How Do You Get Covered Through Medicaid or CHIP in West Virginia?
West Virginia has expanded its Medicaid coverage to low-income adults who aren’t parents or caretaker relatives.16 If you apply for insurance through the Marketplace website at any time of year, you’ll be notified if you’re eligible for Medicaid or WVCHIP. (CHIP was created for working families with too much income for Medicaid, but with no health insurance for their children under age 19.)17
What Are Other Options for Coverage in West Virginia?
You can also get catastrophic health plans, which are available through the Marketplace to those under 30.18 These Qualified Health Plans can protect you against major medical expenses. Still, you may have to pay large amounts out-of-pocket before your coverage begins because of their high deductibles.19
On short-term plans, West Virginia defaults to the federal rules that allow an initial term of up to 364 days and a total of 36 months through renewals.20 However, insurance companies can limit the length of coverage, what’s covered and who they’re willing to cover.21
What Are Resources for West Virginia Students?
You can visit West Virginia’s Health Insurance Marketplace website to see if you qualify for free or low-cost coverage.22 If you need help enrolling, you can find a certified health insurance agent, navigator or assister on the Office of the Insurance Commissioner’s website.23
Next Steps
As you make your important decisions about college, be sure to include health insurance. With a variety of options available in West Virginia, you can find a plan that meets your needs.
