My child is going to school in California (or a different state than I reside) what should he do about health insurance? Currently, he is covered by a plan in the state our family lives.

Admittingly, health insurance is less fun than picking out bedding for the dorm, but arguably more important.  The answer to this question depends on out of state coverage on your current health plan, the school’s health insurance requirements and offerings, and your child’s own healthcare needs. 

Here is a general list to help proceed:

  1. Call your insurance carrier first.   The member’s services number or website on your card will provide information about national healthcare networks and emergency coverage provided on your plan.  What charges are associated with office and emergency visits, are they in or out of network?  If the health coverage on your existing plan is comprehensive in the school’s state, make sure your child has a copy of his medical card AND make sure that you have the important documents signed by your child, detailed in 4 below.

     

  2. No insurance coverage in the school state?  Check with the campus health center, do they offer a student health plan through the school?  What does the plan cover?  Will it satisfy any school or sports requirements for the student to have insurance?  Is it just for emergencies and is it limited to the school health center only?  If the plan will suffice, make sure you have a copy of the student medical card AND the signed documents detailed in 4 below.

     

  3. If coverage under your existing health plan or the school’s existing health plan do not suffice, consider buying the student an individual health plan through the state that the school is located.  Use the services of an agent to help you determine the best plan option.  In California, we can help you, at www.eindividualhealth.com  Note that if you are buying a plan outside of the open enrollment period  http://blog.filice.com/compliance/open-enrollment-for-individual-plans-tips-truths-and-considerations , you need a qualifying event to purchase https://www.healthcare.gov/glossary/qualifying-life-event/ .  Moving states to attend school qualifies by signing an attestation statement available through the insurance marketplace in some states.  Again, use an agent to help you with this.  You can find an agent in your state through the National Association of Health Underwriters, https://nahu.org/looking-for-an-agent/find-an-agent or use the Federal Insurance Marketplace to find local help https://localhelp.healthcare.gov/#/ .  BE WARY OF SCAM HEALTH PLANS, USE AGENTS LICENSED AND CERTIFIED IN THE STATE YOU ARE PURCHASING A PLAN. 

     

  4. IMPORTANT DOCUMENTS.  18 is a milestone birthday, reached by most young adults prior to leaving for college.  At 18, the Privacy Rule of the Health Insurance Portability and Accountability Act, or HIPAA takes effect.  This means that without permission from your child, you are not entitled to discuss their medical conditions or make decisions for them, not ideal in the event of an emergency.   The exact documents vary from state to state, but in general, they include HIPAA Authorization, Medical Power of Attorney, and Durable Power of Attorney.  Additionally, the school may have campus specific forms.  Work with an attorney in your state to ensure all the necessary documents are drafted appropriately.    You can read more on Consumer Reports website https://www.consumerreports.org/health/help-your-college-age-child-in-a-medical-emergency/.

     

  5. The student should go to the doctor before he leaves for school.  It is a prudent to have a physical, update prescriptions, see the dentist and tend to any other health care needs.  An ounce of prevention is worth a pound of cure. 

Good Luck to all of the young adults starting on new journeys and exciting studies, you are all the future.