A warning to all new college students about insurance confusion

How does this work for kids on Medicaid?! Do I just have no insurance when I turn 18? Will I have to get insurance through my school? I’m likely going OOS too. I don’t know if it transfers.

To the OP, my D2’s school also sent tips to the students. Parents there now have a “warning system” where an experienced parent posts on the parent FB page and in the parent Yahoo! group when the email is received (upper class students know enough to pass it on to their parents after the first year). This has played forward for a few years now.

Most schools still let you apply for a waiver if you have other insurance with sufficient coverage at school even if you miss the email (first indication to parents being the charge on the bill for fall tuition).

@Hamlon, Medicaid is a state program with state specific requirements. I believe it is at age 19 when you age out of Medicaid or CHIP, and have to apply as an adult under different criteria. With possible changes coming to the ACA and the associated Medicaid expansion, it is hard to say what the next 4 years will bring. I’d suggest you start a separate thread if you want to explore this topic on CC.

We have a BCBS HMO and it includes nationwide coverage. It’s not always an HMO vs PPO distinction. Check your specific policy.

Is that other than Emergency care? Is your plan thru an employer with an ERISA exemption? Is it self-funded by the employer?

Would that plan allow an out of state dependent child to pick a local primary care physician? Do they have contracts with local OOS hospitals for inpatient coverage other than Emergency care?

We have BCBS PPO through H’s employer (now that he’s retired, former employer). We have a family plan and it has provided coverage for both kids, in CA and throughout the US. D can choose whatever providers she wants. When she choses in-network, reimbursement is much better and our out-of-pocket is much lower. There is no deductible and H and I will have it for our lifetimes. D has seen several providers in CA and both kids have seen providers in Denver and NY and CA.

Our friends had a HMO that was supposed to provide coverage to their kids wherever they were, but unfortunately when their kids were injured, they were taken and treated at out-of-network providers on an emergency basis and that was VERY expensive for them.

@Hamlon

It depends on the state I’m guessing, but you may very well need to get insurance through your school as Medicaid often doesn’t cover anything out of the home state except an emergency.

Depending on the school, there may be financial aid to cover the cost of student medical insurance.

@Hamlon Like OHMomof2 said, Medicaid can only be used out of state at an emergency room so you will need college insurance if you attend OOS. You don’t lose your Medicaid when you turn 18- you will still have that for when you are in your home state during breaks and summers.

@hamlon, your medicaid may end when you turn 18 if you are in a state that did not expand medicaid (I think there are still 19 states that have not). You might be better off becoming a resident of the state where you will attend college and trying to qualify for medicaid in that state if offered. If may depend on whether you are still a dependent on your parent(s) or have another reason to maintain your official residence in your prior state (scholarships, tax benefits)

I just completed the waiver for my rising freshman. Assume that most colleges want students covered, so unless you can prove that they are fully covered on campus by the parent’s policy (or a state subsidized policy), you’ll be billed for the university policy. If you don’t know anything about this, start looking through the information sent to freshman by the school - it’s in the paperwork somewhere and timely - many have July 1 deadlines.

To complete the waiver, you’ll have to submit all of the insurance information, which will be reviewed - usually by a third party before the university policy is waived. My son’s school uses Gallagher Student Health.

@twoinanddone I might have to change residency because well…Texas.

@intparent @OHMomof2 @planner03 @twoinanddone
Thank you so much!! Didn’t mean to hijack this thread. I have more than enough info to mull over and plan ahead with.

@bluebayou, many Blue Cross Blue Shield plans (whether through an employer, or purchased in the individual or exchange markets) include coverage by the national BCBS network. A covered individual can go to any doctor or hospital in that (very broad) network in any state. It can be an excellent choice if you have kids going out of state to college, and can keep you from having to pay thousands for coverage through the college plan. I have seen rates for those plans provided by the colleges that ranged from around $1800 for the year (not including summer) up to $4000 for the 9 month period – it depends on the college. Another choice to insure a college kid is to buy insurance in the open market in the state where the kid goes to college, BUT – that can be problematic because the kid can’t easily and immediately prove that they are a resident of the new state, and they can be denied coverage. It is an ugly and complicated process; we have been dealing with it for several years due to not having a parent with a family plan where my youngest could be covered, AND we moved between states (neither state one where kid goes to college) in the middle of her college years. I am (painfully) well versed in exploring the options.

If you or anyone else decides to go the Blues route, make sure the insurance has the national network included. Starting last year, some of the Blues dropped the national plan from plans purchased through the open or exchange markets. Most employer plans still seem to have it, though. But you need to check the policy, and sometimes a call to the insurer is helpful. I also always need them to help with the search for doctors. The tool for looking up doctors online can be a little glitch, but a quick call to customer service has always gotten me the needed information.

In case you are interested in how that works, the doctor or facility that is local to your kid just bills their local BCBS, and the Blues take care of sending claims back and forth to the one that actually has your coverage. So it is pretty seamless to the doctor, and they generally will do the billing (so your kid doesn’t have to save receipts for later submission and reimbursement). My kid has been to urgent care and also specialists (broke her arm once while at college). But any coverage available at home (inpatient, mental health, ambulance, drugs, etc) is generally covered. During the school year, many small things can be taken care of at the campus health service. But they aren’t always open on weekends or evenings, can’t take care more complex problems, and often aren’t open if your kid is on campus for the summer.

Interesting that it came from the insurance company. We have always had to waive insurance coverage from the college, because our kids are on our plan. We had to prove that the student was covered and this goes back at least 10 years when my oldest started college.

What happened in previous years? Did you waive the school insurance or have you been paying it every year perhaps without knowing it?

Like some other posters, I’m really surprised it came from the insurance company rather than the school. My son would definitely have ignored a post from a random insurance company, and I probably would, too. I can’t begin to list the number of spam emails I get in a month threatening dire consequences if I don’t click on a link and fill in a form. That’s pretty crazy in my opinion. My biggest issue with the way my son’s school (Brandeis) does it is that they only send it to him; it’s in the summer; and it’s only two weeks before the deadline. Last summer he was in Israel and only checked his school email once a week or so. He forwarded it to me with 48 hours to spare. He could easily have missed it.

For us, the Blue Shield Away From Home Care (AFHC) program was a godsend. D had her own primary care physician in her college state and was back on our California plan when she was here during the summer or off on archaeology digs in Greece or Crete. We screwed up one time when she was home for Christmas and her regular doctor referred her for tests that were not approved in advance by the college state HMO (since she was technically under that plan at the time), but it got straightened out in the end. I have to say that the California AFHC people were the most competent and nicest health insurance folks I have ever dealt with.

Wonder what happened to the OP of this thread??

FWIW, I looked deeply into which plan would be primary before I made the decision to purchase the school plan. I wanted D’s expenses to hit the school plan first. It took many phone calls and emails to eventually get a pdf copy of the actual contract that spells out the coordination of benefits hierarchy.

The college told me my plan would be primary but that was incorrect. We haven’t yet put it to the test but the contract language is very clear. Most insurance companies follow the same national guidelines. A policy in a person’s own name is primary compared to a policy in which they are a dependent.

We have had dual coverage at other times & generally everything was covered 100%. However it sometimes took as long as a year for a claim to be finalized. The providers did not hassle me, if I called to follow up, they said the long time frame was expected.

I agree however that it is very difficult to keep all providers up to date even when you provide the insurance cards and inform them which plan is primary. Old info is still floating around, if stuff is sent to a lab, correct insurance info may not follow, etc.

Yes, it can take time to get insurance sorted out, especially if there is (or potentially is) dual coverage. Most providers are pretty patient with this and have experienced it before. It is important to be patient and persistent, getting names and contact info of helpful folks along the way.

I read, much more thoroughly than before, my BCBS policy but still had a few questions. Today, I spoke with a BCBS representative to get clarification on what I wasn’t sure about. The information I received previously led me to believe that my policy would be DDs primary insurance but that was not correct.

BCBS follows the guidelines that @alooknac stated below:

Therefore, Aetna, the school’s policy, will be my daughter’s primary policy because it will be in her name only. Since she is a dependent on my policy, BCBS will be secondary.

Since the school is paying for my daughter’s policy, as part of her fellowship, the representative stated (and I agreed after she explained how BCBS’s secondary policy works) that it would be good for DD to have both.

In general, dual coverage is great for the insured, as long as the costs of having both policies is reasonable. I have had dual coverage sometimes when I got insurance thru my employer and was also covered by a family plan thru H’s employer. My employer was always the primary policy and any other was secondary. Between the two policies, deductibles and copays were minimal or often $0.



Currently, H has dual coverage–Medicare A & B plus his former employer’s family plan. Between the 2, pretty much everything has been paid 100%–Medicare 1st, then insurer pays the rest.

Bumping this up. Just received the annual notice from my kid’s school about cost of mandatory Student Health Insurance and the waiver process. For most schools, it’s that time of year and you often must take a step to opt out and avoid an expensive charge. So, be on the lookout or check into it if you haven’t received notification.