Health Insurance For Out Of State Child

Hey,

I can’t believe I can’t find definitive answers or even discussion about this…

Currently have old, grandfathered health insurance that has out of network benefits. I have a child going to a school out of state that does not offer health insurance to students. They do have a health center that has some basic benefits for low cost. But he’s covered under my existing plan, so all has been good.

My plan just jumped another $270 for 2019. This is nearly unaffordable. I want to look at other plans. I think “I should get him a plan in his school area”, but then what do I do when he is home for the summer? If I get a new local plan with all of us, that leaves him pretty much high and dry at school, instead. He is healthy, doesn’t do anything risky, but what if he gets hit by a car, or something unforeseen? Aside from emergency room coverage, which has to be charged at in-network rates, I could be on the hook for physical therapy or follow up visits or anything. If I get him a plan there, the same thing could happen here, and then I’m out of luck again.

I can’t be the only person dealing with something like this in the world. What do others do? Get two policies? Take the chance?

Thanks.

You will find that it probably isn’t cheaper to get 2 policies. But if you want to look, many Blue Cross Blue Shield plans would cover him in both places. They are picky about state of residence, which can be complicated when buying a policy. One tip - in the past, if you buy the BCBS policy through the ACA exchange for that state, you may not be asked for as much proof of residency paperwork.

There is no BCBS on the exchange here. I’ve got Cigna and Amhealth, the latter appears not to cover any of our medications.

@sj1970

Moving is a qualifying event.

Your student can have a health insurance policy purchased on the individual market in the state your student will be attending college.

Then, when the student is living at home again for summer, you can drop that policy and purchase a health insurance policy purchased on the individual market in your home state. Then, when the student returns to school, sign up for a policy again in that state.

This may or may not be cost effective. You’ll have to look in to the dirty details on both ends (both states). Don’t be surprised if it’s…frustrating. Your options, naturally, will depend on the state-county of residence.

I’m very surprised the college doesn’t offer major medical to OOS students.

Interesting.

No, they only offer it to grad students and foreign students.

@sj1970

Somewhere on the ACA Marketplace website – Healthcare.gov?? – there is a list of qualifying events (for being able to purchase polices outside of the open enrollment period, and college student is one example given.

I can tell you, from experience, it may take talking to more than one customer service representative in order to get an accurate answer.

Short-term major medical policies are perhaps another option for the summer months, albeit with pros and cons and a degree of risk-taking not everyone is comfortable with.

Also, you could try a health insurance broker and ask some questions, in case there are Blue Cross Blue Shield (or other company) student plans available for purchase, not through the college.

Now that they have opened up the short term market again, you could look for two policies. One for the 9 or so months he’s away at school and another for the few months he’s home. Kind of adequate for the young and healthy.

Are any of the options PPOs with a nationwide network of docs?

He probably won’t qualify for ACA subsidies as he’s a student and making well under the minimum (I think it’s about $20k) so an ACA policy is going to be full price, and expensive. If he is going to a school in a medicaid expansion state, he may qualify for medicaid IF he becomes a resident of that state.

My insurance didn’t work for my daughter OOS, so I did buy the school insurance plan. It was about $1200 per year. In the entire time she was there, it paid for a few strep tests, some flu things (i really don’t know what) and some prescription co-pays. She’d get bills for small amounts ($5, $11) which were co-pays or deductibles. In the end, it would have been cheaper to just pay for the charges at the student health center over the years, but you don’t know that when signing up for insurance and of course, it is insurance not a guaranteed investment and just like with car insurance, you really hope you don’t need to use it. I felt she needed insurance as she was an athlete and I didn’t want to pay for an MRI or ACL surgery OOP, and I’m grateful the insurance premiums were ‘wasted’ payments. This summer she had a norplant put in and it was like $3000 (really!) and although it was done here where my insurance does work, the school insurance was deemed ‘primary’ so they paid most of it and my insurance picked up about $200 of the costs not covered (I think it was the deductible). Now she’s working and has her own policy through her employer. Third policy this year and it would be 3 deductibles/co-pay maximums, but luckily, she’s overall pretty healthy (except for strep throat and the flu) and hasn’t paid any deductibles OOP.

YMMV, of course, but I have never been comfortable considering being uninsured or having anyone I cared about uninsured for ANY period of time (I’m very risk averse). Our policy did cover our kids when they were out of state and continues to allow us to see any provider throughout the US (in-BCBS network has better coverage and nearly all the providers we’ve ever wanted have been participating & preferred).

For our S, we did buy the University policy the year he was aging out and when his U policy ended and he moved back to HI to await the start of his job, we bought him a monthly policy until he was again covered as a family member under our family policy.

Our friends had a D who danced ballet in college. They had a HMO and got a waiver for her buying a policy at her U. She was injured and rushed to a nearby out-of-network hospital for treatment and surgery. It was VERY expensive and the dad thereafter always bought the policies at the U for the Us his kids attended. It was a good thing as they had other major medical expenses that fortunately were covered.

You may wish to contact an independent insurance agent to help review your options and provide some advice. We only pay a nominal per policy fee for them to help us with our policies. They also review our policies to help make sure we don’t have gaps in coverage for liability. (Haven’t yet used them for medical insurance, but understand they can be helpful.)

OP, your local plans should cover him while he’s at school for emergencies and at out of network rates for anything else. You have to decide how comfortable you are with that. For my daughter, because she played sports, I thought she needed something local because it was more likely she’d get hurt and need continuing care, not just an emergency (which would have been covered), so I paid for the college policy. For my other daughter, who goes to school just 2 hours away but in another state, we didn’t get the school policy because she could just come home for any illness or treatment. If it was a serious or lingering illness, it might have required her to take a semester off school.

You might find a family plan that is more generous with OOS coverage. If your son doesn’t have a lot of every day medical expenses and can take care of things while home on vacations, he might be fine with just emergency coverage.

Catastrophic coverage? Sometimes a good option for healthy, under 30s. Depending on the state, coverage runs approx. $100/mo and generally covers 3 ‘free’ office visits per year at zero fee and a deductible of around $7500. Assuming no major health catastrophes, this could be a good option. even with major health catastrophe, the deductible is not much more than a regular plan that has higher monthly payments.

“Moving” is a relative term. Insurance companies often require proof of residency, and can be very stubborn about requiring certain documents —college student or not.

Also, even if your exchange doesn’t offer BCBS plans, you can go directly to the company to purchase. You will still (as of this moment, although the future is unpredictable) get the same ACA protections you’d get in an exchange plan. However, some BCBSs don’t sell individual products that include their national network coverage. In the past few years, some of them have stopped. So you have to ask. And they will want proof of residency. We personally found this easier to provide in my/kid’s home state than in the college state. We went through the purchase/renewal process 4 different years with 3 BCBS providers, so I’ve seen the gambit of hassles with this.

What does the COLLEGE require in terms of coverage? My kid is attending a school that didn’t have health insurance BUT they required a certain level of coverage…and it was a lot more than emergency care.

So…start there. What does the college require in terms of health care coverage?

Good question. I’d assumed that if the college didn’t offer a plan, they wouldn’t have a requirement for the student to have coverage. But that is clearly a wrong assumption on my part.

@intparent yes…in our case, the college DOES have a minimum requirement for health insurance coverage, and emergency care only did not meet the minimum requirement. I should add, this became problematic for students, and this year the school reinstated a school plan. There were just enough OOS kids who couldn’t get that minimum coverage easily.

If the school doesn’t offer a program it’s pretty hard for it to require a certain coverage. It’s not like they can say ‘you must go buy a Blue Cross policy’ if they don’t offer that and can’t add it to the bill. Some states don’t have more than one provider and if your student is not a resident of that state, even that might not be available.

@twoinanddone schools do not recommend a specific policy…but many do have minimum health insurance requirements. Our kid needed to have more than ER coverage. She needed doctors in the area and hospital coverage should she need to be admitted…the school specified the level of coverage they required.

And yes, they can…and do require a certain level of coverage at some colleges. Heck even when my kids were on my work coverage, I had to show proof that the coverage I had met the college minimum requirements.

But if the insurance isn’t available, and isn’t available in the state to OOS residents, how can the schools require it? How do they enforce it if they can’t add the premium to the tuition bill? Do they expel the student?

When ACA-level coverage was required (or there was a tax penalty), both schools my kids attended just asked if they had insurance, I could check yes or no, and that was it. I know other schools are more strict, but what can they do if they do not offer insurance?

How can anyone make anyone get coverage? Why is it even the school’s problem? It’s none of the schools business. If a kid gets sick to the point the insurance kicks in he’s probably leaving school anyway. Recovery and school don’t mix all that well.