Jane Dotson
College students have a variety of health insurance options, including university insurance and Medicaid. Many colleges and universities require students to have health insurance and offer their own health plans, often called campus health insurance or student health plans. These plans typically cover essential health benefits and may be bundled with tuition and health-service fees. Students can also explore other options, such as remaining on their parent's health plan until the age of 26 or enrolling in their state's health insurance exchange, where they may be eligible for premium subsidies. Additionally, Medicaid is available for students with limited incomes in states that have expanded the program. When deciding on health insurance, it is essential to compare benefits, costs, and eligibility criteria to find the best option.
| Characteristics | Values |
|---|---|
| Can I have university insurance and Medicaid? | In the US, most colleges and universities require students to have health insurance. Students can buy health insurance from their college or university in most cases. This is called a "student health plan" or "campus health insurance". However, students can also apply for Medicaid if they meet the eligibility requirements. |
| University insurance cost | The cost of university insurance can vary, but it is typically around $2,000 to $4,000 per academic year. This expense is usually included in a student's tuition bill. |
| Medicaid eligibility | Medicaid is a federal program that provides health coverage to people who meet certain income and residency requirements. As of 2025, Medicaid has been expanded in 40 states to cover adults under 65 with incomes up to 138% of the federal poverty level. |
| Student health plan compliance | Nearly all student health plans offered by colleges and universities are fully compliant with the ACA, with a few exceptions. ACA-compliant plans cover pre-existing conditions and essential health benefits, and do not have annual or lifetime benefit caps. |
| Subsidized insurance | Students can qualify for subsidized insurance through the ACA Marketplace/exchange even if they are eligible for a student health plan, as long as they do not enroll in the university's plan. |
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What You'll Learn
Income and eligibility
Medicaid provides free or low-cost medical benefits to eligible individuals with low incomes. Each state has its own requirements and income thresholds, and individuals must be residents of the state in which they are receiving Medicaid. Certain eligibility groups do not require a determination of income by the Medicaid agency. For example, children for whom an adoption assistance agreement is in effect under title IV-E of the Social Security Act are automatically eligible, and young adults who meet the requirements as former foster care recipients are eligible at any income level.
In some states, individuals aged 65 or older or those with blindness or a disability are eligible for Medicaid, and their eligibility is generally determined using the income methodologies of the SSI program administered by the Social Security Administration. States have the option to establish a "medically needy program" for individuals with significant health needs whose income is too high to qualify for Medicaid under other eligibility groups. These individuals can become eligible by "spending down" their income to meet the state's medically needy income level.
For college students, there are several options for health care coverage. Firstly, students can remain on their parent's health insurance plan until the age of 26, regardless of their dependency status for tax purposes. Secondly, they can enrol in a student health plan offered by their college or university, which is often an easy and affordable way to obtain basic insurance coverage. These plans are typically regulated by the ACA and cover essential health benefits. However, it is important to note that self-insured student health plans are not subject to HHS regulation and may not provide the same level of coverage.
Finally, college students may be eligible for Medicaid or subsidized insurance through the Marketplace, depending on their income and the state's eligibility requirements. If a student's parent is applying for Marketplace coverage in a different state, they should include the student on their application as a tax-dependent, even if the student does not need coverage.
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Medicaid expansion
The Affordable Care Act (ACA) has expanded the options for college students to get health insurance coverage. The ACA's Medicaid expansion has extended eligibility to cover more low-income Americans. As of early 2025, Medicaid has been expanded in 40 states and the District of Columbia, with a total enrollment of about 20.9 million people as of June 2024.
The ACA allows young adults to remain on a parent's health plan until they turn 26. If a student is attending college in another state, it may be more practical to get a new health plan that includes providers in the area. If the student is eligible for Medicaid, they should check the eligibility rules for their home state and college state.
Students can also purchase individual coverage or obtain student insurance through their university. Most student health plans offered by colleges and universities are fully compliant with the ACA, with a few exceptions. However, if a student health plan is self-insured, it does not have to comply with the ACA, and some schools with self-insured plans have opted not to bring their plans into compliance with the ACA. It is important to note that the premium subsidies provided by the ACA cannot be used to offset the cost of student health insurance.
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ACA-compliant plans
When the ACA was first implemented, you could be subject to a federal tax penalty if you weren't covered by a health plan that met or exceeded the ACA's minimum essential coverage requirements. The federal tax penalty no longer applies, but state penalties may still apply in some states. If you believe you may be eligible for an exemption, you can learn more at Healthcare.gov about fees and exemptions.
Most student health plans offered by colleges and universities are fully compliant with the ACA, with just a few exceptions that don't affect the enrolled students. However, if a student health plan is self-insured, it doesn't have to be compliant with the ACA. Some schools with self-insured student health plans have opted not to bring their plans into compliance with the ACA.
If you are a student, you can remain on your parents' health plan until you turn 26, regardless of whether your parents claim you as a dependent for tax purposes. If your parents' group health insurance plan includes additional children and your parent works for a large employer, the payroll-deducted premium is likely the "family" rate, and it won't go down if one child is removed from the plan. In that case, staying on a parent's plan might be the best alternative, as there would be additional premiums associated with a university-sponsored plan or coverage purchased in the individual market.
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Self-insured plans
Self-insured health plans, also known as self-funded health plans, are typically offered by employers or associations. In this case, the employer or association takes on the financial risk of providing health care coverage to its employees or members, rather than purchasing coverage from an insurance company. This means that the employer pays for each out-of-pocket claim as it is incurred, instead of paying a fixed premium to an insurance carrier.
However, self-insured plans also come with certain considerations. For instance, the employer must have sufficient financial resources to meet the obligation of paying health care claim costs, which can be unpredictable. To mitigate this risk, most self-insured employers purchase stop-loss insurance, which reimburses them for claims above a specified dollar level.
In the context of university insurance, it is worth noting that if a student health plan is self-insured, it may not have to comply with the Affordable Care Act (ACA). As of 2012, approximately 1% of college students were enrolled in self-insured health plans offered by their universities.
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Student health clinics
In terms of insurance coverage, many colleges and universities offer student health insurance plans that are fully compliant with the Affordable Care Act (ACA). These plans are designed to cover the ten essential health benefits, including preventive care, maternity care, and mental health services, with no annual or lifetime benefit maximums. Enrolling in a student health plan can be a straightforward and cost-effective way for students to obtain the necessary health coverage.
However, it is important to note that not all colleges and universities offer ACA-compliant plans. Some institutions may have self-insured health plans that are exempt from ACA regulations, and these plans may have different coverage levels and exclusions. Students should carefully review the details of their school's health plan to ensure it meets their individual needs.
Even if a student health plan is available, students are not required to enrol in it. They can explore other options, such as remaining on their parent's health insurance plan until they turn 26 or purchasing an individual plan through the State or Federal Exchange. Additionally, students with limited incomes may qualify for Medicaid, depending on their state's eligibility rules.
When considering student health clinics, it is worth noting that they typically provide a range of services, including primary care, mental health counselling, and wellness programmes tailored to the unique needs of students. These clinics often have extended hours to accommodate students' busy schedules and may offer virtual visit services for added convenience. By utilizing student health clinics, students can benefit from accessible and comprehensive care delivered by healthcare professionals who understand the specific challenges and concerns of the student population.
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Frequently asked questions
It depends on your income and the state you are in. If you are eligible for Medicaid, you can have it alongside your university insurance. However, if you are insured through your university, you may no longer be eligible for Medicaid after you graduate.
Many universities offer student health insurance plans, also known as "campus health insurance". You can enrol in one of these plans to get basic insurance coverage.
Campus health insurance can cost between $2,000 and $4,000 per academic year. This expense is usually included in a student's tuition bill.
University insurance plans are usually regulated by the ACA and cover the ten essential health benefits with no annual or lifetime benefit maximums. However, there are some exceptions, and not all plans marketed to students are considered "student health plans".
