On Sept. 23, significant provisions in the Patient Protection and Affordable Care Act will go into effect. If you're a college student—graduate or undergraduate—use these five tips to find out how healthcare reform will affect you.
1. The bill is good news for older students. Before healthcare reform was signed into law, students could generally not stay on their parents' health insurance after they completed their undergraduate degree. One of the most important rule changes in the new law—effective September 23—allows people to stay on their parents' insurance until the age of 26. This will allow graduate students easier and cheaper access to insurance as they continue their studies. Bryan A. Liang, executive director of the California Western Institute of Health Law Studies, has done extensive research on student health and claims that the new rule benefits students who go to schools in large metropolitan areas with access to numerous private doctors.
[Read about problems with campus health centers.]
2. But there is still red tape. Unfortunately, the ability to remain on your parents' insurance won't help many students who wish to visit their campus health center. Liang notes that most college health centers do not accept outside insurance. If you're a student in a rural area or without access to transportation to a nearby doctor's office, expect to pay out of pocket for a campus clinic visit. You have to file separate paperwork provided by the campus in order to seek any reimbursement from your private insurance. While the much-heralded 26th birthday provision will help some students, it won't help them all.
[Learn about how outsourcing medical billing could solve campus health problems.]
3. On-campus health plans will improve. Many independent experts like Liang have long griped about the insufficient coverage that many campus health plans provide. And while this problem is still prevalent, the healthcare reform law will force campuses to structure their health plans in ways that are more favorable to students. Effective Jan. 1, 2011, all insurance plans must have a medical loss ratio that is at least 80 percent to 85 percent (depending on the plan's size). That means that at a minimum, 80 percent to 85 percent of all premiums paid by policyholders must in turn be used to provide medical care (The American Council on Education has requested that student health plans be exempt from this rule, among others.)
A study performed by the Massachusetts Division of Health Care Finance and Policy found that many schools in the state had medical loss ratios well under the 80 percent threshold, sometimes hovering around 50 percent, and that profits from school plans were much higher than those of other insurance plans. A higher medical loss ratio indicates that an insurance plan is providing more thorough coverage. Boston University, for instance, pushed its ratio from 68 percent in recent years to more than 90 percent this school year, allowing it to double its prescription drug coverage limits on its standard plan, among other benefits.
4. No more lifetime caps on coverage. One of the major complaints regarding student health coverage has been the low caps placed on insurance policies. In a March 2010 report on student health plans, Liang notes that "school-sponsored plans commonly limit benefits on a per condition per lifetime basis," and that "the benefits provided by these plans are seldom generous." That is about to change. Also effective this month, no insurance plan—including campus plans—will be allowed to place lifetime limits on coverage. That means that if you're enrolled on a school plan and fall victim to a severe medical trauma or condition, you will be covered no matter how high your medical costs reach. Students will no longer have to be wary of low ceilings on their campus health insurance.
5. You can find an alternative … in 2014. If you don't have access to your parents' insurance, or they don't have any, and you're leery of signing up for a school plan that can only be used at a campus health center, you will have other options. The law mandates the creation of public health insurance exchanges, which will allow students and other consumers a chance to compare different policies and purchase one they can afford. While this helps the uninsured and is a widely publicized rule, don't pin your hopes on it now. These insurance exchanges will be established by Jan. 1, 2014, meaning that until that time, finding suitable insurance outside of your school or your parents may be an opaque—and expensive—endeavor.