As you plan for college, health insurance may not seem like your biggest concern; you’re likely focused on choosing a school and deciding what you want to study. But it’s important to figure out how you will pay for healthcare if you need it while you’re at school.
As a student attending college in Texas, you have a range of options, each of which we’ll explore here.
Why Texas Students Need Health Insurance
Even if you don’t have ongoing medical problems, you may still need care for an unexpected injury or illness. A comprehensive health insurance plan helps with the cost of medical bills; otherwise, you or your parents will likely have to pay entirely out of pocket.
What You Need to Know:
Most Texas colleges and universities don’t require health insurance, but each school sets its own requirements for coverage.
You can remain on your parent’s health insurance until you turn 26, but be sure that plan covers care where you attend school.
If you’re listed as a dependent on your parent’s income tax return and apply for an Obamacare plan, the entire tax household’s income will be used to determine whether you qualify for help paying for your monthly premiums.
What Should You Consider When Choosing Student Health Coverage in Texas?
Start to narrow down your choices for insurance based on your healthcare needs and budget. Do you have a chronic condition such as diabetes or depression that requires ongoing care? Will you need access to mental health, prescription medication or dental insurance while you’re at school? What can you or your parents afford to pay for monthly premiums, coinsurance and an annual deductible?
Here are some more questions to consider:
Will You Attend School In- Or Out-Of-State?
Out-of-state students coming to Texas for college may not be able to use their existing benefits, or they might need to pay more for coverage because their medical providers in Texas will be out-of-network.
If you live in Texas and are going to school away from your hometown, you’ll still want to consider whether any network limitations apply.
Can Someone Claim You As A Dependent?
If your parents, a guardian or someone else claims you a dependent on their income tax return, that may affect your eligibility for help paying for your own insurance. For example, if you apply for your own coverage through the federal Health Insurance Marketplace at healthcare.gov (Texas doesn’t have its own marketplace, or exchange, for purchasing plans that comply with the Affordable Care Act, or ACA) and you’re listed on someone else’s tax return as a dependent, your eligibility for federal subsidies will be calculated based on their income as well, not just yours.
But if you aren’t claimed as a dependent by someone else, only your income will be taken into account. If your income qualifies you, you’ll receive premium tax credits (also called subsidies), which help you pay your monthly premium.
Will You Stay On A Parent’s Plan Or Enroll In Your Own?
There can be advantages to staying on a parent’s plan — you get to keep your current providers, you or your parents won’t need to start paying toward a new plan deductible and premiums may be lower through your mom or dad’s employer.
That said, you may want to look into your own options if you’re attending school away from home. Depending on your eligibility, these may include buying a subsidized ACA plan (as noted above), student health insurance (which you’d buy through your school), Medicaid, a catastrophic health plan, or short-term medical insurance (more about those below).
Out of Network?
Even if you live in Texas, if your school is far from home any providers you’d need to see at college may be out of your plan’s network.
What if I Get Covered Under My Parent’s Health Insurance?
Federal law allows you to remain on a parent’s health insurance until you turn 26. This applies whether or not you’re attending school, living with your parents, eligible for coverage through an employer, financially dependent on your parents, or married.1
If you’re covered through a parent living in Texas and stay in Texas to attend school, this could be a convenient option, but check your plan’s provider network to ensure you’ll have access to providers during the school year. Since colleges and universities decide what health insurance, if any, is needed by their students, they can also require you to have more or different coverage than your current plan provides.
What if I Get Covered by a Student Health Plan?
As mentioned above, most Texas colleges and universities don’t require students to have health insurance, but many endorse a student health insurance plan with rates, benefits and provider networks specifically designed with students’ needs in mind.
Enrollment for returning students is usually limited to the beginning of the fall semester; new students who start at other times of year may be able to enroll later.
If you’re thinking about an academic health plan, be sure to look into what healthcare and medications it covers, when and where coverage may be used (for example, at the student health center, off-campus, during school breaks) and if there are any eligibility requirements, such as being enrolled in a minimum number of credit hours.
What if I Get Covered Through the Affordable Care Act?
As mentioned above, when you buy a plan through Texas’ Health Insurance Marketplace, your income may qualify you for subsidies that help lower your premium and out-of-pocket costs.
This coverage includes 10 essential health benefits and is guaranteed-issue, which means your application can’t be denied based on your health history. An ACA plan (also called Obamacare) typically makes the most sense if you see the doctor regularly and/or take medication(s). Other plans may not cost as much, but they also don’t offer all of the benefits that every Obamacare plan is required to include.
If you aren’t claimed as a dependent on anyone’s tax return, an ACA plan can be appealing to students who buy their own health insurance and have a lower income, especially if you’re someone who needs a range of services to manage an ongoing health issue.
If you are a dependent, you and your parent(s) will need to fill out separate applications and include financial information for everyone in the tax household. On their application, your parent(s) will indicate that they don’t need coverage.
What if I Get Covered by Medicaid or CHIP?
Texas has not expanded Medicaid, which means you can’t qualify for this coverage based on income alone and would need to meet other criteria set by the state to receive Medicaid help. If you are a Texas resident who’s 18 or younger, you may qualify for low- or no-cost coverage through Children’s Medicaid or the Children’s Health Insurance Program (CHIP). The state uses household size and income to determine your program eligibility.
Sticking With Mom and Dad
Staying on your parent’s plan, if they have one, is often the most economical choice for college students, especially if you have any health issues that require ongoing treatment.
What Are Other Student Health Coverage Options in Texas?
If you don’t have coverage through a parent, student coverage isn’t a good fit, don’t qualify for subsidies and can’t otherwise afford insurance, you may want to consider one of the following:
Catastrophic Health Plan
Catastrophic health insurance is available to adults under the age of 30 and others with hardship or affordability exemptions. It’s designed to be cost-effective, with low monthly premiums intended to put worst-case-scenario benefits within reach. As such, the annual deductibles are much higher than traditional ACA plans — $8,150 in 2020.2
These policies do include all ACA essential health benefits, some preventive services and at least three primary-care visits per year before you meet your deductible. Once your deductible has been met, your policy pays for all covered services without copays or coinsurance.3
When you shop for health insurance through Texas’ Health Insurance Marketplace, catastrophic plans will show up as an option if you’re eligible, but they don’t qualify for subsidies.
Short-Term Health Insurance
Short-term health plans provide temporary coverage for as little as 30 days and up to 36 months in the state of Texas.4 The plans are designed to help with medical expenses related to injuries and unexpected illnesses, not provide ongoing care for health issues or preventive care.
You may find this solution a good fit if you don’t have health insurance through a parent and your income doesn’t qualify you for a subsidy. Short-term insurance premiums are typically much less than those of unsubsidized ACA plans, and you can choose the length of coverage you want and cancel at any time.
However, short-term plans are not subject to Obamacare requirements, which means they don’t include all of the essential health benefits and your application can be denied based on your health history. These policies don’t cover anyone with a preexisting medical condition.
You can buy temporary plans through websites such as Pivot Health, an insurance carrier or a licensed health insurance agent in Texas.
What if You Skip Health Insurance in Texas?
Texas doesn’t have a state mandate for its residents, and the federal tax penalty for not having insurance was repealed as of January 2019.5 Legal requirements aside, skipping out on coverage can have financial consequences. If you do need healthcare, you or your parents will have to pay for it out-of-pocket.
What Are School Requirements for Health Coverage in Texas?
Texas colleges and universities set their own student health insurance requirements. Here are some examples from two of the largest schools in Texas:
Texas A&M University (TAMU) College Station
With the exception of international, F1, and J1 students, TAMU doesn’t require coverage and students can access student health services without it.6 Students enrolled in a minimum of nine credit hours of classes may be eligible for a TAMU-sponsored plan.
Houston Community College (HCC)
HCC automatically enrolls students with F1 visas into an International Student and Accident & Sickness Insurance Program. These students may request a waiver of coverage with proof that they have acceptable alternative health insurance.7
Resources for Texas Students
Choosing health insurance is a lot like other big life decisions you’re making right now. Fortunately, there are a number of resources to help you and your family navigate the process:
Federal Health Insurance Marketplace: This can be a helpful starting point as you price out and compare different types of coverage. Visit healthcare.gov to browse ACA plans and rates in Texas anytime of year (though you can only enroll at certain times, unless you qualify for a Special Enrollment Period). You’ll have the option to enter details about your household’s taxable income to estimate any subsidy for which you might qualify. If you are eligible, catastrophic health plans will be included as an option, too.
Texas Health Options: This resource from the Texas Department of Insurance offers lots of information related to finding and understanding health insurance coverage, including how to compare plans and read insurance documents, as well as where to go if you have an insurance complaint. There’s even a place to compare costs for common medical procedures
College or university websites: While not every school in Texas provides its students with health insurance information, many do, regardless of whether they endorse a specific plan or require coverage. At a minimum, you will usually find links to companies that offer student plans or websites that allow you to comparison-shop for student plans. Typically, this information will appear in the student services, student affairs or student health center section of the university’s website. Even if you’re not looking for insurance info, it can be helpful to check your school’s site to understand what student health services are offered on your campus.
Next Steps
Start by surveying your plan options and collecting quotes. If you’d like some assistance, work with a licensed health insurance agent in Texas, call the federal Health Insurance Marketplace’s helpline, or contact customer service for any insurance company whose plans you’re considering.
It’s never too soon to start thinking about your healthcare coverage while away at school. Talk to your parents about which solution works best for your family. As you explore your options, compare plan benefits and exclusions, costs such as premiums and the deductible, and see if the doctors you’d like to see are part of provider networks you’re considering. As your needs change from year to year, you may need to reevaluate and change coverage.
