What You Need to Know
West Virginia law doesn’t require students to have health insurance, but some schools do.
Your college or university may offer a student health insurance plan, which may be optional or required, depending on your school.
You can keep your parent’s health plan until you turn 26, but you’ll want to make sure it covers healthcare providers where you attend school.
As you plan for college, make sure choosing health insurance is on your to-do list. You’ll find that students in West Virginia have many coverage options. We’ll explore the most common ones here.
Why Do West Virginia Students Need Health Insurance?
Everyone needs to see a doctor now and then, even people who are young and healthy. Health insurance helps reduce what you pay for covered medical services, including preventive care and treatment for unexpected injuries and illnesses. Without it, you will have to pay entirely out of pocket for your healthcare.
What Should You Consider When Searching for Student Health Coverage in West Virginia?
You’ll want to assess your healthcare needs and budget before you start looking for coverage. The answers to these questions will help you narrow your options: Do you have any ongoing health concerns or take prescription medications? What can you afford in terms of both premium and cost-sharing (deductible, coinsurance, copayment) amounts?
Also consider the following:
Will You Attend School In State or Out of State?
If you’re from West Virginia and plan to stay there for school, it could make sense to keep your existing coverage. You’ll want to be sure the network includes providers where your college or university is located. If it doesn’t, be realistic about whether or not you can make the trip home when you need healthcare.
If you’re from out of state and heading to West Virginia to attend school, you will probably be out of your existing health plan’s network and want to find new coverage. That’s because not all policies cover out-of-network care, and when they do, they usually charge you more for it.
Can Someone Claim You as a Dependent?
The Affordable Care Act (ACA) makes premium tax credits and cost-sharing reductions available to those who fall within specific income guidelines. Your status as a dependent could impact your eligibility for these subsidies.
If someone else can claim you as a dependent on their tax return, all income included on that return will be used to determine your subsidy. If you are not a dependent, only the income included on your return will be used.
Will You Stay on Your Parent’s Plan or Enroll in Your Own Plan?
If you intend to maintain coverage through a parent, make sure the plan covers doctors and hospitals where you attend school. Even if that is the case, you may want to look into your own plan because less expensive options may be available to you as a student.
What If You Get Covered Under Your Parent’s Plan in West Virginia?
You may find it convenient and affordable to keep coverage you have through your mom or dad. Federal law allows you to do so until you turn 26, regardless of whether you’re in college, living at home, eligible for your own job-based coverage, financially dependent, or married.1
This option tends to work best for students enrolled in a college or university close to home. Some factors that will help you decide include your plan’s network, whether or not you find a more affordable coverage option, and whether or not your coverage meets school requirements (if there are any).
What If You Get Covered Under Your School Plan in West Virginia?
Many schools offer a student health insurance plan. This coverage typically provides comprehensive benefits, low premiums that are usually rolled into your tuition, and provider networks that include on-campus care if your school offers student health services.
Student health plans can be a good fit if you’re uninsured, want coverage that’s less expensive than what you have now, or need coverage with a West Virginia provider network.
What If You Get Covered Through the Affordable Care Act in West Virginia?
An ACA-plan can be a cost-effective choice if you qualify for subsidies. These plans are not only comprehensive, including the 10 essential health benefits, they are also guaranteed issue, which means you can’t be denied coverage if you have any preexisting conditions.
You may decide to get covered through an ACA plan if you:
- Need to see a doctor on a regular basis and/or take prescription drugs.
- Buy your own health insurance and have a lower income.
- Need coverage with a West Virginia network.
- Don’t have access to a student health insurance plan at school.
If you are a dependent who comes from out of state to attend school in West Virginia, you and your parent(s) will need to fill out separate ACA applications and provide financial information for everyone included in the tax household. Your parent(s) will indicate that they don’t need coverage and the policy is for you; however, their income will still factor into your subsidy eligibility.2
No More Tax Penalty
There is no longer a federal tax penalty for not having health insurance, nor does West Virginia impose a state tax penalty.
What If You Get Covered Through Medicaid or CHIP in West Virginia?
You may already have coverage through West Virginia Medicaid or the Children’s Health Insurance Program (CHIP), and you can keep it as long as you continue to meet eligibility criteria. It’s probably your most affordable option. If your school has a campus health center, you may want to check to see if it accepts these benefits. If it doesn’t, you will want to locate nearby providers who do or see if you can afford coverage through your school.
Medicaid and CHIP benefits don’t usually transfer from one state to another. If you are enrolled in one of these programs elsewhere, you’ll need to reapply for coverage in West Virginia. You can apply for either of them through the West Virginia Path website. You can also apply for West Virginia’s Medicaid program through the federal Health Insurance Marketplace.
Most Affordable Option
The most affordable health insurance option for a West Virginia student is through Medicaid or the Children’ Health Insurance Program (CHIP). If you already have coverage under one of these programs, you can keep it as long as you continue to meet eligibility criteria.
What Are Other Options for Coverage in West Virginia?
Two additional options that can work for students include catastrophic and short-term health insurance plans. You may find they have lower premiums than unsubsidized ACA plans, which can be especially appealing if you buy your own coverage. However, due to their more limited benefits and their eligibility requirements, these plans aren’t right for everyone.
Catastrophic Health Plan
Designed for people under 30 and others with hardship and affordability exemptions, catastrophic health insurance provides comprehensive coverage with a low monthly premium. However, these plans have high deductibles, which makes them a better fit for people who don’t have a lot of healthcare needs.
If you qualify, catastrophic health plans will appear among your options at the federal Health Insurance Marketplace. Catastrophic plans are not eligible for subsidies.
Short-Term Health Insurance
Short-term health insurance is a temporary coverage option that can work well for college students who don’t have access to coverage through a parent, can’t afford an unsubsidized ACA plan, attend a school that doesn’t offer a student plan, or need coverage for a month or two.
Benefits for short-term plans center around unexpected healthcare needs, as opposed to preventive services and treatment for preexisting conditions. For this reason, short-term plans tend to cost less than unsubsidized ACA plans.
West Virginia short-term health insurance policies can last up to 364 days, with renewals up to 36 months — the state defaults to federal limits.3 You can quickly apply for coverage online or through an agent. This coverage is not guaranteed issue, which means you can be denied if you have any preexisting conditions.
What If You Skip Health Insurance in West Virginia?
There is no longer a federal tax penalty for going without health insurance. Some states impose a state tax penalty, but West Virginia is not one of them. However, if you do go without coverage, you’ll need to pay for healthcare on your own.
What Are State-Specific Rules for West Virginia Students?
West Virginia allows schools, both public and private, to set their own student health insurance rules.
What Are School Requirements in West Virginia?
When it comes to students and health insurance, policies vary among West Virginia’s colleges and universities. Here are some highlights from two of the state’s largest schools:
West Virginia University
West Virginia University requires domestic (U.S.) students enrolled in six or more credit hours and international students enrolled in one or more credit hours to have health insurance.4 Those who don’t have an approved waiver for the current academic year will be automatically enrolled in the university-sponsored student health insurance plan.
Marshall University doesn’t have a school-wide coverage mandate for domestic students. Students who are registered for six hours or more in the current semester are fully eligible for all services provided at Marshall University’s Student Health Services.6 Those enrolled for one to five hours are assessed a $20 fee for each visit.
The school does require all international students with F-1 or J-1 visas to purchase a school-endorsed health insurance plan, and international student athletes must purchase a different plan that’s suited for their needs.5 International students studying at Marshall University through a government are not required to purchase the student plan but must provide an up-to-date financial guarantee or sponsorship letter that confirms they have health insurance and sponsorship dates.
What Are Resources for West Virginia Students?
To learn more about student health insurance, your school’s website can be a good starting point. If you are looking into individual options, the West Virginia Offices of the Insurance Commissioner website offers a section full of health insurance information for consumers, including a list of companies that sell 2021 individual health plans, contact information for West Virginia health insurance assisters and navigators, an individual health insurance resource guide, and more.
Whether or not your choice is clear, it can be helpful to compare a few health insurance coverage options to be certain. Gather a few quotes for different types of coverage — for example, your parent’s plan, the school plan and an ACA plan. Look at premiums, cost-sharing amounts, plan benefits and exclusions, and provider networks, and consider which could best meet your needs in the upcoming school year. If you have questions along the way, contact the insurance company that offers the plan you’re considering. You can also find local help through the federal Health Insurance Marketplace or contact your school with questions about its student plan.