Quick Disclaimer: While researching for this post, I realize that the ability to have healthcare coverage is still a privilege. The intent of this post is for educational purposes as well as an additional resource to the reader. I am only speaking from my experiences, which is my upbringing in a middle-class lifestyle. It should also be said that I am very grateful for my hard-working parents who made multiple sacrifices to financially support me.
A few months ago, a follower messaged me on Instagram asking me about my medical insurance plan. I never expected such a question, but they had every right to ask. Both of our institutions, along with 99% of the followers who participated in my poll, require students to have medical insurance on file. This is because of the Affordable Care Act and state laws requiring students at health institutions to be medically insured.
For myself and others who attend grad school straight out of undergrad, they are able to rely on a parent’s health insurance plan. However, because I chose to take a 9-month hiatus, I turned 26 prior to job acquisition, meaning I will no longer be covered by my parents. If you a) decide to take a gap year [or two] or b) never had medical coverage prior to pursuing higher education, you will have to purchase a health coverage plan. As soon as I learned that I was going to be kicked out of my family’s insurance plan, I really wished I had someone to guide me in finding a health coverage plan that works for me [Adulting is hard.], so here are some things to know when it comes to finding the best plan for you.
- Remember, the school only requires medical insurance.
In other words, medical insurance is the bare minimum. Understand your medical history and what you’re willing to pay for. For instance, I’m genetically predisposed to have common health risk factors and blind as a bat. Fortunately, my teeth are fine, and I’m not due for another cleaning until next year, so my parents and I agreed to purchase a medical and vision plan. Dental will be paid out of pocket.
2. Give yourself time to prepare.
Allow yourself a MINIMUM of 30 days prior to the termination of your previous plan to register for a new insurance plan. Call your current insurance company and ask when the coverage will end. For me, a representative told me that I will no longer be covered by the end of my birthday month. Sometimes, it takes the new insurance company a month to process the application and may need proof that you are losing your coverage. You need to figure out how you’re going to pay for healthcare coverage (loans, parents, etc.). Also, go see your doctors, dentists, and specialists for one last hurrah before time runs out! I put my current insurance to good use and was able to get my custom night guard fully covered as well as 6 months worth of contacts with my updated prescription (with a nice co-pay).
3. Do your research.
You have the right to not opt-in to purchasing the school’s health insurance plan. If you are still under family coverage, look at your university’s policies about waiving automatic enrollment under their healthcare plan. Since the enactment of the Affordable Care Act, the quality of student health insurance has improved quite a bit. Compare your institution’s premiums to others. Keep in mind, some insurance companies are only offer discounted premiums with selected schools. If you are coming from your parent’s coverage, you could purchase an extension up to 36 months under the federal act COBRA. Personally, my family opted out of COBRA, as it was not financially feasible.
Not only is cost a factor when choosing an insurance plan, consider your current health care provider team. Do you like your primary care physician? If so, find a plan that’s in-network. Healthcare providers in-network of the third-party payor means that you will be covered for most costs and may be required to pay a smaller co-pay. If you can’t find their name in the directory, don’t lose hope! Call your medical provider’s office and ask if they accept the potential plan. Otherwise, ask your classmates about who they see and their experience.
Also there’s a lot of terms and abbreviations: HMO, PPO, deductibles, copay, network. Take the time to know what you’re investing and learn what it all means.
4. They give you the monthly rate, but you may have to pay for it all up front.
Most schools include the cost of health insurance with tuition. Consider the costs of health insurance and cost for medical visits when you are creating budgets for student loans. Annual physicals are usually covered by insurance, but follow-ups for pre-existing conditions and women wellness exams may be additional costs you have to consider.
5. Be aware of deadlines.
If you select the school’s health insurance plan, the payment will probably be due when the tuition is due. For me, my birthday falls in the middle of the school year, which meant I was not able to apply for annual coverage at the beginning of the academic year. Losing coverage at 26 is considered a “qualifying life event,” which enables you to get your coverage plan in your own time at a pro-rated amount.
In general, the last day of open enrollment for marketplace health coverage in the upcoming year (2021) is December 15, 2020.
I hope these tips were helpful. If not, save this post for future reference. Our healthcare system is quite complex, but I personally believe that everyone should have health insurance. No matter how healthy your body is, everyone is susceptible to getting into a medical accident and paying medical bills. Do not sacrifice your health to save money. Consider healthcare coverage as an investment to better your well-being.
As always, you can follow me and my journey #forthedpt on Instagram (@jordaineenriquez).
Until next time,
Jordaine Enriquez, SPT + individually covered