Individual student health insurance plans in Ohio are very affordable and provide all required benefits you need. Comprehensive coverage with large nationwide networks, free preventative benefits, and portability to other states is available. Plans are offered to undergrad, graduate, and recently-graduated students. If the need is short-term, economical temporary plans can provide gap coverage. Several types of plans allow you to see and physician or specialist you like.
Office visits, prescriptions, Urgent Care, Telemed, and outstanding protection for inpatient, outpatient and ER are generally included. Student Medical Center coverage on campus is often considered in-network, and therefore included in a policy. Even if you’re on a tight budget, there are several excellent options that include low copays. Special provisions are typically made if there is a pandemic (COVID-19). These extra benefits often provide free testing and treatment, and coverage is offered to individuals and families.
During Open Enrollment and other parts of the year, if you qualify for a federal subsidy, most of your premium can be paid by the federal government, and all pre-existing conditions will be covered. If you are currently listed on a parent’s plan, several low-cost options are offered. If you are ineligible for financial aid to lower your rate, there are still many affordable options that provide comprehensive benefits. Until age 26, you can remain on a parent’s policy or change to your own plan.
Before determining which option is the most affordable, it is important to understand the health insurance requirement of the college. Here in Ohio, each university has different compulsory coverage. Whether you are attending Miami, Ohio State, Toledo, Cincinnati, Kent State, Bowling Green, or any other school, there will be slight differences in the specific mandatory benefits. Deductibles, copays, and provider networks can greatly vary.
Typically, Buckeye State colleges require office visit, prescription and major medical coverage. You may be required to select a deductible of $3,000 or less, and include maternity, mental health, and Urgent-Care facility benefits. Maximum out-of-pocket expenses are capped, and inpatient and outpatient therapy may be required. Additional information regarding the ACA legislation that impacts these mandates can be found here.
We have listed below several of the most common requirements, which are also recommended by the American College Health Association Standards for Student Health Insurance Plans. Institutions of higher education adhere to these standards for completely insured and self-funded plans.
1. As a condition of full-time enrollment, proof of qualified healthcare coverage must be provided.
2. Provided plans must act and perform as if they are the primary coverage (not secondary or supplementary) of the student. Thus, preventative, major medical, office visit, prescription drug, mental health, and pre-existing conditions must be covered. Additional benefits should include emergency services, chronic disease management, and rehabilitation services.
3. Fiduciary responsibility management.
4. Full and complete compliance of all federal and state regulations.
5. Student staff and other persons affiliated with the program, help determine plan options.
6. Annual review of program costs and benefits.
7. Insurance companies, agents, brokers, and all service providers must disclose expenses and fees.
8. Vendor selection must meet government and institutional requirements.
Additional guideline and recommendation topics that are addressed include: cultural competency, drug education and testing of student athletes, trans-inclusive college health programs, best practices for sensitive exams, HIV pre-exposure, emergency planning for all hazards, TB screening, and ethical guidelines and principles.
We’ll carefully review the requirements of your school and find the private plan that provides the benefits that are needed. But we don’t stop there. Many personal student plans contain important coverage that university policies omit, and we feel it’s important to have them included in the policy you select. Also, if you are in graduate school, you’ll still be able to purchase coverage.
Buying Your Own Policy Vs. School Policy
There are several advantages when you purchase your own coverage. Generally, your catastrophic benefit is significantly higher, since there is no lifetime maximum of covered benefits on University supplement plans, although “qualified” policies must include ACA benefits. Also, with a private plan, you can use off-campus medical facilities, giving you a much broader choice of options. However, sometimes, remaining on a parent’s group or an existing private plan is the best option, depending on the cost of adding a dependent.
Routine office visits, specialist visits and non-generic prescription coverage will tend to be more comprehensive under an individual plan (versus supplemental coverage). And this can be a big money-saver if you develop a condition that requires expensive visits to specialists and non-formulary prescriptions. If you take medication that must be renewed each month, a private policy may offer you more flexibility regarding where you can go to have the prescription filled.
When you purchase your own policy, it’s very possible that your network extends throughout the entire country. If you visit or vacation in another state, or even transfer to a different college, you can still keep your coverage. If you develop a serious medical condition that requires extensive treatment, you can also keep your policy. The policy deductible resets every January 1.
Larger carriers such as Aetna, Humana, UnitedHealthcare, and Cigna feature nationwide provider networks. However, Medical Mutual, SummaCare, and Oscar typically do not feature as many national (and sometimes local) options, especially if you require a specialist or specific facility treatment.
University Health Insurance Plans In Ohio
Most universities in the state offer their own options. Each policy must be ACA-compliant and contain 10 “Essential Health Benefits” as required by the Obamacare legislation.
Ohio State University – All OSU domestic and international students are required to have healthcare benefits if they are actively enrolled (half-time) in a degree program (six credit hours for undergraduates and four hours for professional and graduate, and three hours for post-candidacy). SHI enforces the guidelines. If no choice is made, the SHI Benefits plan will be effective the entire year.
The 2022 rates per semester are $1,683 for a single student, $3,366 for a student and spouse, or a student and one child, $5,049 for a student, spouse, and one or two children, $5,049 for a student and two children, and $6,732 for a student, spouse, and two or more children. Outside of the enrollment period, a qualified event is needed to apply for coverage. The WilceCare supplement costs $225 per year.
UnitedHealthcare underwrites the plan, offering a $20 copay of primary-care physician and specialist office visits. Preventative benefits are included with no copay or coinsurance, and Urgent Care visits are subject to only a $25 copay. The policy deductibles (Tiers 3 and 4) are $500 per person and $1,500 per family. The policy deductibles (Tier 2) are $150 and $350. Coinsurance is 10% and the maximum out-of-pocket expenses are $2,700 (preferred provider) and $6,000 (non-preferred provider).
Generic, preferred brand, and non-preferred brand drugs are subject to $15, $30, and $45 copays respectively. The 90-day mail-order copays are $37,50, $75, and $112.50. OUCC copays are $5, $20, and $35.
Medical procedures, diagnostic tests, and office visits performed at the Wilce Student Health Center are not subject to copays, coinsurance, or a deductible. Preferred providers are UnitedHealthcare PPO (outside of Franklin County) and OSU Health Plan (within Franklin County). Note” The HealthSmart RX network pharmacy is utilized.
Ohio University (Athens) Students enrolled in credit hours are required to secure coverage. Compliant private plans are acceptable if the University waiver requirements are met. Commercial group plans are typically acceptable along with State and Federal Marketplace offerings. Short-term contracts are not compliant.
The University-offered option is issued by UnitedHealthcare, one of the nation’s largest carriers. The Spring rate is $934 for a student, a spouse, or a child. Coverage for all children costs $1,868. The Summer rate is $820 for a student, a spouse, or a child. Coverage for all children costs $1,640.
UnitedHealthcare continues to offer coverage with a Platinum-level plan. The deductibles remain low ($500 per person and $1,000 per family), with an out-of-pocket expenses maximum of $5,000 per person, and $10,000 per family (assuming network utilization). Treatment at the OUCC (including office visits) is covered with a $15 copay. Other physician visits are subject to a $25 copay. The ER copay is $250, and the Urgent Care copay is $35.
Pharmacy benefits are provided for Tier 1, Tier 2, and Tier 3 drugs with copays of $15, $30, and $45 respectively. The 90-day supply copay is discounted. The Campus Care Pharmacy copays are $5, $20, and $35.
Global emergency services are provided when a student is more than 100 miles away from the campus, home, or while studying abroad. A 24/7 physician service (Healthiest You) is also included in the benefit package. The telehealth service provides a toll-free number that can save money, time, and offer a quick medical response in specific situations. 24/7 counseling support is also available. The copay is $0 for UHCSR students and $40 for non-UHCSR students. Mental health online visits for UHCSR students are also $0 when speaking to a therapist or psychiatrist.
An optional UnitedHealthcare dental policy is offered for $487.26 per year. The annual deductible is $50 and maximum yearly benefits are $1,000. Diagnostic and preventative services are covered at 100%. Basic services are covered at 80%.
Bowling Green utilizes UnitedHealthcare for their student medical coverage. Full-time domestic students (eight or more credit hours) must purchase coverage (or show proof of other qualified benefits). The annual cost of coverage is $2,309 ($886 for Fall semester and $1,423 for Spring and Summer semesters). Dependent and family coverage is also offered.
The office visit (pcp and specialist) copay is $25 and 20% of the negotiated charge. The Urgent Care copay is $35 and 20% of the negotiated charge, and the ER copay is $125 and 20% of the negotiated charge. X-rays, lab tests, and physical therapy are also subject to 20% of the negotiated charge. Imaging and MRIs are also subject to 20% coinsurance. The prescription drug copays (Tiers 1, 2, and 3) are $15, $30, and $45. Tier 4 drugs are not covered. Children’s eye exams are subject to a $20 copay. Children’s glasses are subject to a $40 copay.
The University of Toledo (pictured above) has a mandatory coverage rule if you are enrolled in six or more hours of classes. Three options are offered (Bronze, Silver, and Gold) for undergraduate and graduate students. Additional supplemental benefits are also available.
The cost per undergraduate student is $897. The cost for a student and dependent is $1,794, and the cost for a student and two dependents is $2,691. The cost for a student and three dependents is $3,588. The policy deductible is $0 with maximum out-of-pocket expenses of $7,900.
The cost per graduate student is $1,121. The cost for a student and dependent is $1,794, and the cost for a student and two dependents is $2,242. The cost for a student and three dependents is $3,363. The policy deductible is $0 with maximum out-of-pocket expenses of $7,900.
A supplemental policy can be purchased for $207. The student and spouse rate is $759, the student and children rate is $537, and the family rate is $1,089. The annual benefit is $2,500 with a prescription annual benefit of $350.
The University of Cincinnati provides a UnitedHealthcare plan that is similar to “Gold-tier” contracts that are available on the Marketplace. In and out-of-network coverage is offered. Extra benefits are available when utilizing University Health Services, including a $0 deductible and Tier 1, 2, and 3 prescription drug copays of $15, $30, and $60.
The policy UnitedHealthcare deductible is $500, with 20% coinsurance and maximum out-of-pocket expenses of $5,000. The ER copay is $150 and 20%, for in-network and non-network treatment. Office visits and Urgent Care visits must meet policy deductible. The out-of-network deductible is $800.
Annual rates (one person) are $1,180 for each semester (Fall and Spring). The Summer semester rate is $632. Additional annual rates are $4,286 (student plus one child under age 18), $4,720 (student plus spouse or child age 18 or older), $6,212 (student plus children under age 18), $7,080 (student plus spouse and child age 18 or older), and $9,440 (student plus spouse plus children age 18 or older).
The University of Dayton does not offer healthcare benefits to students. International students are required to secure coverage and verify compliance each semester. If information is not received, registration for classes will be delayed. Requirements include deductible of $500 or less, coverage of at least $250,000 per condition, $50,000 of medical evacuation benefits, and $25,000 of repatriation coverage.
The Health Center is available to all UD students and is open during normal business hours. Undergraduate students are not charged for visits. Graduate students typically pay $45-$65 per visit. Prescriptions, allergy injections, lab tests, and x-rays are available for all students.
Kent State University utilizes UnitedHealthcare for their coverage. the annual cost of student-only coverage is $2,234. Additional dependents also cost $2,234, and the graduate assistant rate is $670. Undergraduate students enrolled in at least six credit hours, and graduate students enrolled in at least three credit hours are eligible. International students are automatically enrolled unless proof of benefits that meets University guidelines is provided.
The policy deductible is $500 (maximum $1,000 per family). The out-of-pocket maximum is $5,000 per person and $10,000 per family. The office visit copay is $25. X-ray and lab tests also have a $25 copay. The copay is $35 for urgent care visits and $125 for ER visits (waived if admitted to the hospital). Tier 1, 2, and 3 prescription drug copays are $20, $40, and $80.
Medical Mutual, Anthem BCBS, CareSource, Ambetter and Molina are popular private plan options for persons that live in the Dayton area. Montgomery County offers many local providers that accept multiple insurers and their discounted rates.
An individual policy is likely to cost much less, although there will be different levels of deductibles and coinsurance provided. We’ll provide an unbiased comparison of your specific school policy and a private plan from a major carrier such as Anthem Blue Cross, UnitedHealthcare, Medical Mutual, Humana, Kaiser, SummaCare or Aetna. It’s likely that many cheap medical plans will be offered.
If you have a pre-existing condition (whether you are actively being treated for it or not), it will automatically be covered. You also may be able to receive a subsidy (earlier discussed) that can potentially pay most of your premium. We can quickly determine your eligibility and amount of financial aid you can receive.
In many instances, the policy you have may be less expensive than the plan that your new employer offers. And due to the new healthcare laws, many employers may opt to pay a small fine instead of offering benefits to employees. In those situations, you may keep your policy, despite no longer being enrolled in any type of school.
Student plans are also very flexible. Many different types of billing methods are available, and a policy can be canceled without a penalty at any time. Most Ohio plans are “PPO” based although a few “HMO” contracts are available. However, the “HMO” options may not be the best choice since coverage is limited to only portions of the state.
Also, certain carriers only offer coverage in small areas. For example, Oscar provides very competitive pricing, but outside of the Cleveland and Columbus areas, it may be difficult to find local network providers. SummaCare also offers outstanding products in 40 counties in Northeastern Ohio. But outside of that area, an alternative company should be chosen.
Please feel free to contact us if you would like to compare student rates from the top-rated companies. You can also view rates by utilizing the quote box at the top of the page or by calling or emailing us.