Medicaid For College Students: What You Need to Know

Heading to college and living on your own has plenty of challenges, and healthcare coverage isn’t something you’re likely worried about when you’re excited about school, roommates, and friends.

Unfortunately, college-age students are some of the most underinsured group of people in the nation, which is why it’s important to explore your options so you can stay healthy while in school.

There are several healthcare options available to you including Medicaid for college students. Read on to learn more about this program, what’s required, and how you can apply so that you can stay covered throughout your college years.

Medicaid for College Students: Eligibility

Not every college student will be eligible for Medicaid, and many are already covered under their parent’s current insurance plan. However, if no one can claim you as a dependent and you’re living on your own, you may qualify to get free health insurance coverage through Medicaid.

This program is usually reserved for low-income earners who cannot afford to purchase health insurance on their own. Many college students either don’t work or only work part-time, which means they aren’t exactly earning a lot of money.

If you live with your parents, it’s unlikely that you will be eligible for Medicaid. If your income is at or below the threshold and you’re living on your own, then Medicaid coverage is likely possible for you.

Students with spouses and/or children may be able to cover their family members under Medicaid, even if you have your own insurance somewhere else. Make sure you check with your state’s healthcare exchange or the Federal healthcare exchange to find out who qualifies.

Check the federal government’s healthcare exchange website to find out what the current income limits are to see if you are eligible. You can apply for Medicaid through the federal exchange or at your state’s Medicaid agency office. 

Applying Through the Marketplace

If you want to fill out an application for Medicaid, you can do so through the Health Insurance Marketplace website. Create an account so you can start your application and save your progress as you go.

Once you apply, the Federal marketplace will send the information to your state agency. The agency will then contact you with further information about enrollment if it looks like you or anyone else in your household qualifies.

After you submit the application, you will also learn whether or not you qualify for an individual insurance plan. This option looks at other ways to save on healthcare coverage based on your current income. In most cases, you’ll be able to find an affordable plan that covers most of your needs.

What You Need to Know About Medicaid Coverage

While Medicaid is designed to cover low-income people and their families, pregnant women, the elderly, and those with disabilities, it can help college students, too. Certain states have expanded Medicaid to cover any adult who is below a specific income level.

To determine whether you meet the threshold, you’ll need to check with your specific state agency. Unless you’re making a lot of money, it’s likely that you may qualify while you’re working on your college studies.

All Medicaid programs must follow current federal guidelines. However, specific costs and coverage levels will vary between different states.

Some Medicaid programs will pay for your care directly so you don’t need to worry about being billed. Other programs might use private insurance companies to work with the program and provide Medicaid coverage.

What Medicaid Insurance Covers

Every state administers and determines its own Medicaid programs. These programs vary and differ between the amount, type, duration, and scope of services you will receive. However, Federal law does require that every state provides specific mandatory benefits, while others are optional.

Some of the mandatory benefits under Medicaid include:

  • Inpatient and outpatient hospital services
  • Physician services
  • Laboratory and x-ray services
  • Home health

Some of the optional benefits that may vary among states include:

  • Prescription drug coverage
  • Physical therapy
  • Case management
  • Occupational therapy.

If you want to know exactly what type of benefits you’ll get in your state, contact your state’s Medicaid agency for more details.

Other Options for Insurance in College

If you’re already under your parents’ health insurance plan, you can keep it until you’re 26 years old thanks to the Affordable Care Act. If you’re not currently covered under your parents’ plan, you can be added during the enrollment period.

For college students heading to campus out of state, find out if there will be an in-network provider at your new location. Not all insurance plans cover medical costs at doctor’s offices and hospitals if they are out of the network. If you get medical care that’s out of network, you could be stuck with a hefty bill that you’ll have to pay out of pocket later.

Some colleges offer their own health insurance plans for students. If you are in another state and you can’t find an in-network provider under your parents’ plan, talk to your university to find out if you qualify for the school’s insurance programs.

Whether it’s Medicaid or another plan, you may have certain limits when it comes to healthcare coverage. If you have a chronic condition or need ongoing care, some of these costs likely won’t be included in your benefits.

Most campus-provided plans are extremely limited, so you might not be able to get specific types of care. However, having some coverage is better than none, especially if you become injured or need a simple form of care, such as treatment for the common cold or flu.

Important Details About Medicaid

While it is possible to get Medicaid for college students, it’s not available to everyone. There are a few crucial details you should know before you apply for the program.

First, your income may be up to 138% of the federal poverty level. That’s equal to $29,435 for a family of three or just $17,609 for an individual as of 2020. As a college student, it’s very possible that you meet these income requirements unless you have a full-time job that pays a higher annual salary.

Your parents cannot claim you as a dependent on their tax return if you want to be eligible for Medicaid. This means that you must start to file income taxes on your own in order to qualify.

Another catch is that you must be a resident of the state where you’re receiving Medicaid. If you move to another state to attend college, it could complicate the coverage and application process.

There are currently 12 states that have not expanded Medicaid, which means that you might not qualify, even if you meet the low-income threshold. Always make sure you start with your state’s Medicaid agency to get the details so you can be sure that you’re eligible.

Depending on where you live, your income, and your dependent status, you may get better options when enrolling in the federal marketplace under the Affordable Care Act. University-based insurance is another option, although you should expect the amount of coverage you get to be limited.

One of the perks of choosing Medicaid coverage is that it’s usually free or very low cost. This means you’ll get extremely affordable healthcare coverage while you’re in college so you can focus on other things like term papers and exams.

Fast Facts

If you’re not sure which coverage is right for you, here are some fast facts about health insurance to keep in mind:

  • Just because you’re young and healthy, it doesn’t mean that you should not get some form of health insurance in case you get sick or injured.
  • You cannot be denied insurance coverage if you have a pre-existing condition.
  • The Affordable Care Act is still in full effect and has not been repealed.
  • Once you graduate and find a job, ask your employer about switching to their health insurance plan. You’ll likely get higher coverage limits at a reasonable cost.

Stay Healthy While in School with Medicaid Coverage

If you’re prepping for college and need health insurance, Medicaid for college students is a viable choice depending on your income and other factors. This affordable form of health coverage will keep you protected throughout your college years until you can get insurance through an employer.

With a bit of research and contacting your state’s Medicaid agency, many college students can get the level of coverage they need.

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