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Do student health care plans have to cover preventive care at no charge?

  • April 2, 2016

Q. Do student health care plans have to cover preventive care at no charge?

A. Yes. Student health insurance plans must include preventive care and cannot impose any cost sharing, for “recommended preventive services.” From the perspective of the enrollee, student health insurance plans are fully compliant with the ACA, which includes covering the essential health benefits. And preventive care at no charge is one of the essential health benefits.

But in the Benefit and Payment Parameters for 2017, HHS clarified that student health plans do not have to fall within the narrow actuarial value parameters that apply to metal level plans in the rest of the individual market. And they also do not have to be combined with the carrier’s other individual market business in a single risk pool. These adjustments make it easier for health insurance carriers and universities to continue to offer student health insurance, but their impact from the students’ perspective is minimal. Students can rest assured that the coverage they’re buying through a university is fully compliant with the ACA.

Read more FAQs about health reform, and student health insurance.