1. For College Students, So Many Health Plans to Choose From ANN CARRNS NY Times August 22, 2013 http://www.nytimes.com/2013/08/22/your-money/financial-planners/for-college-students- so-many-health-plans-to-choose-from.html?emc=edit_tnt_20130822&tntemail0=y&_r=0

2. Student health insurance? If you’re headed to college this fall, you’ve no doubt planned to pack your laptop, your bedding and your favorite music. But have you figured out your health insurance? The Affordable Care Act is offering more health coverage choices to young adults, including college and graduate students, said Jen Mishory, deputy director of Young Invincibles, a nonprofit group focused on economic issues affecting young Americans. “There’s going to be options out there to compare and contrast and figure out,” she said.

3. If under 26 For starters, if you’re under 26 and your parents have health insurance that offers coverage for family members, the law allows you to stay on their plan in many cases. The government says more than 3 million people have already gained coverage as a result of this provision, which took effect in 2010. It applies even if you are financially independent, and whether you are single or married. Costs are going up, though, as some plans now charge an additional premium for family members added to the plan.

4. Twists College students have to consider other twists, too. Suppose your parents’ plan requires that you use a local network of doctors, but you’re attending school out of state. Martin Rosen, co-founder of Health Advocate Inc., which helps workers navigate their health benefits, said you should review your parents’ plan before relying on it for coverage during college. If it is a health maintenance organization or preferred-provider plan and you seek care out of network, he said, “you’re going to have less coverage, or you’ll pay more money for it.” In that case, you may want to consider a health plan offered by your college. While student plans have until January to provide the full menu of “essential” health benefits mandated by the Affordable Care Act, many colleges are already offering plans that meet the requirements.

5. But … Self-insured college plans — those in which the school pays claims directly, instead of hiring an insurance company to do so — don’t have to meet the law’s essential-benefits requirement, said Sara Collins, a health insurance expert at the Commonwealth Fund. But again, some colleges are meeting them anyway. Northeastern University in Boston, for instance, says that even though it is self-insured, its health plan will include benefits that “meet or exceed” the law’s requirements.

6. Who’s eligible … what does it cost? (There had been concern that students eligible for student health plans at self-insured schools — which are in the minority — wouldn’t qualify for financial help on the new state-based health exchanges, which open for business Oct. 1 for coverage starting in January. But the federal government cleared up that confusion in recent regulations. As long as students at self-insured colleges don’t enroll in the school’s health plan, they may still qualify for subsidized coverage on an exchange, according to Kaiser Health News.) While benefits in student plans are expanding because of the law, premiums are increasing, too,. The average annual premium for a student plan at a private four-year college is now about $2,200.

7. Typical Questions 1. Can I choose between my parents’ plan and the exchanges? If you’re financially dependent on your parents, and qualify for coverage under their health plan, you’re generally not eligible for subsidized coverage on the exchanges, Ms. Collins said. 2. How can I get coverage on the exchanges at a minimal premium? The exchanges will offer “catastrophic” plans for young people, which offer preventive care but carry low premiums, but have higher out-of-pocket costs. There’s a question, however, about whether such plans will meet some colleges’ minimum coverage requirements, Ms. Haubenreiser said.

8. What about Medicaid? 3. Aside from my parents’ plan and the exchanges, are there other low-cost options? One possibility may be Medicaid, the federal-state insurance program for low-income people. Traditionally, Medicaid coverage has been limited to children, pregnant women and the disabled. But under the health care law, some states are expanding eligibility to cover low-income adults.

9. Economic Analysis Some value insurance more (D), some less (E). Other Goods Health Insurance VmVm VlVl Some may not even value it at all at current prices (C). D E C

10. Some may take it who were not insured. Some may take it who were previously insured. Economic Analysis Suppose that the government introduces free public insurance with generosity M. Other Goods Health Insurance VmVm VlVl Some may stay with previous insurance. D E C M