“Summertime is always the best of what might be.”
Ah, the sand, the sun, the memories made, and the fun. Summer has settled in across the country, and we’re all finding ways to celebrate. But the lull between semesters and before graduation can see the celebration for some to come to a screeching halt: 72% of college students and recent grads are struggling to find affordable health insurance.
With 40% of this demographic mostly concerned about the cost of premiums and 20% concerned about high out-of-pocket costs, these prospective clients will undoubtedly have questions for you this summer. They may be coming off their student coverage through their universities or their parents’ health plans or they may be waiting for coverage sponsored by their new employers to begin. They may also be priced out of traditional major medical coverage as well. Short-term medical plans may be just what they need.
STM plans can include benefits and features such as:
- Flexibility in cost depending on benefits selected
- Variety of deductible and coinsurance options
- Benefits that are paid in a similar manner to traditional major medical plans
- Wellness options
- Little to no waiting periods
- Next day coverage for some carriers
- Relatively inexpensive premiums due to lower and more restricted benefits
- Low-cost doctor and specialist copays depending on plan selected
- Open network of physicians, specialists, and hospital depending on plan selected
It’s not just the college students and recent grads who are concerned. Their families may have questions about what makes sense as well. It’s important to make sure all those concerned understand what benefits STM plans may offer as well as their limitations. This level of coverage is available at any time in the year and can be cancelled at any time. It can also offer access to providers of their choice, including providers they visited through their parents’ health coverage. If they need to change providers, STM plans provide them the opportunity to file their own claim and submit for reimbursement if needed.
However, STM coverage does not provide the minimum essential health benefits required by the Affordable Care Act (ACA) and will not help them avoid the penalty for not carrying health insurance. At this time, STM plans also have a maximum duration of 3 months. Continuation of coverage requires re-application and there are also limits on how many times someone can re-apply. In addition, pre-existing conditions may not be covered. Benefits vary by plan and state and may not include those that are listed above. Make sure your clients review any plans they’re considering carefully.
If these clients aren’t eligible for STM coverage and priced out of ACA coverage, they may find health benefit insurance plans (commonly known as limited benefit medical plans) to fit their healthcare needs.
Health benefit insurance plans are designed to provide a wide variety of expenses for accidental injuries, sickness, inpatient surgical care, outpatient care, and even pre-existing conditions. Plans vary as to which specific expenses they cover, but often times, this level of coverage may provide little to no waiting periods, access to doctors nationwide, and benefits for critical illness and/or accidental death.
HBI coverage can also offer benefits and features such as:
- Freedom to choose any doctor or hospital of their choice
- Guaranteed issue coverage with $50-$100 paid toward doctor and specialist visits
- Next day coverage or little to no waiting periods for accidental injuries or sickness
- 12 month waiting period for pre-existing conditions
- Ability to supplement existing coverage
- Access to non-insurance benefits such as a prescription savings program, 24/7/365 video and phone access to quality physicians, and a patient advocacy service
Before enrolling your clients into this level of coverage, please make sure they understand that it does not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as their only medical coverage. Although the premiums may be lower than a major medical plan, the benefits are also lower and more restricted.
Benefits offered vary by plan and states. Not available in all states.
Are you ready to help college students and recent grads enroll in the coverage they need today?
Learn more today by:
Calling 1.877.376.5831 and selecting option 3
Health Insurance Innovations, Inc. is a leading developer and administrator of affordable, web-based individual health insurance plans and ancillary products. We help consumers address their health insurance needs by offering access to a number of products offered by various insurance carriers.
For agent use only – not for use with the general public