Health Insurance for Teens and Young Adults
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Health Insurance for Teens and Young Adults
I'm sharing our experience with our 21-yr old because I think there
may be other families with this situation. Our soon-to-graduate
daughter comes off our health insurance the day she graduates. She
doesn't have a job that has health insurance, so we applied for an
individual Kaiser policy. The questionnaire was lengthy but gave
virtually no room to explain. Long story short, she was denied
coverage. The decline cited ''serious medication'' and ''alcohol
consumption'' as reasons. She was prescribed a small dose of Trazodone
for temporary insomnia - at the time I was distressed to hear this
because I know that it is more commonly prescribed for depression. Her
alcohol consumption is probably below average for a student at a
school with a party reputation, and with perfect attendance and a 3.65
GPA, and two internships I don't think she has a substance abuse
problem. We will appeal the decision and can COBRA if needed - but I'm
wondering whether other families have had a similar experience? In
hindsight, we would get a note from the dr. re the reason for the
prescription, and we would have attempted to come in under the
established drinking limit, but a six-pack a week is not excessive in
my opinion. Still hoping for health care reform -
The new health insurance laws recently passed by Congress will solve
this problem. Children will be covered past college graduation. A
few weeks ago the SF Chronicle Business section had an article about
how these new laws will affect college graduates and you should
search for this article on sfgate.com. You should also ask your
company's HR department about when the new law is to be implemented
for your work health insurance plan. What I remember from the
article is that some companies were implementing it immediately (so
your 21-year-old would immediately be covered in that case) whereas
others were implementing it when the new health insurance contract
came into effect yearly for each company (which might be October
2010 or January 2011, depending on the company). Your company must
comply and cover your child but it may not start right away. Ask!
Also, if your student had health coverage at the college attended,
usually this runs through the summer after graduation (check on
It is highly annoying that health insurance companies refuse to
offer coverage because of pre-existing conditions or behaviors that
they see linked to increased use of health care services. I don't
know if you can get around this on appeal since they may be allowed
to rule out people based on these factors which may increase risk.
If your child can stay on your health insurance plan for a few more
years, this would be of great benefit. She can also reduce the
behaviors that they used to judge her as ineligible, so a few years
from now her background might pass their review. Good luck! And be
thankful that Congress passed health care reform.
assuming you still have health insurance coverage, your daughter
might still be covered. i believe the new health care legislation
mandates that children up to the age of 26, regardless of dependent
or marital status, can receive coverage under their parents'
insurance. not sure if it's employer dependent, by my employer just
sent out a notice to all employees advising us that this is now in
effect. good luck!
if your daughter had school sponsored health plan... that stinks! the
day she graduates? If you have Kaiser now, Kaiser has generously
implemented the 26 year age limit kids of family plans as of June 1,
ahead of the new national standard (i don't work for Kaiser btw)
I'm wondering if there are any parents out there whose child has gone
to UC Santa Cruz (or to any UC for that matter) and what you did about
the health insurance question? My daughter is going to UCSC next year.
I have health insurance through my job for both of us. We have good
coverage including mental health benefits (which is a particular
concern as she takes an anti-depressant medication), vision and
dental. I am not going to take her off my insurance and substitute the
UCSC insurance. I really want her to be able to get immediate care
on-site and also have access to the mental health services on campus
if she needs them. I was thinking of signing up for CruzCare (which
they say is good for students who are already insured). Does anyone
have experience with this? How has it worked out? Any other tips would
be accepted gratefully! Thanks in advance!
You may have already done this, but have you checked with your current
insurer to see if she can stay on your insurance and use doctors in
Santa Cruz? I went through this kind of research a year ago, when my
daughter went off to college, and found out that within CA my daughter
could stay on our plan and just choose a different primary care
doctor. I realize this varies from plan to plan. We have the Blue
Cross HMO. What I also found out at the time was that Blue Cross has
a little publicized agreement with Blue Cross providers in other
states, so even though my daughter ended up going to school out of
state, she was able to stay on our plan and switch to a ''guest
membership'' in the state where her college is, but still use doctors
here whenever she's home.
There is an option - read the website as well as the brochure.
Do not hesitate to call Health Services and/or email them.
We provided proof of insurance, and we have a modified coverage so our student can go
to Campus Health but is covered for emergency treatment or local doctor's visit with our
coverage. Your coverage is most likely better than the college's.
If you drop your insurance there may be problems getting it back or a time gap. What are
you going to do during breaks and summer? What if you student leaves in the middle of a
quarter because of a serious illness? Serious illness is one of the main reasons one has
On the other hand if you loose your health coverage it is great to have the option to
the University Student Health Insuarance, and many people do not have family coverage.
When my son was at UCSC, even though he remained covered through my Healthnet and we
have switched his primary care physician to someone in Santa Cruz, we paid the extra
so that he could have easy access to health care on campus. He used it a fair amount
and we felt that it was money well spent.
Parent of UCSC grad
It's looking likely that my daughter will be going to
college out-of-state next year. I just learned today that
our medical insurance, through my employer, will cover her
in California, only. It will cover her for emergencies
outside of CA, but even that might be dicey, I suppose, if
she's really living out of state full time. I'm sure some
of you have been through this and can offer some advice. Do
I take her off of my medical plan and sign her up for
medical insurance through the university? It's expensive!
Should I pay out of pocket for little things that might come
up while she's away and keep her on my current plan (Blue
Cross HMO) for emergencies? Thanks for any advice you can
Soon to be Mom of a college student
Check to see if your Blue Cross HMO has any providers
(doctors, hospitals, etc.) under contract in the area where
your child will be going to school. If the number is
limited or nonexistent, then the coverage (your current
coverage) will be of little value to your child while she
is in school.
Check the school's plan to see if it is a comprehensive
plan. If it is, it might be better to have your child
insured under that plan, but make sure that she will be
covered outside of the school year and in her home area as
well as the area where she goes to school.
If you have additional questions, feel free to e-mail me
My son turned 23 and was taken off his health insurance. I
contacted Jean Sturges, a health insurance agent I found
through this web site. She recommended a Health Net plan
that costs $51 per month and has a 25% deductible for each
visit up to $1500 per year. He can get a physical for free,
I think, according to her. The plan only covers a few
generic medications and does not cover birth control or
pregnancy for girls. He got the plan by answering no to
every question-- I would have put a few minor things down
but she encouraged us not to list them. He is on no
medications, has no health problems, eats a healthy diet and
It really depends on how much of a gambler you are--will
your child get sick at college or not? I don't think any
of us can predict that, and I've heard lots of stories of
students getting sick or injured at college. Plus, most
students do not have cars or know how to look for a new
doctor in a new town, especially if they're sick. I think
it's important that children are insured so that they can
immediately seek medical treatment if needed, in a
convenient way. Your choices are to opt for the college
insurance (that's the way I'd go) or to take out an
individual policy for your child. Blue Cross, Atena, Blue
Shield all offer individual policies; the problem is these
policies often have high deductibles. I would think that
the last thing to skimp on would be health insurance for
We have kept our daughter on our medical plan and, in
addition, purchased the (in-state) university's student
medical plan. If she used our plan at school, she would
have to travel a substantial distance to see a doctor (and
she doesn't have a car). The school has a clinic on-site.
In almost two years (she is a sophomore) she has only gone
to the clinic once. During winter quarter this year she
got sick and couldn't shake a fever for a few days. Going
to the on-campus clinic enabled her to get a doctor's slip
which meant some of her assignment due dates could be
delayed because she was so sick.
We have Kaiser and this is how we've handled it. Ours attends college in
Chicago. We fly her home for occasional weekends when it makes sense to
use the medical facilities we pay for here----she notifies her profs in
advance of missing a Friday or a Monday because she's here for a 3 day
weekend, using the weekday to see dentist, dermatology, lab work, primary
physician, orthodontist (lost her retainer), whatever. For illnesses when
back in Chicago, such as repeated strep throat last year, she went to the
emergency room and unfortunately missed classes in order to sit there for
several hours to be seen by a doctor. Just like your coverage, Kaiser only
covers E.R. and Urgent Care outside their contract territories.
Pharmacy: she mailed us her receipts and I forwarded them to Kaiser
Follow-up care after emergency room: she went to Urgent Care (sometimes
Immediate Care), which is covered, and got medical attention there---
follow-up and pharmacy. The biggest headache has been simply to get the
kid to remember to fill out the Kaiser Claims address instead of our
(especially pharmacy, because there were so many items---in the end,
Kaiser reimbursed us totally for all except the co-pay---I love Kaiser). I
we finally have it down, now---it takes awhile to work out the
kinks/problems that arise in each situation. It would've gone a lot
initially if our student had kept a copy of the Claims address handy on
person at all times. I got sick of dealing with Kaiser Claims all the
takes 1/2 yr to get these things straightened out. Another note: she was
by a car on her bicycle last year and there were a lot of expenses
that, including follow-up physical therapy. Of course, we couldn't fly
here for that every week, so we had to pay for that ourselves---however,
insurance policy (hit by a car) covered her expenses generously, so we
up making claims against our own policy for that major item. Good luck.
It's not over when they go off to college.
Our 22 year is in college in the east and needs to buy
private health insurance. Her permanent address is in
CA. She wants a plan with a choice of doctors which also
reimburses for medical care in other states. Does anyone
have any suggestions, referrals?? Thanks.
We've had some experience with medical insurance and
coverage with kids in college. Our son was covered both
through his college health insurance, which was HMO-style,
pretty inexpensive and convenient with a clinic on campus,
and through our family's policy. He was participating in a
very strenuous sports program and had two episodes of
difficulty breathing, blacking out, memory lapse. His coach
urged him to seek medical care, which he did through the
on-campus clinic. The clinic medical staff who saw him in a
non-stress physical situation decided there was no problem,
that he was likely just hyperventilating and getting too
much oxygen; they told him to wear a mask during workouts to
keep the blood oxygen level from getting too high. His
coach said, ''See a real doctor.''
Unfortunately since the college medical plan was HMO style
he needed a referral in order to see someone more skilled in
sports medicine, and they felt they had diagnosed and dealt
with his problem adequately. We would have had to
personally intervene from a distance to navigate through
the bureaucracy and appeal to get further up the chain of
Instead we decided to use our family's health insurance and
were able to get him seen quickly by the renowned sports
medicine staff which, ironically, is affiliated with the
university our son attends. Our sense of urgency was
spurred by the fact that our son was still participating in
his sport and they were in midseason, and we felt the cause
of his collapses needed to be addressed immediately for his
The sports medicine facility was great and were able to
quickly determine the cause of his problem, which turned out
to be a heart defect, and referred him to a cardiologist.
Had we not had our own more flexible insurance we would have
had to go through a cumbersome and time-consuming
negotiation with the HMO structure and wouldn't have known
the cause of the problem until after the sports season ended.
Our conclusion is that the college coverage was convenient
and cheap, but maintaining our son on our family coverage
was very worthwhile. And we would never have him go without
health insurance of some kind in any event; it's way too risky.
I'm curious about how families deal with the medical
insurance issue for college-aged students when their
children have chronic health issues. My daughter has
diabetes and if I understand it correctly, our options are
not great. I would love to hear from others if I'm wrong
about this. The way it seems to me is:
1)If I keep her on my plan and she chooses to go to school
out of the area, she will not have convenient access to her
regular doctors, and most university health clinics are not
set up to deal with the specialized care diabetics require.
(2)If we select the university health insurance, it is
viewed as the primary, in which case my health coverage
wouldn't be utilized to its full advantage.
I also wonder if she switches to the school's plan, if she
(1) would be covered during the summers and (2) would she
be barred from being reinsured under my plan if the school
plan doesn't work out? I've been told that if they're
dropped from the parent's plan that they can't get back on.
I've also been told that if she is unable to find a job
immediately following graduation and loses health coverage
that her diabetes becomes a pre-existing condition that
insurance companies can discriminate against, thus the
importance of Cobra and/or HIPPA.
I would love to hear words of advice from other parents
who've dealt with this already.
My daughter will be graduating from college in June 2007. Because she took
a year off prior to college, she will be 23 when she graduates - just the age
where she ceases to be covered by our health insurance (Health Net). She is
not certain what she'll be doing after graduation, but as she is planning to
take some time off prior to going to grad school, I am not assuming that she
will have a job which immediately insures her. Our insurance provides a kind
of interim coverage (Cobra) for 18-36 months after you go off the family
policy, but it costs over $300/month. Before my daughter and I start
researching other health insurance possibilities, I wanted to ask if anyone
else had suggestions to guide us.
My son turned 23 last November, just before he was
graduating college. He then came back to the Bay Area to do
an internship which is basically unpaid, without health
insurance of course. The Cobra would have cost in excess of
$300/mo, as you found. We have HealthNet. I went to the
Kaiser website and found a policy where we pay $110/month
plus a $50 copayment on each visit. It covers health,
dental, and vision. There's a yearly total deductable, which
is fairly high but not as high as a couple days in the
hospital. So we picked that. He has been to the doc once in
the last year for a checkup, which cost around $200 plus the
co-payment. He was happy with the experience and I'm happy
he's insured and I'm not paying $300 month!
By the way, you only have a small window of time to sign up
for a new policy once they turn 23, so you need to stay on
top of that. Otherwise they are considered uninsured and it
costs more and is more of a hassle
We've had the same questions for our 19 yr. old son who is
currently choosing not to continue in college after his
1st yr, and does not yet have a job (and many low-paying
jobs he may be able to get would not provide health
insurance in any case). If he is not a full time student
our insurance does not cover him. I called Kaiser & Blue
Cross. Both have plans in the $150 per month range (for a
19 yr old male). The one recommended did NOT cover
pregnancy, so that may be a question to ask (just in
case). I was told that he would NOT be required to get a
health exam...just needed to sign up. Good luck
in the same boat
There are so many options and information for your 23 year
old. Be sure to look at Short Term as an option if your
pretty sure she will get a job with coverage. Or look at
a more standard plan which can cover her at a very
reasonalbe cost if she/he does not have any heatlh
issues. I do not recommend letting your COBRA go until
you are sure she is eligible (which is based on the
persons heatlh, what and how many medications and weight)
for the individual plan.
I have been an insurance field for 30+ years and help a
lot of people learn the facts of their options to decide
which overage best meets their needs financially and by
plan design. I would be happy to help. Call me at 800-
222-BLUE or 510 881-4900 for help. There is never any
added cost going through an agent and we can help with
rates and claims and any renewals. Good luck. Also watch
out for plans with no maternity. They are lower in cost
but you always need to be sure of the risk when we deal
with young ladies
Usually the only options for this situation are COBRA or an
individual policy with a high deductible (e.g. catastrophic
coverage). Once in a while there is an organization that
provides group coverage to members, but usually these
policies don't last very long.
We signed our daughter up for a Blue Cross individual
policy. It's $75 a month, has a copay for office visits,
etc but since she is relatively healthy we think it'll be
fine until she gets her own insurance.
My daughter is going to college on the east coast next fall. The college offers
a health insurance plan for $2500 that covers everything. She now has Kaiser
which will only cover emergency room visits when the student is out of the
plan area. The college has a mandetory health service fee of $275 that
provides doc visits but no drug coverage, lab work or xrays. There may be
other kinds of independent student health insurance that would also work,but
it likely has a high deducitble, like $2500. Any experience out there with this
question? Your info will be greatly appreciated. Thank you.
for the parent asking about health insurance in college...as a 19 year old
university of chicago student, i learned this year that whenever you go into the
health center, they pressure you to get the school insurance and make it seem
like you'd be charged less if you had it. however, it's vastly overpriced, and
hopefully your kid won't be spending too much time in the clinic. don't give in!
you're paying the school more than enough already
not-too-sick college student
Our daughter's new school (Sarah Lawrence) offers a $1400
plan. The school says that the plan covers all local docs,
including mental health -- and that without the plan,
student must sometimes return home for medical care if they
are injured or need extra mental health help. We've heard
that my husband's company (Home Depot) offers a low-cost
plan that works out of state, but have yet to check it out.
I'll be interested in hearing more about what you learn
Health insurance is such a thorny issue. Neither of my kids
went very far from home so I know our experience doesn't fit
exactly. However, for the record...
My son attended UCSC and was covered by our HealthNet plan.
However, we did go ahead and pay for the student health
insurance plan for him. He was our first and we thought it
would be easier for him to navigate the system if he just
knew he was covered.
For approximately $55 a month he got: ''worldwide,
year-round coverage, hospitalization, off-campus care with
specialists and other services (e.g.; physical therapy,
chiropractic and acupuncture), pharmacy, x-rays and lab
services, up to $250,000 per calendar year, 85% coverage for
in-network charges, $3000 out of pocket maximum, $200
What did he use? I probably don't know all of his visits
but I remember that he had a bad cold/sore throat that I
think he went for in his freshman year. He also injured his
shoulder and saw someone about that. In his soph or junior
year he decided to get accutane for acne that had bothered
him for several years and the plan covered that drug and the
accompanying visits and bloodwork.
My daughter is finishing her second year at UCD. We applied
for the waiver for her (the plan at Davis costs about
$250/quarter). The UCD health center is open to all
students (whether or not they are enrolled in the student
health insurance plan) and charges small ''deductibles'' for
all services. She has used the women's health care services
but has filled prescriptions through our HealthNet at the
Walgreens in Davis.
$2500 does seem a bit steep. You can probably safely
assume that all she'll need is the occasional drs. visit and
perhaps birth control ;-) . It sounds like the $275 will
cover the visits, generic drugs are relatively cheap (and
that's usually all the plans will cover anyway!), and sounds
like Kaiser would cover a trip to the emergency room where
she would probably end up for x-rays. The beauty of a plan
that covers everything is that it allows them to be totally
independent of you in managing their own health care.
Both my kids are at school back east (college and grad
school) and have full health insurance at their
institutions. One was diagnosed with a chronic illness
several months ago and required emergency surgery, plus a
follow-up surgery and several hospitalizations. The total
cost of that episode was approximately $75,000. We paid more
for plane tickets back and forth than out-of-pocket for the
medical care. The other was taken by ambulance to the
emergency room in the fall. Thanks to the comprehensive
coverage, we were spared additional anxiety and expense.
One hopes that young people will be spared health problems
but there are unforeseen events. Insurance is a gamble and
finances are certainly a consideration but in our case,
choosing the more expensive option turned out to be a wise move
My daughter is 23 and on an expensive Cobra health policy. Since
she has a pre-existing condition (asthma), I'm concerned that
she might be uninsurable. She just graduated from college and
will be job hunting. I suspect she wont be looking for jobs that
provide health coverage. I could really use some advice on how
to approach this. Any suggestions on specific health policies
that might work? Thanks.
I was in a similar position years ago (except for the asthma).
I was paying for a Cobra plan, and when I called the insurance company
about a personal policy, it turned out to be about 1/3 as expensive. So
I switched as soon as I could.
Have your daughter check with the insurance company she has now through
Cobra about an individual policy. Since they should know about her
pre-existing condition already, they might not make a big deal about
swithing her to a personal plan.
It that doesn't work, there is HIPAA. State law says every insurance
company has to offer a plan that basically anyone can sign up for. Of
course it's going to be pricy, maybe more than the Cobra coverage.
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