Student health insurance and national health care reform: What does it mean for you?

National health reform, or the Affordable Care Act (ACA), is a law designed to improve access to health insurance for millions of people. This landmark law introduced some new ways for students to have greater access to affordable health insurance.

  • No-cost or low-cost insurance is available to more people than ever before through MassHealth, Massachusetts’ Medicaid program. Individuals who are 19 and older may also continue to qualify for MassHealth if they meet income and other eligibility requirements.
  • Tax credits help you pay for health insurance premiums if you buy a plan through the Health Connector. If you qualify for tax credits, you can have this credit paid directly to your insurance company every month so that your monthly premium is lower.
  • ConnectorCare plans have low monthly premiums, no deductibles, and lower out-of-pocket costs. If you qualify for a ConnectorCare plan, you can save on your monthly premium and pay less when you go to the doctor. For the first time, students will be able to access no-or low-cost ConnectorCare plans if they qualify.

Students can apply online through the Health Connector website to see if they qualify for MassHealth, tax credits, and ConnectorCare plans.

Better benefits for students

  • Students can stay on their parents’ health insurance until age 26
  • No annual and lifetime limits on the amount that a health plan will pay towards your health services
  • No limits on the amount that a health plan will pay towards your prescription drugs
  • All preventive care is covered at 100% and there are no co-pays, co-insurance, or deductibles for things like:
  • Immunizations
  • Contraceptives
  • Physicals
  • Screening and counseling for sexually transmitted infections, HIV, and tobacco use
  • Screenings for depression, obesity, and diabetes

Frequently Asked Questions

The Massachusetts Health Connector is the regulating agency for Student Health Insurance Programs (SHIPs) in Massachusetts. Massachusetts state regulations, which can be found at 956 CMR 8.00), require that all institutions of higher education in the state offer a SHIP and ensure that all students who are enrolled in at least 75% of the academic requirements for full-time students are enrolled in either the SHIP or a plan with comparable coverage. You can find answers to some frequently asked questions about SHIP below.

Yes. While students may waive their school’s SHIP using comparable coverage, all colleges and universities in Massachusetts are required by law to offer a SHIP to all full- and part-time students.

The SHIP you offer must provide benefits that are substantially equal to the Massachusetts Essential Health Benefits Benchmark Plan. For more details on required benefits, please see 956 CMR 8.04 and 45 CFR 156.115.

All full- and part-time students in Massachusetts are required to have health insurance to attend college or university. A student has to purchase a SHIP through their college or university unless they have health insurance coverage that is considered “comparable coverage” and waive the SHIP. For example, a student with MassHealth coverage, a ConnectorCare plan, or coverage through a parent’s qualifying health insurance plan that covers the area of the school does not have to purchase a SHIP if they use it to waive.

Yes. Colleges and universities in Massachusetts have the option to allow students to waive the SHIP plan, as long as they are covered by a plan with comparable coverage. Schools must clearly communicate the waiver process to their students, including how students may request and obtain a waiver, and deadlines for submitting the waiver request. More details about the waiver process and definitions for comparable coverage can be found at 956 CMR 8.05.

Plans from insurance carriers outside of the United States and coverage by foreign national health service programs are not able to be used to waive participation in the SHIP plan. More details on what plans can and cannot be used to waive participation can be found at 956 CMR 8.05.

An international student who is lawfully present in the United States and is a resident of Massachusetts can buy a plan through the Health Connector. To qualify for premium tax credits, an international student will also have to file federal income taxes.

Schools are required to submit detailed information on enrollment and waiver numbers, performance metrics, and benefits information annually. Typically, the Health Connector will send out a reporting form with the required reporting requirements in March or April. Schools are required to respond by May 1. Additional details about the required reporting elements can be found at 956 CMR 8.07.

All schools, regardless of size, must offer a SHIP. A broker or consultant can help you find a plan to offer, even if your enrollment is very low.

No, schools do not need to offer a SHIP to students enrolled in exclusively online courses.

Schools are required to specify their policy on premium refunds and partial-year enrollments in writing. They should work with their third-party administrator or insurance carrier to set their policy on premium refunds and partial-year enrollments.

Any college or university that fails to offer a SHIP will be out of compliance with the Massachusetts SHIP law and the Health Connector’s regulations. The Health Connector may investigate, review, or audit a school to make sure they are in compliance with SHIP regulations, and is authorized to impose financial penalties on any school that fails to comply with those requirements.