What Is Catastrophic Health Insurance?
In this article, we’ll explore catastrophic health insurance. You’ll know how it works for college athletes and whether it provides adequate coverage for their unique health needs.
When you’re a college athlete, health is more than just a priority—it’s a vital part of your ability to compete and succeed. As an athlete, you’re constantly pushing your body to its limits. You run, jump, tackle, and sprint—sometimes on hard surfaces, under extreme conditions, and often with little room for error.
While the NCAA does require all athletes to have health insurance, they don’t require colleges to cover the costs. If you’re injured, your parents’ insurance is usually the primary coverage for medical expenses. This is actually part of why the term “student-athlete” exists—so colleges aren’t held responsible for injuries that happen during sports.
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With so many college athletes’ health insurance available, it can be hard to decide what type of insurance is best for you. One option that comes up often is catastrophic health insurance. Catastrophic health insurance is popular among certain groups of people, including:
- Young adults (under 30) who are generally healthy and don’t need frequent doctor visits.
- Students, particularly those enrolled in college or university, who have no access to any employer-sponsored health insurance.
- People without dependents who are looking for coverage without paying the high premiums of more comprehensive plans.
- Low-income individuals who don’t qualify for other programs like Medicaid but still need some form of insurance.
Catastrophic health insurance can protect you against worst-case scenarios while keeping your monthly premiums low. This insurance aims to protect you from large, unexpected medical bills. But is this type of insurance enough to cover the needs of college athletes?
This can be an attractive option for college students, especially those under 30, because the premiums are much cheaper than standard plans. However, the catch is that it doesn’t offer much coverage for routine medical expenses. The plan is primarily for major emergencies rather than ongoing care or minor health issues.
Why College Athletes Are at Higher Risk for Medical Expenses
Being a student-athlete is tough. The physical demands of college sports are no joke. You’re putting your body through intense training, competition, and even injury rehabilitation. You’re required to push your body to its absolute limit. The risk of injury is high, and the costs associated with the treatment of these injuries can be enormous.
For example:
- Football players experience collisions that can lead to concussions, broken bones, and torn ligaments.
- Basketball players might deal with ankle sprains, knee injuries, or stress fractures due to constant jumping and pivoting.
- Track athletes can suffer from overuse injuries such as shin splints or stress fractures from constant running.
To give you an overview of the possible expenses, here is the cost of a major injury like a torn ACL:
- Surgery: The cost of ACL repair surgery can range within $10,000 and $25,000, depending on the facility and surgeon.
- Physical Therapy: After surgery, many athletes need months of physical therapy, which can cost anywhere from $5,000 to $10,000, depending on the intensity of the rehabilitation.
- Prescription Medications: Painkillers and other medications may add another $1,000 to $2,000 to the total cost.
Now, keep in mind that this is just one example. College athletes can face numerous types of injuries. Without the proper college athletes health insurance, the financial burden of these injuries will skyrocket and lead to large student debts.
In addition to the physical stress, you’re also facing a lot of mental stress. You’re not completely exempted from exams, projects, hands-on learning, or other coursework activities.
Excelling in both academics and athletics can feel overwhelming. As deadlines and exam season approaches, stress and anxiety levels rise. This is when time management and prioritizing come into play. Are you a student-athlete or an athlete-student? At this point in the semester, your initial momentum usually fades. It takes more effort to attend lectures and seminars, and preparing for them feels like a challenge. Before long, everything starts piling up, leading to even more anxiety.
Student-athletes are not only at risk of physical injuries, but they’re also more likely to experience mental health issues.
Many would recommend catastrophic health insurance for college athletes. But are the benefits of catastrophic health insurance sufficient to address the mental and physical challenges student-athletes face?
What Does Catastrophic Health Insurance Cover?
As we mentioned, catastrophic health insurance plans are designed to cover major health events. Nevertheless, they still come with limitations. Here’s what they typically cover:
Emergency care
If something serious happens to you, like a life-threatening injury, these plans generally cover ER visits and hospital stays. However, you have to meet the deductible first.
Specialty care
Let’s say you need surgery, like if you tear a ligament or break a bone. Catastrophic insurance could help with those costs, too, but again, only after the deductible.
Preventive care
Some of these plans might cover basic preventive services, like vaccines or screenings, but it’s usually pretty limited.
Prescription drugs
If you need medication after an emergency (like painkillers post-surgery), they might cover that, depending on the plan.
Now, the downside is the deductible. Catastrophic student health insurance plans come with a high deductible, often around $8,000 or $9,000. That means you have to cover that out-of-pocket before your insurance kicks in. For a college athlete dealing with an injury, that can be a pretty big financial burden.
After meeting the deductible, there are still other costs to consider:
- Copays: You’ll likely need to pay a copay for things like doctor visits or physical therapy.
- Out-of-pocket maximum: Even once the deductible is met, there’s usually an annual limit on how much the insurance will pay. After reaching this limit, you may still need to pay a portion of the costs.
So, while catastrophic plans can help in a serious situation, they can leave athletes with a lot of financial risks due to the high deductibles and extra costs.
The Limitations of Catastrophic Health Insurance for Athletes
The benefits and protections provided to student-athletes, particularly injuries and insurance coverage, are widely discussed in sports media today. However, confusion and misinformation often cloud the topic.
What medical insurance does the NCAA provide? What do its bylaws require of colleges and universities? Let’s break it down.
Under NCAA rules, schools are required to ensure that student-athletes have accident insurance to cover sports-related injuries. This insurance must cover costs up to the deductible amount of the NCAA Catastrophic Injury Insurance Program, which is currently $90,000. Student-athletes must have this coverage in place before they are allowed to practice or compete.
So, if NCAA programs and school/personal insurance are supposed to cover injuries, why is there still so much media attention? The gaps lie in inconsistencies and limitations within accident insurance policies:
- Coverage Exclusions: Policies provided by schools, parents, or individuals may not cover all tests or procedures needed to evaluate an injury. Example: Medical services near campus could be “out-of-network,” leading to higher costs.
- Out-of-Pocket Costs: Even if a school provides coverage, policies may still require athletes or families to pay co-pays, deductibles, or out-of-network charges.
- Lack of Uniformity: There is no standardized accident insurance across the NCAA or its member institutions. Each school may offer different policies, leading to inconsistencies in coverage and care.
Additionally, one of the most significant issues is long-term care for sport-related injuries. A student-athlete may require medical care for injuries years or even decades after their college career ends. Catastrophic insurance typically doesn’t cover specialized care. For example, a college athlete might need access to specific orthopedic specialists, sports medicine doctors, or advanced rehabilitation services, but those may not be covered.
Main point: Catastrophic plans are among the best affordable health insurance for athletes. They can cover major accidents or illnesses. However, they aren’t the best solution for athletes who need regular care to stay healthy and recover from injuries.
Alternative Health Insurance Options for College Athletes
So, if catastrophic college athlete insurance coverage isn’t enough, what other options do college athletes have? Some colleges offer health insurance plans specifically for students, including athletes. These plans are typically more comprehensive than catastrophic plans and may cover things like:
- Regular doctor visits
- Sports injuries and rehabilitation
- Prescription medications
- Preventive care
These plans may have a higher premium, but they often provide better coverage for student-athletes, especially for ongoing treatment.
For athletes under 26, staying on a parent’s insurance plan might be an option. These plans are usually more comprehensive than catastrophic plans. They can cover both emergency and routine care, including sports injuries.
Some athletes may also have access to employer-sponsored insurance if they work part-time jobs that offer benefits. These plans may provide athletes with a better safety net than catastrophic insurance. Some of the top providers of health insurance for sports injuries include:
- Blue Cross Blue Shield Student Health
- UnitedHealthcare Student Resources
- Cigna’s Student Health InsuranceCigna
- Aetna Student Health
- Marketplace Health Insurance Plans
- Medicaid (if eligible)
Tips for Choosing the Right Health Insurance as a College Athlete
Selecting the right insurance plan that covers a significant portion of medical expenses for college athletes is challenging.
Here are some tips to help make the decision easier:
Review your sport’s physical demands.
If you’re in a high-contact sport like football or rugby, you’ll likely face a higher risk of injury, so you’ll need more comprehensive coverage.
Consider the cost of care.
Consider not only the cost of insurance premiums but also the potential out-of-pocket costs for treatments, surgeries, and rehabilitation.
Look at school-provided plans.
Many colleges offer insurance plans specifically designed to cover student-athletes’ needs.
Get second opinions.
Talk to other athletes, coaches, or even medical professionals to determine what type of sports injury insurance coverage you really need.
How Colleges Support Athlete Health Insurance Needs
Many colleges understand the unique health needs of their student-athletes, and as such, they often offer health insurance plans tailored to athletes. Affordable catastrophic health insurance for student-athletes might cover the following:
- Medical treatment for injuries sustained during training or competition
- Access to specialized sports medicine doctors
- Rehabilitation services
Some colleges even provide supplementary coverage or subsidies to help with costs. This ensures that athletes have access to the best possible care without bearing the full financial burden.
Final Thoughts: Is Catastrophic Health Insurance Enough?
Catastrophic health insurance is seen as an excellent option for college athletes looking to save on costs. It covers major injuries and emergencies, like serious accidents, surgeries, or hospital stays. However, there are a few things to keep in mind.
One downside is that catastrophic insurance usually has high deductibles. Athletes may have to pay a lot upfront before the insurance kicks in. It also mainly covers major injuries, not things like ongoing treatment or minor medical issues.
Even after meeting the deductible, athletes could still face high copays, prescription costs, or treatments that aren’t covered. Plus, it doesn’t cover long-term care, like rehabilitation or specialized care after a serious injury.
College athletes should also check out the insurance options provided by their schools or the NCAA’s Catastrophic Injury Insurance Program. These might offer better coverage tailored to their needs.
College sports are physically demanding, and injuries are common. It’s important to have insurance covering emergency care and long-term recovery.