Understanding Health Insurance Options for Graduate Students
This post explains health insurance subsidies for graduate students. It covers the different types of subsidies available, how to qualify for them, and tips on how to make the most of these healthcare benefits.
Healthcare in the US is expensive. According to a 2023 Federal Reserve report, about a quarter of American adults had to deal with surprise medical bills of $1,000-1,999 in the past year. The US spends more on healthcare than any other country. Healthcare accounts for nearly 18% of the nation’s GDP. Still, millions of Americans face barriers to access and affordability.
Having to pay for medical expenses and being in debt can make it hard to concentrate on school and stay in education. Without health insurance, you miss out on things like dental care, medication, mental health support, vaccinations, and regular check-ups. This could make you much sicker, as the high cost of medical care might prevent you from getting the treatment you need.
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Many think that undergraduate and graduate healthcare insurance is the same. Although partially true, graduate students are not automatically eligible for the same health insurance benefits that undergraduates might receive. Much like financial aid, health insurance subsidies for graduate students can also be different.
However, health insurance subsidies for graduate students serve the same purpose as undergraduate subsidies. These assistance are designed to help reduce the financial burden of healthcare.
There are different types of health insurance subsidies for graduate students. These typically include:
- University-Sponsored Subsidies
- Government-Sponsored Subsidies (ACA Marketplace)
- Medicaid Subsidies
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What Are Health Insurance Subsidies and How Do They Work?
A health insurance subsidy is like a discount from the government to help you pay for health insurance. It lowers the amount of money you must pay monthly for insurance or other costs. Having health insurance as a graduate student can help you save money on insurance and other unexpected medical bills.
The Affordable Care Act provides the most well-known healthcare subsidies. In March 2010, President Obama signed the ACA into law to help make healthcare more affordable and accessible across the United States. Under the Affordable Care Act, every adult in America has to have good health insurance. In fact, not having health insurance could cost you a penalty.
The ACA makes it so that most insurance plans, even those on the Health Insurance Marketplace, cover check-ups, counseling, immunizations, and health screenings free of charge. ACA subsidies decrease the price of health insurance for low-income people and families. If you can’t afford health insurance from work and don’t qualify for Medicare or Medicaid, you may qualify for assistance.
A health subsidy can help you pay less for your health insurance each month and reduce the amount you have to pay for medical expenses. About 90% of the people in the country qualify for a health subsidy through the ACA.
Your income, how many people are in your household, and how much healthcare costs in your area are all reviewed to see if you can get help paying for health insurance. This includes you, your spouse, and any children you financially support and claim on your taxes.
The ACA offers two kinds of financial help for people who qualify:
These are the most common subsidies. They lower your monthly premiums based on your income and household size. You might qualify if you earn between 100% and 400% of the federal poverty level.
Cost-Sharing Reductions (CSRs)
These help lower out-of-pocket costs like copays and deductibles for those with lower incomes. If your earnings fall between 100% and 250% of the federal poverty level, you could qualify for CSRs on Silver plans through the ACA marketplace.
Not everyone will qualify for ACA subsidies. Listed below are factors that affect graduate student health insurance eligibility:
- Whether you’re considered a dependent on your parent’s tax return
- If you’re eligible for other government programs (like Medicaid or employer-sponsored insurance)
- Your state’s Medicaid expansion policies (since some states expanded Medicaid coverage, which can affect your options).
Can Graduate Students Qualify for Health Insurance Subsidies?
Yes, graduate students can qualify for health insurance subsidies. Financial assistance for graduate student health insurance exists but is offered to specific groups of graduate students. The core eligibility requirements include:
Your income level
Generally, you need to earn between 100% and 400% of the federal poverty level. The FPL changes every year. In 2024, the FPL for a single person is about $14,580, so you’d need to make between $14,580 and $58,320 a year to qualify for subsidies.
It’s also important to keep in mind that money you receive from fellowships, assistantships, or part-time jobs can push your income over the eligibility limit. So, even if your base salary is low, these extra sources of income might affect your eligibility for subsidies.
Your enrollment status
Subsidies do not usually fixate on whether you’re a full-time or part-time student. Yet, most programs require you to be enrolled at least half-time to qualify for health insurance subsidies. This means you generally need to be taking a minimum number of credits, typically around 4-6 credits per semester.
Dependency Status
If you’re still listed as a dependent on your parents’ taxes, it could complicate your ability to apply for subsidies on your own. In this case, your parent’s income would be considered. This might make you ineligible if they earn above the subsidy threshold.
Conversely, if you file your taxes independently, your eligibility will be based solely on your income.
Additional requirements to meet requirements for health insurance subsidies and ACA include:
- US Citizenship or Legal Status: To qualify for subsidies, you must be a US citizen, a green card holder, or an eligible immigrant.
- Not covered by employer-sponsored insurance: If your employer offers affordable health insurance for graduate students, you typically won’t qualify for subsidies. The government assumes that the insurance your employer provides is good enough.
- Not Eligible for Medicare or Medicaid: You can’t be eligible for Medicare or Medicaid and still get subsidies. These programs have their health coverage options.
Challenges Graduate Students Face in Getting Health Insurance Subsidies
Finding low-cost health insurance for graduate students comes with its own set of challenges. Here are some common challenges graduate students face when securing health insurance subsidies:
Income Issues
- Part-Time Jobs: Many grad students work part-time, whether as teaching or research assistants or other on-campus gigs. But those jobs usually don’t pay enough to qualify for health insurance subsidies or afford good coverage.
- Stipends & Fellowships: Even though stipends or fellowships might cover living expenses, they’re often irregular or not enough to hit the income threshold for government subsidies (like under the Affordable Care Act). Sometimes, the stipend is too high to qualify for Medicaid but not enough to pay for private insurance.
- Income Fluctuations: Grad students’ incomes can fluctuate greatly depending on the semester, making it hard to know if they’ll qualify for income-based health insurance subsidies. This makes it tough to plan for steady health coverage.
No Employer-Sponsored Insurance
- Grad Assistantships: Even though grad students working as teaching or research assistants spend a lot of time doing university work, they’re usually not considered full-time employees. This means they often don’t qualify for the university’s employee health insurance.
- Inconsistent Benefits: Some schools do offer health insurance plans for grad students, but these plans might not be as good or as affordable as the ones offered to full-time staff. And even if they are, they might not cover everything or might be too expensive.
- Dependents: If a grad student has a spouse or kids, they might have trouble finding affordable coverage for their family members, especially if their university plan doesn’t cover dependents well.
Confusion About Government Health Insurance Programs
- ACA Subsidies: Technically, grad students might qualify for health insurance subsidies under the ACA, but it all depends on their income and family size. Many students get caught in a coverage gap. It means that their income is too high for Medicaid but too low to afford insurance through the marketplace, even with subsidies.
- Short-Term Options: Some students might be eligible for Medicaid or state-sponsored programs, but these can come with limited coverage, leaving some healthcare needs uncovered.
- State Differences: Medicaid and subsidy eligibility vary a lot by state, so in states that haven’t expanded Medicaid, grad students may be left without affordable options.
Can international students qualify for health insurance subsidies? Usually, no. Since they’re considered non-residents, they’re ineligible for programs like Medicaid or ACA subsidies, which are for US citizens or residents. Some states or universities may offer limited options, but these are rare. For most international students, the best bet is university-sponsored insurance or private coverage that works both in the US and abroad.
Tips for Maximizing Health Insurance Subsidies as a Graduate Student
#1 Remember that income and household size matter.
Your eligibility for subsidies depends on your income and the number of people in your household. Just remember, most subsidies are only available to US citizens or legal residents.
#2 Check Healthcare.gov.
This is your go-to website to apply for marketplace health insurance subsidies for students. When you apply, ensure you have all your income documents ready—like tax returns and pay stubs.
#3 Use tax credits.
You can apply tax credits to lower your monthly premiums. At the end of the year, you’ll check if your actual income matches the estimate used to calculate your subsidy.
#4 Consider university health plans.
Many schools offer health plans for grad students through campus health centers, which can be cheaper. But these plans may not cover everything, so you might want to add extra coverage.
#5 Review your coverage.
If your school offers health insurance, make sure you understand the details—deductibles, copays, and out-of-pocket limits. Compare the cost of the university plan with other options, including financial aid and marketplace plans, to find the best deal for you.
#6 Look into Medicaid.
If you don’t qualify for subsidies, you can look into Medicaid. It’s a government program that provides low-cost health insurance for people with low incomes. Eligibility rules are different in each state, so you’ll need to check the requirements in your state. You may apply for Medicaid through your state’s Medicaid office or the online marketplace.
Conclusion: Making the Most of Health Insurance Options for Graduate Students
Navigating health insurance can be overwhelming—but you need to do it as a way of prioritizing your health and well-being.
Fortunately, various health insurance options are available for graduate students. You must know how to take advantage of subsidized health insurance for grad students to make healthcare more affordable.
You may qualify for government-sponsored subsidies through the ACA based on your income, household size, and state policies. Some universities also offer subsidized health plans for graduate students. To be eligible for subsidies, your income generally should fall between 100% and 400% of the FPL.
The ACA marketplace is a valuable resource if you’re not eligible for employer-sponsored insurance or Medicaid. You can apply for subsidies via Healthcare.gov or your state’s marketplace. Just be sure to apply during open enrollment and have your income documents ready.