Marketplace Health Insurance vs. Student Health Plans: Which is Right for You?

Understanding Health Insurance Options for Students

In this guide, we’ll break down the differences between Marketplace Health Insurance vs. Student Health plans.

As a college student, health insurance might not seem important, especially if you’re young and healthy. But accidents and illnesses can happen to anyone; without insurance, you could face huge medical bills. That can be tough, especially when you’re already on a tight budget.

Healthcare can be very expensive even if you have insurance. But without coverage, the risks are much greater. Without insurance, you might not be able to afford treatment for health issues, and medical bills can quickly pile up. Many plans cover free check-ups, vaccines, and screenings, which can catch health issues early.

In affordable health insurance for students, you have two options. You can search the marketplace or use specialized student health plans. Both options provide coverage, but it’s important to compare them to find the best fit for your needs and budget.

What Are Student Health Plans (SHIPs)?

Student Health Plans (SHIPs) are health insurance plans made for college and university students. A SHIP helps students get affordable health care while they’re at school. SHIPs usually cover things like:

• doctor visits
• emergency care
• prescriptions
• mental health services
• dental or vision care (optional)

Many schools set up SHIPs to work with their on-campus health centers, making it easy for students to see a doctor without leaving campus. SHIP coverage typically lasts the whole academic year, from the fall to the spring semester, and sometimes even during the summer if you take classes.

The main benefits of SHIP are convenience and peace of mind. You can get care right on campus, which saves time and effort. Plus, you’re covered for common health problems like colds, injuries, or stress.

To be eligible for a SHIP, you just need to be a student at the school. Some universities require all students to have SHIP coverage, while others let you opt-out if you already have your insurance. To waive the SHIP, you must:

1. Ensure your insurance covers the entire academic year.
2. Show proof that your insurance meets the university’s requirements.
3. Complete the waiver by the university’s deadline.

Overall, SHIPs are a simple and reliable option for students to stay healthy at school.

Related Articles:

• What is a Student Health Insurance Plan (SHIP) and How Does it Work
• The Best Marketplace Health Insurance Plans for College Students in 2024
• Online Colleges with Student Health Insurance: Low-Cost Options
• Medicaid vs. Student Health Insurance: Which is Better for College Students
• How to Compare SHIPs to Private Health Insurance Plans

What Are Marketplace Health Insurance Plans?

Marketplace Health Insurance Plans are plans available through the health insurance marketplace, a service that helps people find and buy insurance. Marketplace plans offer different levels of coverage and costs, so you can choose one that fits your needs and budget. Like SHIPs, marketplace insurances vary in terms of

• premiums (how much you pay each month)
• deductibles (how much you pay before insurance starts covering costs)
• out-of-pocket costs (like copays for doctor visits)

Compared to a Student Health Insurance Plan, marketplace insurances have more flexibility. For one, these plans can offer a wider choice of doctors, hospitals, and specialists. They’re not usually tied to a specific campus health center.

Another key advantage of marketplace plans is that they offer financial assistance to qualified individuals. If your income is below a certain level, you may be eligible for subsidies to lower your monthly premiums or out-of-pocket costs. This makes marketplace plans a more affordable option for many people. The availability of subsidies depends on your income, family size, and where you live.

You can access college health insurance options through the federal website, Healthcare.gov, or through state-run marketplaces if your state has one.

Cost Comparison: Marketplace Plans vs. SHIPs

The first thing many students look at when deciding between Marketplace Health Insurance vs. Student Health Plans is the costs.

Marketplace Health Insurance

Marketplace Health Insurance for college students, offered as part of the Affordable Care Act (ACA), features different levels of coverage: Bronze, Silver, Gold, and Platinum, with varying costs and benefits.

• Premiums:
  • You could pay anywhere from $100 to $300/month for a Silver plan (which is the middle ground in terms of coverage).
  • If you choose a Bronze plan, it could be cheaper, like $100 to $200/month, but keep in mind that the deductible will be higher.
  • A Gold or Platinum plan could cost between $300 and $500/month, but it would have lower deductibles and out-of-pocket costs if you need extensive care.
• Deductibles: This is how much you need to pay out-of-pocket for care before your plan starts picking up the tab.
  • On Bronze plans, deductibles can be $6,000 to $8,000.
  • If you go for a Silver plan, they might range from $3,000 to $5,000.
  • Gold and Platinum plans have lower deductibles, typically between $500 and $3,000.
• Out-of-Pocket Costs: The ACA caps how much you’ll pay (including deductibles, co-pays, and coinsurance). For 2024, that cap is $9,100 for individuals. So, if you reach that, the insurance covers everything else for the year.
• Tax Credits & Subsidies: The best part of Marketplace plans for students is that if you don’t make a ton of money, you might qualify for subsidies that can bring your premiums down a lot. For example, if you earn around $20,000 a year, your premium could drop from $200/month to something like $50–$100/month.

Plus, you might get cost-sharing reductions (CSRs), which lower things like co-pays and deductibles.

Student Health Insurance Plan

• Premiums: SHIPs usually cost somewhere between $500 and $2,000 a year (roughly $40–$170/month). The exact price depends on your school and the plan, but in general, SHIPs are more predictable than Marketplace plans since the cost is fixed for the year.
• Deductibles: SHIPs typically have lower deductibles compared to Marketplace plans. You might be looking at something like $250 to $1,500.

Some SHIPs even have no deductible for certain services, like wellness exams or vaccinations, which can be a nice perk if you need those things.

• Out-of-Pocket Costs: The max out-of-pocket costs for SHIPs are usually between $3,000 and $6,000. After meeting your deductible, that’s the total amount you’d pay for health care in a year.
• There are no subsidies as the school fixes the costs.

Coverage Comparison: What’s Included in Each Plan?

Another consideration to take into account when comparing SHIPs and marketplace plans is its cost coverage.

Marketplace Plans:

• Hospital stays: Covered, but out-of-pocket costs depend on your plan (higher for Bronze, lower for Platinum).
• Mental health: Therapy and inpatient care are covered, with varying co-pays.
• Prescriptions: Covered, but co-pays depend on the drug tier. Some plans have higher costs for brand-name meds.
• Out-of-network care: Higher costs for non-emergency care outside the plan’s network.
• Travel: Limited coverage for international travel; you may need extra insurance.

SHIPs:

• Hospital stays: Covered but usually limited to the on-campus network. Higher costs if you go outside it.
• Mental health: Covered, but visits may be limited to campus-based services.
• Prescriptions: Covered, but typically only at school pharmacies with higher co-pays for brand names.
• Out-of-network care: Limited; you often need a referral for specialists.
• Travel: No coverage for studying abroad, so extra insurance is needed.

Pros and Cons of Student Health Plans

Pros:

• Easy access to health services on or near campus, often with no need for referrals.
• Typically known for being a more affordable student health insurance option, with premiums ranging from $40–$170/month.
• Automatically tied to your school, so signing up is easy and bundled with tuition.
• Covers essential health needs like doctor visits, prescriptions, and emergency care.

Cons:

• Restricted to on-campus or school-network doctors, which can be inconvenient if you need specialized care.
• Higher costs or no coverage for non-campus providers.
• Fewer visits for therapy or restrictions on meds, especially if you need brand-name prescriptions.
• If studying abroad, you’ll need extra insurance for health coverage.

Pros and Cons of Marketplace Health Insurance Plans

Pros:

• Unlike university health insurance, you can select your doctors and hospitals, even outside your campus.
• Covers more types of care, including mental health services, specialized treatments, and prescriptions.
• You may qualify for financial help based on your income, lowering monthly premiums and out-of-pocket costs.
• Often includes coverage for out-of-network care and emergency services while traveling.

Cons:

• Generally more expensive than SHIPs, with premiums ranging from $100–$500/month depending on the plan.
• Navigating the marketplace and understanding plans can be confusing.
• Lower-tier plans (like Bronze) may have high deductibles and co-pays.
• May not be as convenient for on-campus care compared to SHIPs.

Who Should Choose a Student Health Plan?

If you’re going to school full-time and plan to stick around campus a lot, a Student Health Plan (SHIP) could be a good fit. They’re usually pretty affordable and designed with students in mind, so if you want easy access to campus health services, it’s super convenient.

SHIPs are also great if you’re on a tight budget because they tend to be cheaper than other options. This is especially true if you don’t need a ton of coverage outside the campus.

Who Should Choose a Marketplace Health Plan?

Now, if you’re someone who needs more flexibility or coverage that goes beyond campus, a Marketplace plan might be better. It gives you more options for doctors, specialists, and even coverage for things like prescription drugs, mental health services, or out-of-network care.

Marketplace health insurance options for students are also a good choice if you’re

• financially independent,
• living on your own,
• or just want something that works wherever you are.

You will not be tied to a specific school’s health services. Plus, you can shop around and pick a plan that fits your needs and budget better if you want more comprehensive coverage.

How to Evaluate Which Option Is Best for You

The following guide will help you decide which will suit you best: Marketplace Health Insurance vs. Student Health Plans.

Your Healthcare Needs:

• Do you have ongoing health issues (e.g., diabetes, heart disease)?
• Do you need regular checkups, screenings, or vaccinations?
• Will you need coverage for ER visits or urgent care?
• Do you see specialists (e.g., cardiologists, therapists)?

If you answer YES to any of these questions, a Marketplace Health Insurance plan might be a better option. These plans typically offer more comprehensive coverage. If you only need basic coverage for emergencies or occasional visits, consider SHIP.

Your Budget:

What’s your monthly premium budget?

Marketplace plans vary based on income and coverage, with lower-cost subsidies available. SHIPs are usually cheaper but offer limited coverage and higher out-of-pocket costs for more care.

How much can you afford to pay out-of-pocket?

Marketplace plans typically have higher deductibles but lower copays, which is better for frequent care. SHIPs have lower premiums but higher costs if you need specialists or urgent care.

Your Location:

Do you live on or near a campus?

SHIPs give you easy access to campus health centers for routine care if you’re at school. If you’re off-campus or not near a school, Marketplace Health Plans offer broader coverage with a wider network of doctors and hospitals.

Do you plan to travel or live in different places?

Marketplace plans are more flexible, covering you across the country (and sometimes internationally). SHIPs are usually limited to the campus area, so you may not have coverage if you travel or live elsewhere.

Conclusion: Making the Right Health Insurance Choice for Your College Experience

Choosing the best health insurance for college students involves careful consideration of personal healthcare needs, budget, and lifestyle. Both options offer essential coverage, but each has distinct advantages that can impact your experience during school.

• SHIPs are more affordable and convenient for on-campus care but may have limited coverage outside campus.
• Marketplace plans offer broader coverage, more flexibility, and potential subsidies but are often more expensive.