Adequate Health Insurance Guidelines
Our guidelines are based on the minimum requirements of student health insurance plans under the Affordable Care Act (ACA), the standards for Student Health Insurance Plans from the American College Health Association, and benchmarked subsidized plans available in the health insurance marketplace.
The Ohio State Student Health Benefits Plan (SHBP) exceeds minimum requirements for student health insurance under ACA. Our Plan Comparison Worksheet presents the basic health services available under Ohio State’s plan. You can compare your current health plan coverage with our plan to see which is right for you.
Required
- Provides Minimum Essential Coverage (MEC)* and Essential Health Benefits (EHB) as required by the Affordable Care Act (ACA).
- Essential Health Benefits (EHB) include benefits for Ambulatory Services, Emergency Services, Hospitalization, Pregnancy and Newborn Care, Mental Health and Substance Use, Prescription Drugs, Rehabilitative Services, Laboratory & Imaging Services, Preventive & Wellness Services and Pediatric Services.
- No pre-existing condition exclusions.
- No annual or lifetime limits.
- Guaranteed issue – you can buy the plan regardless of your health status.
- The plan is underwritten in the United States and regulated by a state department of insurance or federal agency.
- Coverage must span the entire period of your academic-year eligibility.
*Plans that qualify as MEC include:
- Employer-sponsored insurance: Offered by large employers (50+ employees) or smaller employers, including some limited-benefit or “skinny” plans.
- Individual market plans: ACA-compliant plans purchased through the Health Insurance Marketplace or state exchanges.
- Government programs: Medicare, Medicaid, CHIP, TRICARE, and certain other federal or state programs.
- COBRA and retiree plans: Temporary continuation or retiree coverage that meets ACA standards.
Recommended
- Network provider/facilities are within thirty (30) miles of your campus of enrollment and across the United States.
- Deductible and Coinsurance amounts should be affordable for your budget.
Excluded
- Health reimbursement plans/programs that are not backed by guaranteed payment
- Travel Insurance Plans
- Defined Benefit Indemnity Plans
- Short-term or Limited Duration Plans
- Catastrophic Health Plans
- Life Insurance, Dental Insurance or Vision Insurance Plans
- Hospital or Provider Office Assistance or Discount Programs