Adequate Health Insurance Guidelines
Our guidelines are based on the minimum requirements of student health insurance plans under the Patient Protection and Affordable Care Act (PPACA), the Standards for Student Health Insurance Plans from the American College Health Association, benchmarked subsidized plans available in the health insurance marketplace, and our experience in serving Ohio State students.
Our Plan Comparison Chart presents Ohio State’s options organized by basic health insurance components and common services used by students. The Ohio State Student Health Insurance Benefits Plan exceeds minimum requirements for student health insurance under PPACA.
Guidelines
Adequate Health Insurance:
- Must provide coverage for a comprehensive set of services, including, but not limited to, preventive screenings and vaccines, primary and specialty care, hospital admissions, surgical services, emergency services, ambulatory patient services, mental health and substance abuse, inpatient and outpatient, prescription drug.
- Must have coverage for all benefits, not limited to emergency coverage, around the student’s campus.
- Has network provider/facilities within ten (10) miles of your campus of enrollment and across the United States.
- Must have no annual or lifetime caps.
- Must be underwritten in the United States and regulated by a state department of Insurance or federal agency.
- Must provide coverage for the entire duration of the academic year that you were eligible for coverage.
- Provides a minimum of 80% coverage of hospitalization fees.
- Provides a minimum of 80% coverage of professional fees (e.g., lab tests, x-rays, doctor's visits, etc.)
- Has an annual out-of-pocket maximum less than or equal to $5000
- Has no pre-existing condition exclusions or waiting period.
- Has a low annual deductible so you don’t have to pay all, or most of the cost each time you see a doctor (under $500 is recommended)
- Has repatriation coverage.
Reimbursement programs that are not backed by guaranteed payment are not recommended.